MVA & Workers’ Comp billing
Chiropractic MVA & Workers’ Comp Billing (Done Electronically)
Auto and Workers’ Comp claims are where the slowest money lives, and where “we never got it” quietly kills payments. We bill the carriers electronically and confirm receipt within 24 hours.
Two claim types
MVA and Workers’ Comp claims don’t pay like regular insurance. They pay slowly, and only when nothing falls through the cracks.
A commercial claim follows a well-worn path: submit, adjudicate, pay. Motor-vehicle-accident (MVA) and Workers’ Compensation claims don’t. They run on fee schedules, lien rules, and attorney timelines that vary by state, they sit open for months, and they punish any practice that can’t prove exactly when a claim was sent and received. The single most common way money disappears on these cases is the oldest one in the book: the carrier says “we never got it.”
There are really two kinds of accident claim, and they need to be worked completely differently. First-party claims (PIP and Med-Pay) are billed straight to the auto or Workers’ Comp carrier. Third-party claims ride on a personal-injury attorney’s case and settle later. ACB handles both, electronically and on the schedule you set. Below is exactly how, and why being electronically integrated with the carriers changes the outcome.
Billed directly to the carrier
The patient’s own auto policy (Personal Injury Protection or Medical Payments coverage) or the Workers’ Comp carrier pays the practice directly. These are real-time, fee-schedule claims, and the faster you can prove receipt, the faster they pay.
Settled through the patient’s lawyer
Care is provided on a lien or letter of protection while a personal-injury attorney builds the case. The balance is paid out of the settlement, which means the work is relationship management: keeping the firm current, turning records around fast, and following up on the schedule you choose.
First-party claims
We’re electronically integrated with most major auto and Workers’ Comp carriers, so within 24 hours we can confirm the claim was received, not just sent.
When ACB submits a first-party claim, it goes in electronically, the HCFA (CMS-1500) with the chart notes attached, and a digital acknowledgement comes back from the carrier. That means within roughly 24 hours we can tell you a claim wasn’t just submitted, but landed. Compare that to a practice still mailing paper claims, where the first sign of trouble is silence, and the first answer is “we have no record of it.”
Think of it like sending every claim certified mail: there’s a timestamped record that it arrived, who it arrived to, and what was attached. On accident claims, where carriers are slow by design and the burden of proof sits with the provider, that acknowledgement is the difference between a clean payment and a months-long fight over whether the claim ever existed.
The paper alternative loses claims to the post office, to a mailroom, to a fax that never printed, and every lost claim is weeks of delay before anyone even notices. Electronic submission with a return acknowledgement closes that gap on day one.
Proof of receipt
In a Pennsylvania case, that electronic record helped a client recover 3× the state fee schedule.
Here’s why the “received” timestamp isn’t a technicality. On a Pennsylvania auto case, the carrier claimed it never received the claim. That’s the move that, on a paper-billed account, usually ends with the provider eating the balance or settling for the bare fee-schedule amount. Because ACB had submitted electronically and had the acknowledgement on file, we could prove the claim was received, when, and with what attached. That single piece of evidence held the carrier to the wall, and the client recovered three times the state fee schedule on the claim.
The proof, on the record:
One client’s result on one claim; outcomes vary by state, carrier, and case. The point is the mechanism: a provable receipt date is leverage a paper claim simply doesn’t have.
Attorney cases
On attorney cases, the money sits in a settlement, so the job is keeping the firm current and the records moving.
When care is provided on a lien or letter of protection, the practice gets paid out of the patient’s settlement, sometimes a year or more later. There’s no clearinghouse to submit to and no remittance to post. There’s a relationship to manage. A balance the attorney’s office can’t see, or a records request that sits unanswered for three weeks, is how a practice quietly drops off a firm’s referral list. ACB works the case the way the attorney’s office needs it worked.
The running balance, always available
We keep the attorney’s office up to date on the patient’s balance and treatment status, so when the case moves toward settlement the medical number is current and defensible, not a scramble at the eleventh hour.
Quick medical-records turnaround
Personal-injury cases run on documentation. We turn around medical-records and itemized-bill requests quickly, because a firm waiting on records is a firm whose case (and your payment) is stalled.
On the schedule you set
Some practices want a quarterly status check on open cases; others want monthly. We follow up on the cadence the client chooses, so long-tail cases never go dark and nothing ages out unnoticed.
We’re the billers; you decide
Attorney relationships are valuable and easy to strain. Having a dedicated billing office handle the back-and-forth keeps the tone objective and professional, and protects the referral relationship that sent the patient in the first place.
Reduction requests
When the firm asks for a reduction, we gather the facts and bring them to you to decide.
Near settlement, the attorney’s office will often ask the practice to reduce its bill so more of the recovery reaches the patient. That’s a normal part of personal-injury work, but it’s a decision about your revenue, and it shouldn’t be made on a phone call under pressure. So we do the legwork first.
We gather the facts that actually inform the call: the settlement amount, the total medical on the case, and whether the firm is also reducing its own fee, because a reduction request lands very differently when the attorney is sharing the cut versus asking the provider to absorb all of it. Then we bring that picture to the practice. We’re the billers; the practice decides. That separation keeps the negotiation clean and keeps you in control of every dollar you write down.
Codes & modifiers
MVA and Workers’ Comp open up codes Medicare won’t pay, if they’re billed correctly.
