Web page link

https://www.ctchiro.com

Membership Fees:

Membership Benefits:

• Protects rights to practice
• Advocacy 
• Education
• Mentorship program 
• Local meetups (district) 
• Conferences

NBCE requirements

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

NBCE Acupuncture NOT accepted.

NBCE SPEC utilized for reciprocity and endorsement licenses or disciplinary cases.

None

Website to apply for license:  https://portal.ct.gov/dph/practitioner-licensing–investigations/chiropractor/chiropractic-licensure

• License fee $565
• Fingerprinting and background check NOT required

Contact State for precise definition by state law.

The practice of that branch of the healing arts consisting of the science of adjustment, manipulation and treatment of the human body in which vertebral subluxations and other malpositioned articulations and structures that may interfere with the normal generation, transmission and expression of nerve impulses between the brain, organs and tissue cells of the body, which may be a cause of disease, are adjusted, manipulated or treated. Examine, analyze and diagnose the human living body and its diseases, and use for diagnostic purposes, the X-ray or any other general methods of examination for diagnosis and analysis; treat the human body by manual, mechanical, electrical or natural methods including acupuncture, or by use of physical means, including light, heat, water, or exercise in preparation for chiropractic adjustment or manipulation, and by the oral administration of foods, food concentrates, food extracts or vitamins, administer first aid and, incidental to the care of the sick, advise and instruct patients in all matters pertaining to hygiene and sanitary measures as taught and approved by recognized chiropractic schools and colleges approved by the State Board of Chiropractic Examiners.

Synopsis taken from FCLB.org

• $570 renewal fee
• Renew: Biennially (during birthday month immediately following issuance of license)
• 24 hours per year (48 per renewal)
  • Requires 2.5 hours in clinical radiology
  • Requires 1 hour in risk assessment and prevention of falls
  • Requires 1.5 hours in sexual boundaries
• 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.

STATE SPECIFIC INSURANCE CREDENTIALING LINKS:

Credentialing: 

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.

• 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:
  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 (BCBS of CT), Cigna, UHC (Optum)

• Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
• Anthem/BCBS of CT: https://www.anthem.com/provider/credentialing/
  • https://providernews.anthem.com/connecticut/articles/new-requirements-for-credentialing-and-recredentialing-16937-16937
• Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network
• ConnectiCare:https://www.connecticare.com/providers/resources/provider-toolkit/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

• Medicaid coverage for HUSKY Health members 
• Members age 21 and older with a set spinal diagnosis 
• Prior authorizations required for more than 5 visits per month
• Under age 21 requires all prior authorizations 
• Initial exam not covered 
• Handbook: https://www.huskyhealthct.org/providers/provider_postings/benefits_grids/Chiropractor_Grid.pdf

• Covered, requires employers to provide medical and rehabilitative services for injured employees
• Employee may choose their own physician as long as it’s an eligible medical provider (yes chiropractors)
• Medical plans by employer may be a preferred provider for various worker’s compensation benefits
• General legislation https://www.cga.ct.gov/PS97/rpt/olr/htm/97-R-0430.htm#:~:text=The%20workers’%20compensation%20law%20requires,be%20adequate%20and%20reasonably%20accessible