ChiroLogic – Payer Specific Logic
Adaptive AI

Payer-Specific Intelligence

Standard spellcheckers treat every note the same. ChiroLogic knows that Medicare requires different documentation than Commercial plans.

Strict PART Criteria Tracking

Medicare is notoriously rigid. Our AI scans strictly for the required Pain, Asymmetry, Range of Motion, and Tissue/Tone changes required to validate your active treatment plan.

  • Validates exact subluxation matching
  • Ensures 2 of 4 PART components are met
  • Flags omitted Asymmetry or ROM deficits
  • Verifies AT Modifier necessity
AI Analysis: Medicare Note
Warning: Claimming 98941 requires 3 regions. Only Cervical and Lumbar are documented with PART criteria.
Missing Data: No Asymmetry (A) or Tissue (T) changes documented for the Thoracic region.
Action: Update Thoracic documentation or downcode to 98940 to avoid denial.

Commercial Medical Necessity

Major payers like United Healthcare or Cigna look heavily at functional improvement and specific diagnosis pointers linking your treatment to the chief complaint.

  • Tracks functional outcome goals
  • Validates Modifier 25 application on E&M codes
  • Ensures treatment duration aligns with payer caps
  • Checks for unbundled therapy codes (e.g., 97140)
AI Analysis: Commercial Note
Warning: Modifier -25 appended to 99213, but documentation lacks significant, separately identifiable E&M service.
Review Required: Manual therapy (97140) performed in same anatomic region as CMT (98941).
Action: Append modifier -59 if performed in a separate region, or remove 97140.

Personal Injury & No-Fault Narratives

PI billing is all about the narrative. The AI ensures causality is clearly documented, correlating the subjective accident details directly to objective orthopedic and neurological findings.

  • Ensures causality phrasing is present
  • Cross-references subjective pain with objective severity
  • Validates daily functional limitation impacts
  • Secures documentation against attorney cross-examination
AI Analysis: PI Initial Exam
Warning: Mechanism of injury lacks specifics regarding seating position and point of impact for MVA.
Missing Data: No daily functional limitation percentage recorded for lumbar pain.
Action: Add ADL functional impact score to strengthen med-legal narrative.
Sample Audit Report

See the AI Logic in Action

Compare a raw clinical SOAP note to the structured ChiroLogic audit output. Notice how the engine identifies PART criteria and corrects diagnostic coding.

Clinician Input

Raw SOAP Note Text

Patient ID: SUB-100234
Date: March 25, 2026
Visit Type: Routine Maintenance
Payer: Commercial Insurance

S: SUBJECTIVE
Chief Complaint: Patient presents for maintenance care. Reports mild stiffness in thoracic spine after long desk hours. Pain Level: 2/10.

O: OBJECTIVE
Posture: Mild forward head posture observed.
ROM: Slight limitation in thoracic rotation.
Palpation: T3-T5: Segmental dysfunction noted, accompanied by mild tenderness.
Thoracic Paraspinals: Minimal hypertonicity (tone 1/4).
PART Assessment: P and A confirmed.

A: ASSESSMENT
Primary Diagnosis: S39.012A (Strain of muscle, fascia and tendon of lower back, initial encounter) OR M99.02 (Segmental and somatic dysfunction of thoracic region).
Progress: Stable on monthly maintenance plan.

P: PLAN
Treatment: Performed Diversified spinal manipulation to T3-T5 to reduce subluxation.
Chiropractic Economics
Chiropractic Economics
Next Visit: 4 weeks.

ChiroLogic Audit

AI Structured Output

Audit Status: PASS
Ref: #SUB-100234

I. Audit Summary

The documentation supports a billable CMT. PART criteria are clearly met. Correction required: diagnostic coding conflict identified in Assessment.

II. Billing Recommendations

CPT Code 98940 (1-2 Regions)
ICD-10 Corrected M99.02 (Thoracic)

Note: S39.012A was rejected. It describes an “initial encounter” lower back strain which contradicts the documented chronic thoracic maintenance.

III. PART Evidence Mapping

PAIN

“Mild tenderness at T3-T5”

ASYMMETRY

“Segmental dysfunction / posture”

R.O.M.

“Limited thoracic rotation”

TISSUE

“Minimal hypertonicity”

V. Documentation Fixes

  • Remove “Chiropractic Economics” (Repeated Copy/Paste Artifact).

  • Update ICD-10 to M99.02 to accurately reflect the thoracic region treated.

Experience it with your own notes.

Test the auditor in the live beta environment. See how it identifies gaps in your actual clinical encounters.

ChiroLogic – Comparison Table

Stop Wasting Time on Manual Audits

See why modern chiropractic offices are switching to ChiroLogic AI for bulletproof compliance.

Manual Auditing

  • Slow & Tedious Takes 10–15 minutes per note. Exhausting at the end of a long clinical shift.
  • Prone to Human Error Fatigue leads to missed modifiers, undocumented regions, and coding inconsistencies.
  • Vague Feedback Third-party audits typically return generic spreadsheets days or weeks later.
  • Expensive Scaling Consultants charge expensive hourly rates that spike as your patient volume grows.
VS
The Future

ChiroLogic AI

  • Lightning Fast Full analysis in under 10 seconds. Process 100 notes in the time it takes to do one manually.
  • Surgical Precision 100% repeatable, payer-specific engine (Medicare vs Commercial rules built-in).
  • Actionable Fixes Instant, line-by-line recommendations (e.g., “Missing Asymmetry in Thoracic region”).
  • Flat Predictability One low monthly subscription. Infinite audits. Massive ROI on time and recovered claims.
ChiroLogic – Audit Risk Calculator

Audit Risk Exposure

Estimate your practice’s hidden revenue leakage from documentation errors and denials.

800
$65
12%
Annual Revenue at Risk
$74,880

This is the estimated amount you’re leaving on the table every year due to manual auditing vulnerabilities.

Plug The Leak for $99/mo
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