Buyer's guide
The best chiropractic billing service depends on who does the work.
Medicare pays for chiropractic care only while the patient is still improving. Once progress stalls, the same visit becomes uncovered maintenance care, and that is where most claims deny.
At a glance.
| Product | Best for |
|---|---|
| Altair | Chiropractic practices with no billing team of their own. |
| ACOM Health | Chiropractic practices that want a dedicated US-based team with software included. |
| ClinicMind | Practices that want one system for charting and full-service billing. |
| ChiroTouch | Chiropractic practices that want software and keep billing in-house. |
Claims for spinal manipulation without the AT modifier are treated as maintenance therapy and denied, and the AT modifier cannot be used for maintenance care.
The landscape, by who does the work.
Every option here touches billing, but the models differ. Some are services where billers work your claims off your desk. Some are software the practice runs, with the billing left to your staff. Altair is the done-for-you model, run by AI and backed by our in-house billers, on the systems you already use.
Done for you, run by AI and backed by expert billers
Altair works the claims. Our billers handle the exceptions. Nothing comes back to your front desk.
Altair
Runs the whole chiropractic claim on the systems you already use. Checks each claim against the payer's current policies before it goes out, including the AT modifier for active care, subluxation level documentation, and the line where active care becomes maintenance, so the ones that would deny get caught first. Works denials on arrival, files appeals, posts payments, and sends patient statements. Our in-house billers work the exceptions.
Best for: Chiropractic practices with no billing team of their own.
Chiropractic billing services
Teams that run the billing off your desk, under a service contract.
ACOM Health
A chiropractic-specialized billing service. Its US-based billing team submits claims, follows up, and runs collections, and it includes its own EHR and practice-management software with the billing service. Chiropractic is its focus.
Best for: Chiropractic practices that want a dedicated US-based team with software included.
CT RevAccel
ChiroTouch's managed billing service. An expert-managed team runs claims, follow-ups, and denials, including personal-injury and workers' compensation claims. It is available to ChiroTouch Cloud customers who bill insurance.
Best for: ChiroTouch Cloud practices that want ChiroTouch to run the billing.
Outsource Strategies International
A multi-specialty outsourced billing company with a chiropractic line, covering verification, prior authorization, coding, claims, denial management, accounts receivable, and credentialing. Its coding runs on MedGenX, its own AI-assisted coding platform with a human reviewer in the loop.
Best for: Chiropractic practices that want billing and coding handled together.
Software with optional managed billing
Software the practice runs, with a full-service billing team you can add on.
ClinicMind
Chiropractic-origin and now multi-specialty. It offers an EHR and a done-for-you billing service, Claims 360, that runs the full revenue cycle from charge capture through denial management and posting, inside the same EHR providers chart in. Its EHR includes an AI Scribe for documentation.
Best for: Practices that want one system for charting and full-service billing.
Billing Dynamix
Focused on chiropractic and physical therapy. It offers cloud billing software the practice runs, with real-time claim submission, scrubbing, eligibility, and reporting, plus an optional full-service billing team that handles coding and billing consultation, follow-up, and appeals.
Best for: Chiropractic and physical-therapy practices that want software with an optional billing team.
Software you run, not a billing service
Chiropractic software the practice runs itself. The billing work stays with your staff. Listed so the comparison is honest.
ChiroTouch
A chiropractic EHR and practice-management system the practice runs. It handles claim submission and tracking, ERA auto-posting, eligibility, and payments through its clearinghouse. Its Rheo AI Scribe drafts documentation. The billing work stays with your staff.
Best for: Chiropractic practices that want software and keep billing in-house.
ChiroHD
A chiropractic EHR and practice-management system the practice runs, with built-in tools for insurance and billing. The billing work stays with your staff.
Best for: Chiropractic practices that want an all-in-one system and run billing themselves.
PayDC
A chiropractic EHR and practice-management system built for chiropractic. It generates the CMS-1500 claim, scrubs claims before submission, and checks coding edits against CPT. The billing work stays with your staff.
Best for: Chiropractic practices that want built-in claim scrubbing and run billing themselves.
Based on publicly available vendor information, current as of August 2026. Vendor names are trademarks of their respective owners and are not affiliated with Altair.
Choosing a chiropractic biller, answered.
What should a chiropractic practice look for in a billing service?
Start with who does the work. Does the service work your claims, or hand you software to run yourself? Then ask whether it knows chiropractic coverage, the AT modifier for active care, subluxation documentation by spinal level, and the line where active care becomes maintenance, and whether it checks each claim against the payer's current policies before submission. Then integration: does it run on the systems you already use.
Why do chiropractic claims deny so often?
Medicare covers only manual manipulation of the spine to correct a subluxation, so exams, x-rays, and therapies are excluded. Active care needs the AT modifier and a subluxation documented by spinal level, and once the condition plateaus the same manipulation counts as non-covered maintenance. Any one of these missing on the claim is a denial, even when the care was warranted.
Do these options do the billing, or only provide the software?
Some do the billing and some do not. ACOM Health, CT RevAccel, and Outsource Strategies International run the billing for you. ClinicMind and Billing Dynamix sell software and offer a managed billing team you can add. ChiroTouch, ChiroHD, and PayDC are software the practice runs, with the billing left to your staff.
Can Altair do our chiropractic billing if we have no biller on staff?
Yes. Altair is the done-for-you billing service for practices with no billing team, run by AI and backed by our expert in-house billers. Altair checks each claim against the payer's current policies before it goes out, works the denials, files appeals, and sends patient statements.