Accident and injury cases are usually richer than a typical Medicare visit, because the payer is an auto or Workers’ Comp carrier rather than Part B. That’s an opportunity and a trap: the codes are billable, but only when they’re documented to the carrier’s rules and matched to the injury. Here’s the stack we bill on these cases.
98940 to 98943
- 98940: CMT, 1–2 regions
- 98941: CMT, 3–4 regions
- 98942: CMT, 5 regions
- 98943: extraspinal CMT
Extraspinal 98943 is excluded by Medicare but often payable on auto and Workers’ Comp cases.
97110 / 97112 / 97140
- 97110: therapeutic exercise
- 97112: neuromuscular re-education
- 97140: manual therapy
Time-based codes that frequently need a 59 modifier to bill alongside CMT without bundling denials.
99202 to 99215
- New vs. established patient
- Level set by MDM or time
- Modifier 25 for a separate E/M same day as CMT
The initial accident evaluation is often a billable E/M, commonly undercoded or left off entirely in-house.
Diagnoses are ordered to the injury, not a template: the subluxation in the M99.0x family tied to the region treated, with the neuromusculoskeletal complaint (the M54.x back and neck pain codes, for example) supporting it. Knowing which carrier pays for which code, and which modifier (AT, 59, 25) the line needs to clear, is the difference between a clean accident claim and a write-off. See the full chiropractic CPT code breakdown for how each one is used.
Why claims are lost
Accident claims are exactly the ones a stretched-thin biller writes off.
A single in-house biller juggling the front desk, the phones, and commercial claims rarely has the hours to chase a Workers’ Comp claim across three follow-ups, or to keep a personal-injury attorney current for fourteen months until a case settles. So these claims age, then get written off, and they’re often the highest-dollar claims in the practice.
A dedicated coordinator (not a call center) owns your accident book end to end. Many of our clients run multi-specialty centers, so the same coordinator also bills the physical therapy, massage, and acupuncture that ride along on an injury case, with each line sent to the carrier or attorney that’s actually responsible for it. It’s all one flat fee, laid out on our pricing page.
Proof
The follow-through shows up in the collections.
“In practice over 30 years, I have never found a more professional, knowledgeable company. I have a dedicated person accessible at all times, and they’re compatible with my EHR so I have no extra steps.”
“ACB has been instrumental in cleaning up our accounts receivable, helping us transition between software, and staying on top of all our billing. Knowledgeable, and most importantly, effective.”
“I used to spend a lot of time calling insurance companies when claims weren’t paid. Now they’re part of my team, so I can focus on patient care. Highly recommend.”
FAQ
MVA & Workers’ Comp billing, answered.
First-party claims are billed directly to a carrier: the patient’s own auto policy under Personal Injury Protection (PIP) or Medical Payments (Med-Pay) coverage, or the Workers’ Comp carrier. They pay the practice on a fee schedule. Third-party claims ride on a personal-injury attorney’s case and are paid out of the eventual settlement, often a year or more later. The two need completely different handling, and ACB works both.
Because we’re electronically integrated with most major auto and Workers’ Comp carriers, the carrier returns a digital acknowledgement when a claim arrives, so within about 24 hours we can confirm the claim (the HCFA plus chart notes) was actually received, not just sent. It works like sending every claim certified mail. In one Pennsylvania case, that acknowledgement let a client prove receipt after the carrier claimed otherwise and recover three times the state fee schedule. A practice mailing paper claims has no such proof.
On attorney (third-party) cases we keep the firm current on the patient’s balance, turn medical-records requests around quickly, and follow up on the schedule you set so long-tail cases never go dark. When a firm asks for a reduction near settlement, we gather the facts (the settlement amount, the total medical, and whether the firm is also reducing its own fee) and bring them to you. We’re the billers; the practice decides. That keeps the attorney relationship objective and professional and keeps you in control of every write-down.
Accident cases are usually richer than Medicare because the payer is an auto or Workers’ Comp carrier. You can typically bill spinal CMT (98940 to 98942) and extraspinal CMT (98943, which Medicare excludes), time-based therapy such as 97110, 97112, and 97140, and an evaluation-and-management visit (99202 to 99215) for the initial accident eval. Each line has to be documented to the carrier’s rules and carry the right modifier: 59 to unbundle therapy from CMT, 25 for a separate same-day E/M. See our CPT code guide for details.
Yes. We work inside any EHR you already use, so there’s no new software for your team. MVA and Workers’ Comp billing is included in our standard fee: 7% of net collections, or a $1,500/month minimum, whichever is greater. All-inclusive, month-to-month, no contract and no setup fee. The full breakdown is on our pricing page.
Pricing
All of this, for 7% of net collections.
Electronic first-party submission with 24-hour receipt confirmation, attorney-case management, records turnaround, scheduled follow-up, and the consultative coding work: it’s all included in one performance-based fee of 7% of net collections, or a $1,500/month minimum, whichever is greater. All-inclusive, month-to-month, no contract. Weighing the build-vs-buy decision? See in-house vs. outsourced, or run the numbers on our pricing page.
Official sources
Where these rules come from
Auto-injury (MVA/PIP) and Workers’ Comp billing are governed by each STATE, not a single federal source. Statutes, fee schedules and deadlines differ by state. The code and denial-code references below are federal; the state-specific rules are cited on each state’s page.
Billing rules also vary by state. See our state-by-state chiropractic billing guides. Each covers the local auto-injury, Workers’ Comp and Medicaid rules, cited to the governing statute.
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Electronic carrier integration · 24-hour receipt confirmation · Any-EHR compatible · Month-to-month · Transparent 7%