Learn how to reconcile chiropractic insurance reimbursements like a pro. Step-by-step EOB workflows to protect cash flow, accuracy, and compliance.
How to Reconcile Chiropractic Insurance Reimbursements Like a Pro
Listen on the go: You can now listen from anywhere — The Deep Dive, where we dig deeper into this topic, ‘Stop Losing Thousands – The Chiropractic Cash Flow Secret to Mastering EOBs & Reconciling Revenue’. Listen or download here now.
Introduction
If you run a chiropractic practice, you already know that chiropractic insurance reimbursements can make or break your cash flow. Between delayed payments, partial reimbursements, and confusing EOBs, it’s easy for your books to fall out of sync.
The result? Lost revenue, reporting headaches, and compliance risks that could cost you thousands.
In this guide, Giesler-Tran Bookkeeping (GTB) breaks down a simple, repeatable process to keep your reimbursements accurate — and your finances healthy.
Understand Your EOBs (Explanation of Benefits)
Before you can reconcile chiropractic insurance reimbursements, you need to understand what your EOBs actually tell you. Each EOB outlines what was billed, what was allowed, and what was paid — but most practices overlook the fine print.
Breakdown of Key EOB Elements:
– Allowed Amounts: The portion the insurer agrees to pay for each service.
– Adjustments / Write-Offs: Contractual amounts the provider must discount based on agreements.
– Patient Responsibility: Co-pays, deductibles, and coinsurance you must collect directly.
Actionable Takeaway: Always verify that each payment or adjustment matches your contract — never assume the EOB is correct by default.
A Clean Reconciliation Workflow (Step-by-Step)
Reconciliation is the process of confirming that the money you billed, received, and recorded all match. Here’s how to do it like a pro:
Step 1: Match Deposits to EOB Batches – Group payments by date, payer, and batch total. Match deposits in QuickBooks or your practice management system to the corresponding EOBs.
Step 2: Record Adjustments Properly – Never bury adjustments in miscellaneous categories. Post each write-off or discount accurately so your reports reflect true revenue, not inflated billings.
Step 3: Track Partial or Denied Claims – Set up follow-ups for partial or denied claims. Missing just one resubmission cycle can create thousands in uncollected revenue annually.
Actionable Takeaway: Create a weekly reconciliation checklist to prevent backlog and missed collections.
QuickBooks Setup That Prevents Errors
Using QuickBooks Online correctly is half the battle in chiropractic bookkeeping.
Chart of Accounts: Customize your Chart of Accounts to include Insurance Receivables (per payer), Patient Payments, Adjustments / Write-Offs, and Reimbursement Income.
Bank Rules and Automation: Set up bank rules to automatically categorize deposits by payer and reduce manual entry errors.
Actionable Takeaway: Use Undeposited Funds in QuickBooks to match multiple EOB payments to a single bank deposit for cleaner reconciliation.
Metrics That Matter for Chiropractors
Tracking the right KPIs helps ensure your reimbursement process supports your business growth.
Key Metrics:
– Days in A/R (Accounts Receivable): How long it takes to collect payments.
– First-Pass Acceptance Rate: Claims accepted the first time.
– Denial Rate: Percentage of claims rejected.
– Net Collection Percentage: Actual cash collected vs. allowed amount.
Actionable Takeaway: Review these metrics monthly to spot payer issues or staff bottlenecks early.
Red Flags to Watch For
If you notice any of these, your reconciliation process needs improvement:
– Batch totals don’t tie to your bank deposits.
– Frequent use of ‘Ask My Accountant’ or ‘Misc Expense’ categories.
– Unexplained variances between EOBs and deposits.
Pro Tip: These issues are often why CPAs struggle at year-end — they’re trying to fix bookkeeping that’s been inaccurate all year.
When to Bring in a Specialist
At GTB, we know that healthcare bookkeeping isn’t one-size-fits-all. Our Certified Bookkeeper, Senior Tax Accountant, and Executive Oversight team provide chiropractic practices with audit-ready accuracy and proactive financial strategy — not just data entry.
Three levels of expertise. One affordable rate. Real results.
Final Thoughts
Reconciling chiropractic insurance reimbursements isn’t just about balancing accounts — it’s about protecting your profits. With a clean workflow and professional oversight, your cash flow improves, audits become painless, and your reports finally reflect reality.
Don’t let disorganized books choke your practice. Let Giesler-Tran Bookkeeping align your finances while you align your patients.
Schedule your free consultation: Click Here to Schedule
Or call 971-200-5158 to speak with our team today.
That’s not just bookkeeping. That’s The GTB Advantage.
Giesler-Tran Bookkeeping • gieslertranbookkeeping.com • 971-200-5158