RightLine Check for New York chiropractors

Rules from published plan policies

What it checks in New York

• 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.
• Highmark BCBS in western and northeastern New York (commercial): rules from Highmark's public policies, including its filing deadline, and 98943 flagged as possibly not covered.
• Anthem BCBS (Empire) in downstate New York (commercial): general coding and documentation rules; Anthem publishes no chiropractic visit limits or prior authorization.
• Aetna (commercial): Rules from Aetna's public chiropractic policy and claim pages, plus general checks. Aetna's 120-day New York filing deadline is checked, shown as a warning. Rules behind Aetna's provider login aren't checked.
• Other commercial plans, including Excellus BlueCross BlueShield: general coding and documentation rules, not plan-specific policies.
• Medicaid: general coding and note checks, with the program'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 New York.