ROAD TO PRACTICE:
Indiana
1. Join State Association
Web page link
https://indianastatechiros.org
Membership Fees
Membership Type | Fee |
Student | FREE |
General Member | $600.00/ year |
Premium Member | $1,200.00/ year |
New doctor and semi-retired discounts. Out-of-state offerings.
Member benefits
- Classifieds list
- Free attendance to ISCA annual conference
- CEUs
- Referral listing
- Legislative and political advocacy work
- Support with insurance questions
2. License Requirements
Website to apply for license: https://www.in.gov/pla/license/
- Apply online – instructions: https://www.in.gov/pla/professions/chiropractors-home/chriopractors-licensing-information/#Chiro_App_Inst
- Official transcripts
- NBCE scores
- $100 application fee
- Jurisprudence exam – $100 fee
- Students may sit for exam prior to graduation, and may seek a temporary permit to practice under a licensed DC until fully licensed.
- 75% is passing (30 question, true-false and multiple choice)
- Fingerprinting with background check required
NBCE Requirements:
Parts I*, II*, III* and IV*, PT: Required – PASSING SCORE IS 375
NBCE Acupuncture is not accepted.
NBCE SPEC is not accepted; instead, may utilize reciprocity or license by endorsement.
STATE SCOPE OF PRACTICE:
Contact State for precise definition by state law.
The diagnosis and analysis of any interference with normal nerve transmission and expression, the procedure preparatory to and complementary to the correction thereof by an adjustment of the articulations of the vertebral column, its immediate articulation and includes other incidental means of adjustment of the spinal column and the practice of drugless therapeutics. Chiropractic does not include prescription or administration of legend drugs or other controlled substances; performing incisive surgery or internal or external cauterization; penetration of the skin with a needle or other instrument for any purpose except the purpose of blood analysis; use of colonic irrigations, plasmatics, ionizing radiation therapy, or radionics; conducting invasive diagnostic tests or analysis of body fluids except for urinalysis; the taking of X-rays of any organ other than the vertebral column and extremities; and the treatment or attempt to treat infectious diseases, endocrine disorders or atypical or abnormal histology.
Synopsis taken from FCLB.org
CONTINUING EDUCATION:
- Biennial renewal, $100 (July 1, on even years)
- 12 hours per year (24 per renewal)
- 4 hours muse be in public health and/or risk management
- Requires sexual boundaries training
- Accepts PACE
3. Getting Your NPI Number
(New Practioner Identification) Number
Step by step instructions
https://www.nata.org/sites/default/files/apply_npi_instructions.pdf
4. Obtaining an EIN
Step by step instructions
https://sa.www4.irs.gov/modiein/individual/index.jsp
Note: This is your tax ID number as a practitioner
TYPE OF BUSINESS BREAKDOWN
Business Structure |
Ownership |
Liability |
Taxes |
Sole Proprietorship |
One person |
Unlimited personal liability |
Personal tax only |
Partnership |
Two or more persons |
Unlimited personal liability unless structured as a limited partnership |
Self-employment tax (except for limited partnership), Personal tax |
Limited Liability Company (LLC) |
Two or more persons |
Owners are not personally liable |
Self-employment tax, Personal tax or Corporate tax |
Professional Limited Liability Company (PLLC) |
Two or more persons |
Owners are not personally liable |
Self-employment tax, Personal tax or Corporate tax |
Corporation – C Corp |
One or more persons |
Owners are not personally liable |
Corporate tax |
Corporation – S Corp |
One or more persons, but no more than 100 and all must be US citizens |
Owners are not personally liable |
Personal tax |
Corporation – B Corp |
One or more persons |
Owners are not personally liable |
Corporate tax |
Corporation – Nonprofit |
One or more persons |
Owners are not personally liable |
Tax-exempt, but corporate can’t be distributed |
Note: The difference between an LLC and a PLLC is that all members of PLLC are required to be designated professionals.
What is an Associate?
An associate receives pay from the office by which they are employed. If you are an associate who will be dealing with vendors for selling goods, you should consider getting an EIN.
What is an independent Contractor?
An independent contractor receives pay from their patients and insurance companies directly. If you are an independent contractor, you need an EIN.
5. Obtaining Malpractice Insurance
Malpractice Insurance Providers
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NCMIC – https://www.ncmic.com/malpractice-insurance/how-to-apply-online/
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ChiroSecure – https://www.chirosecure.com
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General Liability Insurance – https://generalliabilityinsure.com/small-business/chiropractic-insurance.html
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ChiroFuture – https://chirofutures.org/online-quote/
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SDN Insurance – http://sdnins.com/chiropractor.html
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CoverMD – http://www.covermd.com/chiropractor-malpractice-insurance.aspx
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Insureon – https://alliedhealth.insureon.com/resources/cost/chiropractic
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MBS Insurance Services – https://www.mbsinsure.com/solutions/malpractice-insurance/
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USA Business Insurance – https://www.businessinsuranceusa.com/chiropractor-professional-liability-insurance
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CM&F – https://www.cmfgroup.com/professional-liability-insurance/chiropractic-assistant-insurance/
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MACARIO Insurance Group – https://www.macarioinsurance.com/who-we-cover/all-classes-of-business/
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Chiroprefered – https://chiropreferred.com/find-the-right-coverage
Claims Made
A policy providing coverage that is triggered when a claim is made against the insured during the policy period, regardless of when the wrongful act that gave rise to the claim took place. (The one exception is when a retroactive date is applicable to a claims-made policy.)
