Chiropractic ABN’s

Bonnie J. Flom • December 25, 2018
Medical Billing

Welcome to Billing Buddies YouTube and Podcast series.

In this episode, we will be discussing Chiropractic ABNs.

First, let’s define an ABN.  An ABN is an abbreviation of a Medicare form known as the Advanced Beneficiary Notice.  Medicare requires providers give an ABN to beneficiaries if the Medicare services they are proposing to deliver is suspected to not be covered by Medicare.  If the service is statutorily excluded from the Medicare program, such as exams and therapies for chiropractic care, Medicare does not require an ABN be presented to the patient.  Medicare only requires an ABN be presented on services that can be covered under the program such as CMT’s for chiropractic care.

It’s very important when receiving information that you can look up and research the data yourself.  For this reason, whenever possible, Billing Buddies will share the source for you to review.  The information from this presentation came from www.CMS.gov.  You can type ABN in the upper right-hand corner of the screen and search for information on Advance Beneficiary Notices or ABN’s.

Now, let’s take a look at the form.  There are several boxes to complete.  You can see items A through J are to be completed by the provider and the patient.  Let’s review the form.

Field A = Enter the Notifiers Information – This is the clinic and staff member presenting the ABN.

Field B = Enter the Patient’s Name

Field C = Enter the Patient’s Medicare Number

Field D = Enter the Service to be provided.  In Chiropractic care, this would be the CMT.  You could enter codes 98940 – 98942 in this field.

Field E = Enter the Reason Medicare may not pay.  In Chiropractic care, the most common reason would be that the CMT was considered maintenance care.  But, review your Local Coverage Determination from your carrier for a complete list.

Field F = Enter the estimated cost.  If more than one service is listed in Box D, enter the estimated cost for all services.

Field G = All the fields on the ABN are important, but this one is especially important.  Patient’s are required to pick one of the three options.  The provider may not complete this portion of the form or it will invalidate the form.

Field H = This is a field where additional information may be provided.

Field I = This requires the patient or representative to sign the form.  If a representative signs the form, have the representative write “representative” in parenthesis after his/her signature.

Field J = The patient or representative must date the form when signed.

That completes our ABN video.  Thank you for watching.  Please subscribe to our channel and like our videos. Also, please comment if you would like other videos presented and suggestions on topics.

Billing Buddies has been assisting providers since 1994 and offers billing services, training and consulting.  For more information, call or text 612.432.2366 or email bonnie@billingbuddies.com.

 

Medical Billing

Billing Nightmares with ARHMS in Minnesota? Here’s the Real Fix Nobody Talks About

By Bonnie Flom • April 21, 2025
Fact: ARHMS providers across Minnesota – especially in Minneapolis – are spending more hours than ever on billing, and it’s affecting client care. Between compliance rules, rejected claims, and slow payments, many teams are overwhelmed. But what if ARHMS billing didn’t have to be a full-time job? Table of Contents: ● The Real Problem with ARHMS Billing Today ● What Makes ARHMS Billing in Minneapolis Especially Challenging ● How Outsourcing Isn’t Just Easier — It’s Smarter ● What Billing Buddies Does Differently ● Quick Comparison: DIY Billing vs. Partnering with Billing Buddies ● Final Word + How to Connect The Real Problem with ARHMS Billing Today Let’s be real: ARHMS billing is no longer just about submitting claims. It’s about understanding state-specific codes, documenting every move correctly, and constantly adjusting to DHS updates. If you're still relying on manual methods or a stretched-thin team, the odds of losing revenue go up fast. What Makes ARHMS Billing in Minneapolis Especially Challenging? Minneapolis is fast-paced, and so is the demand for mental health and habilitation support. But here’s the kicker — more clients mean more billing. More billing means more room for error. If even one code is off or a note is missing, your claim can get stuck for weeks. Providers here aren’t just looking for help — they need speed, accuracy, and someone who actually gets local systems. How Outsourcing Isn’t Just Easier — It’s Smarter? Outsourcing ARHMS billing isn’t just about handing off tasks. It’s about: ● Reclaiming Time: So your team can focus on what they’re best at — client care. ● Reducing Stress: Say goodbye to rejections, late filings, and compliance fears. ● Improving Cash Flow: Claims are submitted right, the first time. What Does Billing Buddies Do Differently? We’re not a generic billing company. We’re local experts who specialize in Minnesota Medicaid systems — especially ARHMS. With Billing Buddies, you get: ● A team trained in Minnesota-specific ARHMS codes and DHS guidelines ● Fast turnaround on claims and re-submissions ● Clean reporting so you always know where your money’s at ● Support that’s personal — we work with your staff, not around them We work with providers throughout Minneapolis and beyond — helping small teams grow by giving them their time and cash flow back. Quick Comparison: DIY Billing vs. Billing Buddies

Is Your Mental Health Practice Losing Money? Here’s How Credentialing Services Can!

