Web page link

https://chirohealth.org

Membership Fees

• Discounted rates for those in their first 3 years of practice.
• Discounted rates for retired DCs.
• Other levels in between tiers with varied benefits.

Member benefits

• Advising’s based on current federal and state requirements (i.e./ No Surprises Act forms and guidelines)
• Classifieds
• Professional development resources
• Legislative and advocacy efforts
• Discounts to professional events or free attendance based on membership level
• Corporate discounts

Website to apply for license:  Chiropractor, Chiropractic X-Ray Technician | Washington State Department of Health 

• $741 for application and jurisprudence exam (Jurisprudence retake fee $100)
• Background check required, no fingerprinting unless out of state applicant. 
• May NOT sit for exam prior to graduation 
• Students may intern under licensed DC (Licensed DC must have more than 5 years of license and be in good standing) 
• Official transcript
• Letter of recommendation (form online)

NBCE Requirements:

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

NBCE Physiotherapy not accepted.

Physiotherapy is considered within scope of practice as defined as follows, not requiring additional certifications:

• PHYSIOTHERAPY: Chiropractic treatment or care includes the use of procedures involving spinal adjustments, and extremity manipulation. Chiropractic treatment also includes the use of heat, cold, water, exercise, massage, trigger point therapy, dietary advice and recommendation of nutritional supplementation, the normal regimen and rehabilitation of the patient, first aid, and counseling on hygiene, sanitation, and preventive measures. Chiropractic care also includes such physiological therapeutic procedures as traction and light but does not include procedures involving the application of sound, diathermy, or electricity.
• NBCE acupuncture is not accepted
• NBCE SPEC is not accepted unless to reinstate a license that has been inactive or expired for at least three years.

STATE-SPECIFIC EXAMS:

Jurisprudence exam online after license is issues.

STATE SCOPE OF PRACTICE:

Contact State for precise definition by state law.

RCW 18.25.005 (1) Chiropractic is the practice of health care that deals with the diagnosis or analysis and care or treatment of the vertebral subluxation complex and its effects, articular dysfunction, and musculoskeletal disorders, all for the restoration and maintenance of health and recognizing the recuperative powers of the body. (2) Chiropractic treatment or care includes the use of procedures involving spinal adjustments, and extremity manipulation. Chiropractic treatment also includes the use of heat, cold, water, exercise, massage, trigger point therapy, dietary advice and recommendation of nutritional supplementation, the normal regimen and rehabilitation of the patient, first aid, and counseling on hygiene, sanitation, and preventive measures. Chiropractic care also includes such physiological therapeutic procedures as traction and light, but does not include procedures involving the application of sound, diathermy, or electricity. (3) As part of a chiropractic differential diagnosis, a chiropractor shall perform a physical examination, which may include diagnostic x-rays, to determine the appropriateness of chiropractic care or the need for referral to other health care providers. The chiropractic Quality Assurance Commission shall provide by rule for the type and use of diagnostic and analytical devices and procedures consistent with this chapter. (4) Chiropractic care shall not include the prescription or dispensing of any medicine or drug, the practice of obstetrics or surgery, the use of x-rays or any other form of radiation for therapeutic purposes, colonic irrigation, or any form of venipuncture. (5) Nothing in this chapter prohibits or restricts any other practitioner of a ‘health profession’ defined in RCW 18.120.020(4) from performing any functions or procedures the practitioner is licensed or permitted to perform, and the term ‘chiropractic’ as defined in this chapter shall not prohibit a practitioner licensed under chapter 18.71 RCW from performing medical procedures, except such procedures shall not include the adjustment by hand of any articulation of the spine.

Scope synopsis from FCLB.org

Further regulations can be found at: https://app.leg.wa.gov/RCW/default.aspx?cite=18.25.005

CONTINUING EDUCATION:

• Annually, on birth date
• Renewal fee: $566, late penalty $225
• 25 hours CEU per year (Up to 12 online, 12 must be in a classroom setting)
• 3 hour one time suicide screening requirement
• Accepts PACE
• Licensing requirements taken from FCLB.org and https://doh.wa.gov/licenses-permits-and-certificates/professions-new-renew-or-update/chiropractor-chiropractic-x-ray-technician

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

Links below allow you to apply for participation in their networks. 

• Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
• AWB HealthChoice: https://www.myhealthchoice.com/providers/facility-community/network-credentialing/
• Asuris: https://www.asuris.com/provider/contracting-credentialing/credentialing
• Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network
• Envision (Medicare) https://www.envisionhealth.com/
• Humana (Medicare): https://www.humana.com/provider/medical-resources/join-humana-network
• Hartford Healthcare: https://hartfordhealthcare.org/health-professionals/education/credentialing
• Kaiser Permanente: https://wa-provider.kaiserpermanente.org/provider-manual/working-with-kp/credential-pract
• Lifewise: https://www.lifewise.com/provider/resources/news/online-tools-resources/11220
• Molina (Medicaid) https://www.molinahealthcare.com/providers/ky/medicaid/home.aspx
• Mutual of Omaha: https://www.mutualofomaha.com/provideraccess/contact/index.php
• Pacific Source: https://pacificsource.com/providers/partner-with-us
• Premera Blue Cross: https://www.premera.com/wa/provider/reference/join-our-network/
• Regence Blue Shield: https://www.regence.com/provider/contracting-credentialing/credentialing
• UHC (viaOneHealth) https://www.uhcprovider.com/en/resource-library/Join-Our-Network.html

Note: There are many Health Trusts within the state that offer improved rates for their members or associations. These trusts may have other names, but the insurances provided are underwritten by other organizations. 

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

• Through Washington State Healthcare Authority
• Apple Health: This is the name of the state Medicaid and CHIP program.
• Must be within scope, and medically necessarily
  • Verify eligibility: https://www.hca.wa.gov/billers-providers-partners/program-information-providers/managed-care
• Billing guide below includes procedures, required modifiers, and comments on use.
• Coverage includes variations of imaging (x-ray), and chiropractic manipulation.
  • Therapy modalities, supplements, medications, or drugs, or any braces or supportive supplies are not covered.
• Fee schedule: https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/provider-billing-guides-and-fee-schedules#c
• Chiropractic Services Billing Guide: https://www.hca.wa.gov/assets/billers-and-providers/Chiropractic-serv-bg-20220701.pdf