Web page link

https://www.chirotexas.org/

Membership Fees

May be billed quarterly to monthly, as well.

Member benefits

• CEUs
• Networking
• Legislative support

Website to apply for license:  https://www.tbce.texas.gov/

• $150 application, initial license fee prorated
• Jurisprudence exam online
  • E-strategy
  • Exam fee: $150
    • Covers governing laws and Texas Board of Chiropractic Examiners’ rules
  • Fingerprinting and background check required
  • Requires letter of good standing

NBCE Requirements:

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

NBCE Acupuncture accepted.

NBCE SPEC utilized at discretion of the board.

STATE SCOPE OF PRACTICE:

Contact State for precise definition by state law.

Any person shall be regarded as practicing chiropractic within the meaning of this Act who shall employ objective or subjective means without the use of prescription of controlled substances, dangerous drugs, or any other drug that requires a prescription, the use of X-ray therapy or therapy that exposes the body to radioactive materials, to analyze, examine or evaluate the biomechanical condition of the spine and musculoskeletal system of the human body; performs non-surgical, non-incisive procedures, including adjustment and manipulation, to improve the subluxation complex or the biomechanics of the musculoskeletal system; or represents to the public that the person is a chiropractor; or uses the term “chiropractor,” “chiropractic,” “doctor of chiropractic,” “D.C.,” or any derivative of those terms or initials in connection with the person’s name.

Synopsis taken from FCLB.org

CONTINUING EDUCATION:

• $300 renewal fee, biennial
• Renew: 1st of birth month
• 16 hours per year (32 per renewal)
  • No more than 10 hours per year may be distance learning
  • 1 hour in risk management
  • 3 hours of board rules
  • One-time 8-hour course on Medicare
• Texas requires an additional Human Trafficking course that is not part of your CEUs
• 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, Ambetter, Anthem, Cigna, Molina, Superior HealthPlan, UHC (Optum)

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

Ambetter: https://www.ambetterhealth.com/en/ok/provider-resources/join-our-network/ 

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

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

Moda: https://www.modahealth.com/texas/member 

Molina: https://www.molinahealthcare.com/providers/tx/medicaid/home.aspx 

SuperiorHealthPlan: https://www.superiorhealthplan.com/newsroom/provider-credentialing-information-and-rights-04192023.html 

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

• Texas Medicaid covers subluxation corrections of the spine with manual manipulation
  • 12 visits per year in a 12 month period
  • Does NOT include coverage for x-rays or other diagnostic or therapeutic services
• Handbook: https://www.tmhp.com/sites/default/files/file-library/resources/provider-manuals/tmppm/pdf-chapters/2022/2022-08-august/2_Med_Specs_and_Phys_Srvs.pdf
  • Starting on page 13 has details on chiropractic coverage, including eligible diagnosis codes (segmental codes). Also covers provider enrollment criteria.

Department of Insurance, Division of Workers Compensation allows chiropractors to be a treating doctor for those eligible. (Title 28, part 2, chapter 42, subchapter A, Rule 42.20)