By Bonnie Flom • April 21, 2025
Over 40% of mental health professionals in private practice report delays or denials in insurance reimbursements due to credentialing issues. Without proper credentialing, therapists and counselors risk being excluded from insurance networks—directly impacting patient access and practice revenue. That's where credentialing services for mental health come in. For providers in Minnesota and beyond, working with a dedicated billing partner like Billing Buddies can make the difference between reimbursement success and financial stress. Table of Contents: What This Blog Will Cover What Is Credentialing in Mental Health? Why Is Credentialing So Important? Common Challenges in the Credentialing Process How Billing Buddies Simplifies Credentialing for Mental Health Providers Benefits of Outsourcing Credentialing Services Credentialing vs. Re-Credentialing: Know the Difference The Minnesota Advantage: Why Local Expertise Matters Conclusion + CTA What is Credentialing in Mental Health? Credentialing is the process of verifying a provider’s qualifications—including licenses, education, training, and work history—to ensure they meet the standards of insurance networks. It’s mandatory if you want to be reimbursed by insurers like Blue Cross, Medica, UCare, or UnitedHealthcare. Why is Credentialing So Important? Without proper credentialing: ● You cannot accept insurance. ● Your claims may be rejected. ● You miss out on a major client base. And here’s the kicker—credentialing takes time (30-120 days) and must be accurate to avoid denial. Common Challenges in the Credentialing Process Challenge: Incomplete Applications Missed Deadlines Lack of Follow-Up Misunderstanding Payer Requirements Confusion Between Credentialing & Contracting Impact: Delays or denial in approval Need to restart the process Long waiting periods without updates Leads to rework and frustration Payment delays or lost payer relationships How Billing Buddies Simplifies Credentialing for Mental Health Providers? Billing Buddies offers personalized credentialing services tailored for mental health practices. Our team: ● Prepares and reviews all documents. ● Submits applications to insurance networks. ● Tracks application status with regular updates. ● Handles payer communication. ● Maintains re-credentialing timelines. You focus on patients. We focus on paperwork. Benefits of Outsourcing Credentialing Services When you work with credentialing pros like Billing Buddies, you: ● Speed up approvals ● Reduce errors and rejections ● Improve insurance payouts ● Save administrative time ● Avoid burnout from non-clinical tasks It's a smart move for solo providers and group practices alike. Credentialing vs. Re-Credentialing: Know the Difference Credentialing is the first-time process of getting approved by an insurance network. Re-credentialing happens every 2-3 years to verify that your information is still accurate. Both are necessary—and both are time-sensitive. The Minnesota Advantage: Why Local Expertise Matters? When you choose Billing Buddies, you're not just getting generic credentialing services. You’re partnering with a team that understands mental health billing in Minnesota , including local payer systems, Medicaid requirements, and state-specific nuances. We’ve helped therapists across Minnesota get credentialed quickly and keep their payments flowing. Don’t Let Credentialing Hold You Back Whether you're launching your private practice or expanding your network, proper credentialing is essential. And with so many moving parts, it’s easy to get overwhelmed. That’s where Billing Buddies steps in—to take credentialing off your plate and help you focus on what really matters: patient care. Let Billing Buddies handle the paperwork so you can focus on healing. Also, learn more about our expert solutions for mental health billing in Minnesota today!

Why Mental Health Billing Is a Nightmare—and How to End It for Good?

By Bonnie Flom • April 18, 2025
Fact: Nearly 60% of mental health providers say that insurance billing and credentialing slow down their ability to focus on patient care. Between changing payer rules, claim rejections, and the exhausting credentialing process, providers often find themselves spending more time on admin work than therapy sessions. That’s where specialized mental health billing and credentialing services come in—and Billing Buddies is leading the charge. Table of Contents Why Mental Health Billing Is So Complex What Credentialing Means (and Why It’s a Game-Changer) Benefits of Outsourcing to Billing Buddies Mental Health Billing vs. Medical Billing: What’s Different? Our Process: How Billing Buddies Simplifies It All Summary Table: What You Get with Billing Buddies Final Thoughts + How to Get Started Why is Mental Health Billing So Complex? Unlike general medical billing, mental health services involve unique codes, session limits, and pre-authorizations. Even small errors in time-based coding or failing to include proper documentation can lead to claim denials. Key challenges include: ● Frequent insurance changes ● Limited sessions per year ● Confusing modifiers and CPT codes ● Authorization requirements ● Varied payer-specific rules What Credentialing Means (and why it’s a Game-Changer)? Credentialing is the process of verifying a provider’s qualifications with insurance companies so they can join a payer network. It involves paperwork, follow-ups, and long wait times—anywhere from 60 to 180 days. If you’re not credentialed, you can’t bill insurance. And if you’re improperly credentialed, delays and rejections will keep stacking up. Benefits of Outsourcing to Billing Buddies When you hand off your billing and credentialing tasks to Billing Buddies, you save hours weekly—and potentially thousands of dollars monthly. Perks include: ● Fewer claim denials ● Faster reimbursement ● Error-free submissions ● Up-to-date compliance ● Full credentialing support ● More time for patient care Mental Health Billing vs. Medical Billing: What’s Different?