ROAD TO PRACTICE:
California
1. Join State Association
Website
Districts Breakdown
https://calchiro.org/district-directory/
Member benefits
- Members maps
- Classifieds
- CEUs
- District meetings
- Advocacy
2. License Requirements
Applying For NBCE Exams
- NBCE Link – https://www.mynbce.org/
- Parts I*, II*, III* and IV*: Required
- Physiotherapy*: Required
*PASSING SCORE IS 375
- May be used to endorse license application
- Travel to Treat not authorized
- Telemedicine not authorized
The application is now online:
Applicants – Board of Chiropractic Examiners
Applicants must apply, wait for approval and verification of academic requirements such as graduation and completion of board exams and identity verification (fingerprints), then take the Jurisprudence exam, and submit final application.
There are application fees ($371 as of 8/2022) and Exam fees
The application process is fairly streamlined and may be started before graduation.
Check Sheet for the “Application for a License to Practice Chiropractic”
- Application
- Fees ($371 as of 8/2022)
- Transcripts from NBCE
- Transcripts from Chiropractic College
- Official documentation (diploma photocopy, certification of licensure from other states, etc.)
- Fingerprints (Live Scan for CA residents)
Article 1 & 2 of the Rules and regulations
Rules and Regulations
Licenses or Satellite Licenses must be clearly displayed
Section §312.1
“No unlicensed individual may own a chiropractic practice regardless of the form in which the practice is established”
Scope of Practice
“The Act”
Initiative Act – Board of Chiropractic Examiners
Article 1 Section §302: Practice of Chiropractic:
“(3) Other than as explicitly set forth in section 10(b) of the Act, a duly licensed chiropractor may treat any condition, disease, or injury in any patient, including a pregnant woman, and may diagnose, so long as such treatment or diagnosis is done in a manner consistent with chiropractic methods and techniques and so long as such methods and treatment do not constitute the practice of medicine by exceeding the legal scope of chiropractic practice as set forth in this section.”
Section §361. “Continuing Education Requirements” of the rules and regulations
- 24 Hours per year.
- up to 12 hours may be distance learning
- 2 Hours of Ethics and Law
- 4 Hours in any combination of: History Taking and Physical Examination; Chiropractic Adjustive Techniques; Proper and Ethical Billing and Coding.
- 18 Hours in any subject listed in section §361.g
You can Find a list of approved CEUs here:
Continuing Education – Board of Chiropractic Examiners
Other Relevant Information
Licensees must maintain proof of completion for 4 years.
“The Board shall conduct random audits to verify compliance with Continuing Education requirements of active licensees. Licensees shall secure and retain certificates of completion issued to them at the time of attendance of approved Continuing Education courses for a period of four (4) years from their last renewal and shall forward these documents to the Board upon request.”
CoVid-19 relevant waivers:
Waiver Information for Continuing Education Requirements: All Licensees – Board of Chiropractic Examiners
3. Getting Your NPI Number
(New Practioner Identification) Number
Step by step instructions
https://www.nata.org/sites/default/files/apply_npi_instructions.pdf
4. Obtaining an EIN
Step by step instructions
https://sa.www4.irs.gov/modiein/individual/index.jsp
Note: This is your tax ID number as a practitioner
State specific rules
- Link to state-specific “starting a business” https://www.virginia.gov/state-government/business/
- You need to have a physical address, PO boxes do not apply for address qualifications.
- File your business here: https://cis.scc.virginia.gov/
- You will need to reserve your name, and can do so before you are ready to actually file your business
- You will file your articles of organization and registered agent
- You will also need to register for your business itself for future tax purposes here. In Virginia, chiropractors may file under either PLLC or LLCs, as well as other organizations. However, depending on who reviews your materials, they may want your LLC to be a PLLC or vice versa. Legally you can file for either.
Note: This is your tax ID number as a practitioner
Type Of Business Breakdown
Business Structure |
Ownership |
Liability |
Taxes |
Sole Proprietorship |
One person |
Unlimited personal liability |
Personal tax only |
Partnership |
Two or more persons |
Unlimited personal liability unless structured as a limited partnership |
Self-employment tax (except for limited partnership), Personal tax |
Limited Liability Company (LLC) |
Two or more persons |
Owners are not personally liable |
Self-employment tax, Personal tax or Corporate tax |
Professional Limited Liability Company (PLLC) |
Two or more persons |
Owners are not personally liable |
Self-employment tax, Personal tax or Corporate tax |
Corporation – C Corp |
One or more persons |
Owners are not personally liable |
Corporate tax |
Corporation – S Corp |
One or more persons, but no more than 100 and all must be US citizens |
Owners are not personally liable |
Personal tax |
Corporation – B Corp |
One or more persons |
Owners are not personally liable |
Corporate tax |
Corporation – Nonprofit |
One or more persons |
Owners are not personally liable |
Tax-exempt, but corporate can’t be distributed |
Note: The difference between an LLC and a PLLC is that all members of a 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.
5. Obtaining Malpractice Insurance
Malpractice Insurance Providers
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NCMIC – https://www.ncmic.com/malpractice-insurance/how-to-apply-online/
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ChiroSecure – https://www.chirosecure.com
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General Liability Insurance – https://generalliabilityinsure.com/small-business/chiropractic-insurance.html
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ChiroFuture – https://chirofutures.org/online-quote/
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SDN Insurance – http://sdnins.com/chiropractor.html
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CoverMD – http://www.covermd.com/chiropractor-malpractice-insurance.aspx
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Insureon – https://alliedhealth.insureon.com/resources/cost/chiropractic
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MBS Insurance Services – https://www.mbsinsure.com/solutions/malpractice-insurance/
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USA Business Insurance – https://www.businessinsuranceusa.com/chiropractor-professional-liability-insurance
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CM&F – https://www.cmfgroup.com/professional-liability-insurance/chiropractic-assistant-insurance/
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MACARIO Insurance Group – https://www.macarioinsurance.com/who-we-cover/all-classes-of-business/
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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.
6. Participating with Insurance Providers
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