Web page link

https://www.richiro.org

Membership Fees

New doctor and semi-retired discounts. Out-of-state offerings. 

Member benefits

• 24 CEUS per year discounted
• Legislative presence 
• Provider listing
• Networking and committee opportunities
• Mentorship program
• Biannual events (June banquet, December holiday party)

Website to apply for license: https://health.ri.gov/licenses/detail.php?id=250 

• $210 initial fee/ $210 renewal fee
• No background check or fingerprinting required 
• Application with PT requires designation 
• Transcripts
• Board exam scores
• 3 letters from licensed chiropractic physicians attesting to the applicants moral character, including one from a faculty member if graduated in the past five years
• License verification from other states (if applicable) 
• Requires a bachelor’s degree before DC

NBCE Requirements:

Parts I*, II*, III* and IV*, PT, SPEC: Required – PASSING SCORE IS 375

NBCE Acupuncture accepted.

STATE SCOPE OF PRACTICE:

Contact State for precise definition by state law.

Scope of practice: § 5-30-1. “Chiropractic medicine” defined.

For the purpose of this chapter, the practice of “chiropractic medicine” is defined as the science and art of mechanical and material healing as follows: the employment of a system of palpating and adjusting the articulations of the human spinal column and its appendages, by hand and electro-mechanical appliances, and the employment of corrective orthopedics and dietetics for the elimination of the cause of disease; provided, that chiropractic physicians may not write prescriptions for drugs for internal medication nor practice major surgery as defined in chapter 37 of this title.

Synopsis taken from FCLB.org Synopsis taken from FCLB.org

CONTINUING EDUCATION:

• Triannual renewal
• 60 hours over 3 years
• At least 30 hours of instruction per 3 year period must be live, didactic learning experiences
• Accepts PACE

Step by step instructions

https://www.nata.org/sites/default/files/apply_npi_instructions.pdf

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

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.

• NCMIC – https://www.ncmic.com/malpractice-insurance/how-to-apply-online/

• OUM – https://www.oumchiropractor.com/quote/apply

• ChiroSecure – https://www.chirosecure.com

• PRI – https://www.pri.com/who-we-serve/chiropractors

• General Liability Insurance – https://generalliabilityinsure.com/small-business/chiropractic-insurance.html

• ChiroFuture – https://chirofutures.org/online-quote/

• SDN Insurance – http://sdnins.com/chiropractor.html

• CoverMD – http://www.covermd.com/chiropractor-malpractice-insurance.aspx

• Insureon – https://alliedhealth.insureon.com/resources/cost/chiropractic

• MBS Insurance Services – https://www.mbsinsure.com/solutions/malpractice-insurance/

• USA Business Insurance – https://www.businessinsuranceusa.com/chiropractor-professional-liability-insurance

• CM&F – https://www.cmfgroup.com/professional-liability-insurance/chiropractic-assistant-insurance/

• MACARIO Insurance Group – https://www.macarioinsurance.com/who-we-cover/all-classes-of-business/

• 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.

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.

• • 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.

1. NUCC Grouping: Chiropractic Providers
2. Provider type: Doctor of Chiropractic
3. Select your state
4. Social security number
5. Demographics and contact information
6. License number(s) and state(s)
7. Educational information (about your chiropractic school and degree)
8. Board certified: No (chiropractors are not board certified, and do not need to be)
9. You may select directory listings and other searchable tags
10. Practice location(s), including TIN
11. 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.
12. Malpractice insurance information: company, expiration dates, and policy numbers.
13. 10 year work history, dates, addresses, etc.
14. Professional disclosures
15. Documents to upload:
    1. Standard authorization release; updated every 120 days
    2. Professional liability insurance verification (proof of insurance)
    3. State license (copy)
    4. W9

Common insurance companies include Aetna, BCBS, Cigna, Neighborhood Health Plan, Oscar, Tufts Health Plan (Point23Health), UHC (Optum)

• Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
• BCBS of Rhode Island: https://www.bcbsri.com/providers/participating
• Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network
• Neighborhood Health Plan (Medicaid): https://www.nhpri.org/providers/join-our-network/
• Oscar: https://www.hioscar.com/joinournetwork
• TUFTS (Point23Health): https://www.point32health.org/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

• Chiropractic treatment, evaluation and management services
• Integrity plans: no annual limit, treatment reviewed for medical necessity
  • X-rays may be performed but are not a covered service
  • Maintenance therapy, non-musculoskeletal care not covered
• Commercial plans: 12 visits/plan year
  • X-rays may be performed but are not a covered service
  • Maintenance therapy, non-musculoskeletal care, asymptomatic persons not covered
  • Approved codes can be found in the guide linked below
• Link to provider guide: https://www.nhpri.org/wp-content/uploads/2021/12/Chiropractic-Services-Payment-Policy-12.01.21.pdf

• For work-related injuries, as a physician 
• Department of Labor and Training guide: https://dlt.ri.gov/sites/g/files/xkgbur571/files/documents/pdf/wc/MedServiceTreat.pdf