6 min readBy Eric L. Eakin, DC
Why chiropractic claims get denied — and the four fixes that move the needle
Most denials in a chiropractic practice trace back to a handful of repeatable causes. Here is where to look first.
When a practice tells me “we get denied a lot,” the instinct is to blame the payer. But in almost every billing export I review, the denials cluster around a small number of fixable causes — not bad luck, and not a hostile insurer.
The four that matter most
- Eligibility and benefits not verified before the visit, so visit limits and inactive coverage surface only after the claim.
- Documentation that does not establish medical necessity for the date of service billed.
- Coding mismatches — units, modifiers, and region counts that do not match the note.
- No structured follow-up on the first denial, so recoverable dollars quietly age out of A/R.
A denial is not a verdict. It is a question the payer is asking about your documentation — and most of the time it has a defensible answer.
None of these require a new platform. They require knowing which one is costing you the most, in dollars, this month. That is what a denial diagnostic is for.
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