Appeals for chiropractic practices, built from your chart.
Medicare covers manual manipulation of the spine for a subluxation, so appeals turn on the exam findings, the treatment plan and whether care is corrective or maintenance. Checks the chart for the initial-visit and subsequent-visit documentation Medicare lists, the active-treatment modifier, and a plan with goals and objective measures, before the letter goes out.
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What the reviewer looks for.
These are the points a chiropractic appeal has to prove. ClaimDoc checks each one against your record and names the page that proves it, or the document that is missing.
Subluxation shown by exam or imaging
The record demonstrates a spinal subluxation by physical examination findings or by imaging, and names the level.
Symptoms tied to the treated level
The history and symptoms are described (location, quality, onset, duration, intensity) and relate to the level treated.
Treatment plan with goals and objective measures
A plan states the recommended level of care (duration and frequency), specific goals and the objective measures that will show treatment is working.
Corrective treatment, not maintenance
Visit notes show treatment given that day and measurable change in the condition, so care is active and corrective rather than supportive.
The records it asks for.
ClaimDoc asks only for what this denial needs, marks what you've uploaded, and says in a line why each one matters.
- Initial visit record: history, exam, diagnosis and treatment planneededShows the subluxation, the symptoms tied to it, and the plan of care.
- Visit notes for the denied datesneededShow the exam of the involved spine, the change since the last visit and the treatment given that day.
- X-ray or other imaging, if used to show subluxationImaging is one way to show the subluxation when the exam alone does not.
- Re-examination or progress notesShow improvement, which is what separates corrective from maintenance care.
Denials it handles.
Plain words first. For each, what usually decides the appeal.
“Not medically necessary”
Exam findings for a subluxation, symptoms tied to the level, and measurable improvement.
“Maintenance care, not covered”
Medicare: documentation that care is active and corrective, with the active-treatment modifier on the claim.
“Visit limit reached”
The plan's exception path or a documented change in condition.
The rules ClaimDoc holds for chiropractic.
Stored word for word
Medicare coverage on file
7 local and national coverage documents from CMS, across 4 Medicare contractors. When a Medicare denial rests on one, the letter names the one for your contractor and asks which provisions applied.
Payers, by how much is known
- Original Medicare (Part A outpatient and Part B)
- Aetna
- Aetna Medicare Advantage
- Alignment Healthcare
- Cigna Healthcare
- Cigna Medicare Advantage
- Clover Health
- Devoted Health
- Humana
- SCAN Health Plan
- UnitedHealthcare
Tested, not promised.
Each of these ran from upload to a finished, verified packet on synthetic records, and every factual sentence traced to a page of the record or a stored policy.
- Original Medicare (Part A outpatient and Part B)A maintenance-therapy denial answered point by point against Medicare's stored chiropractic rules; the contractor's LCD named; 19 of 19 sentences sourced
Send back proof.
Free to start, no card. HIPAA compliant, with a business associate agreement for every clinic.