Occurrence
An occurrence policy covers claims resulting from an injury or another event that occurs during the policy term. Coverage depends on the timing of the event. A claims-made policy covers claims that are made during the policy period.
Tail Coverage
An addition to a claims-made policy. It extends coverage for incidents that happened during the time you had your policy, but a claim was not filed until after your policy expired or was canceled. Tail coverage is another name for an extended reporting period.
Note: $1 Million/$3 Million is the minimum plan required in order to participate with some Insurance Companies.
6. Participating with Insurance Providers
As of this writing, most private insurance companies rely on the Council for Affordable Quality Health Care (CAQH) to verify your credentials. You will also need CAQH credentialing for some of the government supplemented participations as well. Others will use Availity for your credentialing, however as of this writing that is becoming less common. Keep in mind, you only need one account on either of these, and then will give permissions to each insurance company you are working to participate with to access your information and to be verified as a provider.
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- Availity: https://www.availity.com/essentials
CAQH: information needed can be filled out here: https://proview.caqh.org/Login/
The following is a quick step by step of what things you should select as a chiropractor and documents/information you may need.
- NUCC Grouping: Chiropractic Providers
- Provider type: Doctor of Chiropractic
- Select your state
- Social security number
- Demographics and contact information
- License number(s) and state(s)
- Educational information (about your chiropractic school and degree)
- Board certified: No (chiropractors are not board certified, and do not need to be)
- You may select directory listings and other searchable tags
- Practice location(s), including TIN
- You may add credentialing contact information if you are using a third party, but if you are doing this yourself you may skip this section.
- Malpractice insurance information: company, expiration dates, and policy numbers.
- 10 year work history, dates, addresses, etc.
- Professional disclosures
- Documents to upload:
- Standard authorization release; updated every 120 days
- Professional liability insurance verification (proof of insurance)
- State license (copy)
- W9
Common insurance companies include Aetna, Ambetter from MHS, Anthem BCBS, CareSource, Cigna, Healthy Indiana Plan, United Health Care
- Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
- Ambetter: https://ambetter.mhsindiana.com/provider-resources/join-our-network.html
- Anthem BCBS: https://providers.anthem.com/indiana-provider/join-our-network
- Care Source: https://www.caresource.com/in/providers/education/become-caresource-provider/medicaid/
- Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network
- Healthy Indiana (Medicaid plans): https://www.in.gov/medicaid/providers/provider-enrollment/enrolling-as-a-managed-care-program-provider/
- UHC (viaOneHealth) https://www.uhcprovider.com/en/resource-library/Join-Our-Network.html
Medicare Enrollment:
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855i.pdf
Medicare Revalidation: PECOS:
https://www.youtube.com/embed/PaLEWx0JGPw?rel=0&autoplay=0
Tips For Medicare Audit/Record Request Tips
https://www.acatoday.org/Practice-Resources/Medicare/Medicare-Audit-Record-Request-Tips
Type Of Audit And Record Requests
https://www.acatoday.org/practice-resources/medicare/medicaretpe/
Targeted Probe And Education (TPE)
http://www.acatoday.org/MedicareTPE
Medicare Training For The Chiropractic Office
https://learn.acatoday.org/products/medicare-training-for-the-chiropractic-office
How To Bill Secondary Insurance Plans
https://www.medicare.gov/supplements-other-insurance/how-medicare-works-with-other-insurance
Which Insurance Pays First
https://www.medicare.gov/supplements-other-insurance/how-medicare-works-with-other-insurance/which-insurance-pays-first
Medicaid Participation
- Indiana Health Coverage Programs (Medicaid services) cover medically necessary care.
- Fee for service, or managed care
- Specialty: 150
- DME and EMG testing is not reimbursable
- No prior-authorization required for office visits
- Muscle testing (manual and electrical) do require a PA
- 50 units per calendar year
- Units may be office visits (max. 5) (office visits are E/M codes), spinal manipulation, or physical medicine services
- Hoosier Healthwise Package C plans limit to 5 office visits and 14 therapeutical physical medicine treatments per year. Up to 36 additional visits may be approved with PA
- List of service codes and ICD reimbursable codes: https://provider.indianamedicaid.com/ihcp/Publications/providerCodes/Chiropractic_Services_Codes.pdf
- Reference for Providers: https://www.in.gov/medicaid/providers/files/modules/chiropractic-services.pdf
- Chiropractors may participate
- Fee schedule set: https://www.icrb.net/references/fee-schedule/