Read the Jane-style visit export
Map the practice's visit, patient reference, provider, location, service, diagnosis, unit, and charge fields. Duplicates and missing required fields stop before review.
For independent chiropractic practices
Test one insurance claim lane without giving up review.
Claims Native turns a Jane-style visit export into a review queue built for chiropractic care. It checks configured CMT and X-ray rules, requires separate office and provider approval, then creates a superbill or a clearly labeled electronic dry run.
Start with one location, one configured lane, and named office and provider approvers. The pilot does not promise payer access or a financial outcome.
One configured laneKeep the visit type, route, rules, and exceptions narrow enough to inspect.
Two approval rolesOffice facts and provider judgment do not share one approval.
Truthful output stateA superbill and an electronic dry run stay distinct from payer results.
From visit export to artifact
A short path with visible stops.
The pilot does not try to cover every payer, code, or visit. It tests whether one configured slice of your current visit flow can produce reviewable claim work without hiding missing facts.
Apply the lane's rules
Run configured service, diagnosis, documentation, and charge checks. The system points to the source field and rule behind each stop.
Keep authority separate
Office staff approve administrative facts and charges. The treating provider approves clinical code and documentation support for the exact claim version.
Create the selected artifact
Generate a superbill for the practice or patient workflow, or create a test electronic claim marked as a dry run. Keep the audit history with it.
Chiropractic review rules
Check what matters. Do not invent what is missing.
Each rule is configured for the pilot lane. It can compare source facts and stop the work. It cannot create a diagnosis, rewrite the chart, or replace provider judgment.
CMT review
Match the code to documented care.
- Compare the selected 98940, 98941, or 98942 code with the count of documented treated spinal regions.
- Check that the diagnosis links and visit evidence required by the configured lane are present.
- Stop when the code, documented regions, units, or configured modifier rule do not agree.
X-ray review
Match the line to available image evidence.
- Compare the body area and view count on the service line with the available order, report, and visit record.
- Check the service date, diagnosis link, and configured same-day or frequency rule.
- Stop when evidence is missing, contradictory, or outside the configured lane.
Safe stop: The queue names the mismatch and the person who must resolve it. It does not select a more payable code or fill a clinical gap.
Separate authority
Office approval is not provider approval.
The two roles answer different questions. The pilot records both decisions and ties each one to the reviewed version.
Are the administrative facts right?
- Patient and coverage fields in scope for the configured lane
- Rendering provider, location, visit date, and charge details
- Duplicate, missing-field, and office-policy exceptions
Does the claim match the care?
- Diagnosis selection and links to service lines
- CMT regions and code choice
- X-ray body area, views, and available clinical support
A material edit starts a new review version.Changing a diagnosis, service, unit, charge, provider, or route clears any approval that no longer applies.
Two honest outputs
Choose the artifact. Keep its status plain.
The pilot ends its default scope at a reviewed artifact. What happens after that depends on the practice's route, access, contracts, and payer process.
Reviewed superbill
A human-readable claim package for the practice or patient workflow. It contains the approved visit and coding details but is not itself proof that a payer received a claim.
Released superbill
Electronic claim dry run
A test 837P built from the approved version so the practice can inspect field mapping and rule output. The file is not transmitted in dry-run mode.
Dry run · not submitted
What this pilot can show
Measure the work before you widen it.
The pilot can show whether the Jane-style export maps cleanly, how often configured CMT and X-ray rules stop a visit, how long each approval takes, and whether the final artifact matches its approved source. It does not grant payer access, prove network status, promise parity, reimbursement, payment, or posting, or run without named human authority.
Common questions
Know where the test stops.
A narrow pilot is useful only when the practice can tell what it tested and what remains unknown.
Does the chiropractic pilot submit claims to a payer?
Not by default. The pilot can produce a superbill or a clearly labeled electronic dry run. A dry run is not transmitted and does not show payer acceptance or adjudication.
What do the CMT and X-ray checks do?
Configured checks compare CMT code selection with documented treated regions and compare X-ray body area and view details with available order, report, and visit evidence. A mismatch stops for provider review.
Why are office and provider approvals separate?
Office staff review administrative and charge details. The provider reviews diagnoses, treated regions, and clinical support. Both approvals attach to the exact reviewed version.
Start with the opportunity, then test one lane.
Use practice-level counts and ranges for the first review. Do not send patient names, dates of birth, charts, member IDs, or other PHI.
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