RightLine Check for Massachusetts chiropractors

Rules from published plan policies

What it checks in Massachusetts

• Medicare Part B: national rules. Your contractor is Wellpoint Federal (formerly National Government Services), jurisdiction JK; its own rules aren't checked yet.
• Medicare Advantage: general coding and note checks, with the plan's own rules flagged for you to confirm.
• Aetna (commercial): Rules from Aetna's public chiropractic policy and claim pages, plus general checks. Rules behind Aetna's provider login aren't checked.
• Other commercial plans, including Blue Cross Blue Shield plans not named above: general coding and documentation rules, not plan-specific policies.
• MassHealth (fee-for-service): rules from the program's published chiropractic policy on prior authorization after 20 visits, therapy not covered, E/M billed with manipulation, the place of service and maintenance care.
• Medicaid managed care plans: general coding and note checks, with the plan's own rules flagged for you to confirm.
• Self-pay visits: note and coding checks.
• Benefit managers on commercial plans: two ASH review checks when ASH manages the plan. For other managers, a reminder that their own rules aren't checked.
• Every visit: copied-note check, ICD-10-CM validity, and DC sign-off with a PIN.

Not checked yet: auto injury (PIP), workers' comp, each Medicare Advantage plan's own rules, Medicaid managed care plans' own rules, Aetna's rules behind its provider login, and other commercial plans' own rules.

Availability

Available to practices in Massachusetts.