The problem
Before a new patient's first visit, the front desk calls the payer or logs into a portal to check active coverage, copay and deductible. At 12 new insured patients a week and 15 minutes each, that's 12.9 hours a month (12 x 15 x 4.3), and a missed inactive policy becomes a visit nobody pays for.
What the AI does
ChiroSpring's Clearinghouse add-on, for 360 Pro or Pro+, includes a Trizetto connection, 1,000 claims a month, single-click insurance verification (100 a month included, then 20¢ each), ERA posting done by ChiroSpring, and a rejection and denial center. The desk runs a check when the visit is booked and again before it, and calls the payer only for what the response doesn't show, such as visit limits or prior authorization. A staff member, not the software, explains to the patient what they're likely to owe.
A worked example
A two-doctor clinic in Kansas City on 360 Pro+ books about 12 new insured patients a week and has been checking benefits by phone and payer portals.
Before
15 minutes per new patient on the phone or payer portals: 12.9 hours a month
After
About 3 minutes per patient with a one-click check, plus calls only for visit limits: 2.6 hours a month
What it's worth
About $206£155€184A$297C$291 a month of front desk time, against $149£112€133A$215C$211 for the Clearinghouse add-on. Cutting each check from 15 to 3 minutes for 52 new patients a month saves about 10.3 hours, at an assumed $20£15€18A$29C$28 an hour. If ChiroSpring's ERA posting saves another 4 hours, add $80£60€72A$115C$113. Claim submission is included too, so a practice paying another clearinghouse saves that fee as well.
How to set it up
- Add Clearinghouse to 360 Pro or Pro+ and complete the Trizetto and ERA setup with ChiroSpring for your main payers.
- Run a verification when each new patient books and again two days before the first visit.
- Call the payer for anything chiropractic-specific the response doesn't cover, such as visit limits, prior authorization or plan exclusions, and note the call reference.
- Give insured patients a written estimate of their share, marked as an estimate; for uninsured or self-pay patients, give the Good Faith Estimate the No Surprises Act requires.
- Watch the count: after 100 verifications in a month, each one costs 20¢.
What goes wrong
- An eligibility response shows active coverage, not always chiropractic visit limits or authorization rules. Treating active as covered leads to denied claims.
- Coverage changes mid-year. Re-run the check during long care plans, not just at the first visit.
- If you already pay another clearinghouse, compare totals before switching: ChiroSpring includes 1,000 claims, then charges 35¢ each.