Web page link

https://www.ndca.net/

Membership Fees

5% discount on all dues received and paid in full before January

Member benefits

• Classifieds
• Find-a-Chiropractor directory
• Negotiation support with BCBS and Work Safety Insurance for equitable reimbursement 
• Education seminars at reduced rate 
• Lobbyist support
• Legal support

Website to apply for license: https://www.ndsbce.org/   

• Link to apply: https://www.ndsbce.org/
• License fee: $300
• Instructions for application: https://www.ndsbce.org/www/download_resource.asp?id=691

NBCE Requirements:

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

NBCE Acupuncture is not accepted.

NBCE SPEC may be required based on graduation dates or at the board’s discretion for reciprocity or endorsement applications  

STATE SCOPE OF PRACTICE:

Contact State for precise definition by state law.

Scope: The practice of chiropractic” includes: (1) The examination, evaluation, and diagnosis by means including x-ray, other appropriate diagnostic imaging, clinical laboratory procedures, or pertinent examinations taught by chiropractic colleges accredited by the council on chiropractic education or its successor or equivalent; (2) The treatment of patients by means of the adjustment or manipulation of the spinal column, the vertebral articulations, the appendicular skeleton not excluding the skull, and of any displaced tissue of any kind or nature; (3) The practice of physiotherapy, electrotherapy, or hydrotherapy; (4) All other procedures, treatments, and interventions taught by chiropractic colleges accredited by the council on chiropractic education or its successor; (5) The rating and reporting of any permanent impairment of function and the providing of professional opinions regarding any matter included in this definition of practice of chiropractic as set out herein; (6) Delegation of basic health care duties in the practice of chiropractic to a certified chiropractic clinical assistant; and (7) Telehealth. The practice of chiropractic does not include prescribing for or administering to any person any medicine or drug to be taken internally which is now or hereafter included in materia medica, nor performing any surgery, except as is provided in this section, nor practicing obstetrics.

Synopsis taken from FCLB.org

CONTINUING EDUCATION:

• $400 per renewal (annually)
• Renews September 1st
• 20 hours per year, may all be distance learning
• Requires professional boundaries training (3 hours per 3 years)
• Additional CEUs are required if certified in acupuncture or dry needling
• 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, Anthem, Cigna, Medica, Stanford Health Plan, UHC (Optum)

Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html 

Anthem: https://www.anthem.com/provider/credentialing/ 

Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network 

Medica: https://partner.medica.com/providers/join-our-provider-network 

Stanford Health Plan: https://www.sanfordhealthplan.com/providers/contracting-and-credentialing 

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

• Limited E/M and x-ray coverage
• Maintenance therapy is NOT covered
• Extra-spinal joint manipulation is not covered
• Must be medically necessary: neurological or musculoskeletal condition directly related to subluxations observed
• Documented improvement within the first two weeks

Dept. of Health and Human Services overview including CPT codes and billing guidelines:  https://www.hhs.nd.gov/sites/www/files/documents/Medicaid%20Policies/chiropractic-services.pdf

• ND Workforce Safety Insurance
  • State association helps with negotiating fee schedules
• Includes rehabilitation codes
  • Other codes may be approved with a further request 
• Visits must be approved, additional visits may then be requested based on status: https://www.workforcesafety.com/sites/www/files/documents/Forms/UR%20CHIROPRACTIC%20REVIEW%20REQUEST%20-%20MEDICAL%20SERVICES.pdf
• X-ray utilization: can be approved when medical necessity is documented.
  • There is a guideline posted on the WSI website, however as of this posting the link was broken. Please reach out to WSI for further guidelines
• Read further: https://www.workforcesafety.com/news/clarifications-providing-chiropractic-treatment