Template Letter-Amend Provider Agreement to Use S1001

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This template is an example of a letter you may send to your provider relations department to request an amendment to your agreement. This amendment allows you to offer items to your patient that may be enhanced or luxury items that could cost more than the traditional fee allowed for the item, per your agreement. NOTE: Once you click on the resource, look for the document in your downloads or taskbar. Unlike a PDF, these will not open up on your desktop.

Template Letter-Amend Provider Agreement to Use S1001


Orthotics Verification Form & Training

Watch this tutorial to understand the intent behind the specific questions we recommend when verifying third-party coverage for custom orthotics. Download, review and save this customizable tool to reference as you learn the reasoning and recommendations behind performing specific orthotics verification. Put this form into practice when verifying coverage in your office. Review the sample to see how to use the form.

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Download, review and save this customizable tool to reference as you learn the reasoning and recommendations behind performing specific orthotics verification. Put this form into practice when verifying coverage in your office. Review the sample to see how to use the form.

Customizable Orthotics Verification Tool
Customizable Orthotics Verification Tool-Example

1500 Claim Form Instructions

Download Support Tool Seeing is believing and that starts the learning process. In this very helpful tool, we’ve created a visual map that outlines the most important fields on the 1500 billing form and what should be included. Use it to ensure that your billing software maps the most important information to the proper section...
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ChiroHealthUSA Reference Tools

Download Reference Documents If you haven’t realized it by now, we love CHUSA, and more reasons to love them are these helpful tools they have supplied for your use. Download, save and review these tools as you implement CHUSA in your practice for legal discounts. The proper use of the Election to Self-Pay form and...
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The Managed Care Contract Cover Sheet

Because so much of billing compliance relates to the agreement (or lack thereof) signed by a provider of service, there is no more important document than the provider’s agreement with a payer. These contracts are often signed in haste when the practice is young, and sometimes are updated with only a short email that the...
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Samples: Documentation and Informed Consent

Templates and Support Tools to Help Two of the most important locations for proper documentation of the CMT are when it’s prescribed in the initial treatment plan, and when it’s described on a Routine Office Visit (ROV). We provide documentation samples throughout the KMC University Library, examples of the necessary components of a note for...
Oops, your level of membership doesn’t include access to these full training courses. Please reach out to the HelpDesk to learn more about accessing these trainings and resources. Click here to learn more.