Web page link

https://www.wvchiropractic.org/

Membership Fees

• Graduation year – free
• Membership otherwise pro-rated for first four years in practice

Member benefits

• Advocacy within government organizations, insurance companies, and regulatory bodies.
• Provided education for the state
• Free advertising for members
• Quarterly calls
• CEUs through conferences and webinars
• Registration discounts for events for members

• Website to apply for license: https://boc.wv.gov/
  • License regulated by the Board of Chiropractic Examiners
  • $45
  • Application deadline 6 weeks prior to jurisprudence exam date
  • Annual renewal
  • Fingerprinting and background check required
  • Jurisprudence exam in February and August, annually * dates subject to change by year and determined by board
  • License application checklist (from WV Board of Chiropractic Examiners):
    • Completed Application (Application [reverse side] must be mailed to Chiropractic College for Seal and Signature of Dean, Secretary or Registrar.)
    • Certified Birth Certificate – (Contact County in which you were born – Bureau for Public Health)
    • Undergraduate College Transcripts
    • Chiropractic College Transcripts
    • National Boards (Parts I, II, III, & IV required)
    • License Verification (If licensed in another state, active or inactive, contact State Licensing Board and request verification be mailed directly to the WV Board of Chiropractic)
    • Non-Refundable Application Fee (certified check or money order payable to WV Board of Chiropractic)
    • Signed & dated Notification of Conduct Prohibitions
    • Criminal History Background Check: identogo.com
  • General Requirements:
  • NBCE Part I, II, III, IV
  • SPEC exam accepted for reciprocity and endorsement purposes after 2+ years lapse in licensing
  • Physiotherapy and Acupuncture NBCE accepted
    • Physiotherapy NBCE required to perform and bill physiological therapeutic procedures; this provides an endorsement on license
      • 120 hours education in subject also required
      • No additional fee for endorsement
    • Jurisprudence exam, February and August* dates subject to change by year.
      • $130 exam fee
      • May NOT sit for jurisprudence exam prior to graduation
      • Students may work under D.C.s direct supervision
    • Telemedicine rules and regulations are currently “in progress.” Yet, is generally authorized and permitted by the board.
    • Travel to treat not authorized

“The practices and procedures which may be employed by Doctors of Chiropractic are based on the academic and clinical training received in and through accredited chiropractic colleges. These shall include the use of diagnostic, analytical and therapeutic procedures specifically including the adjustment and manipulation of the articulations and adjacent tissues of the human body, particularly of the spinal column; included is the treatment of intersegmental disorders for alleviation of related neurological aberrations. Patient care and management is conducted with due regard for environment and nutritional factors, as well as first aid, hygiene, sanitation, rehabilitation and physiological therapeutic procedures designed to assist in the restoration and maintenance of neurological integrity and homeostatic balance.” From FCLB.org

Further reading on legalities of practice: https://boc.wv.gov/uploads/1/4/8/4/148467522/4.01._regulation_of_chiropractic_practice.pdf
Includes details on billing practices, advertising requirements, and chiropractic assistant requirements

CEU (for renewal) requirements

• Annually
• 18 hours per year
• Maximum 6 hours distance learning per year
• Sexual boundaries training not required
• AIDS/risk prevention training not required
• Does not accept 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

State specific rules

• PLLCs are utilized, not LLCs if option for this designation of business, for offering a professional service
  • Link about PLLC requirements and formation legalities: https://boc.wv.gov/uploads/1/4/8/4/148467522/4.04._formation_and_approval_of_professional_limited_liability_companies.pdf
  • Initial filing fee and renewal fee
  • $1 million PLLC insurance (proof of insurance required or assets)
  • Annual report required to be filed with the SEcretary of State
• FinCEN required (federally) with reporting

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 – http://chirosecureform.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.

• Common insurance companies include United Health Care, BlueCross (Blue Access, Highmark), Aetna, Cigna, and CareSource. Links below allow you to apply for participation in their networks.
  • Highmark: https://hbs.highmarkprc.com/Credentialing/Professional-Initial-Credentialing-Set-Up
  • UHC (viaOneHealth) https://www.uhcprovider.com/en/resource-library/Join-Our-Network.html
  • CareSource: https://www.caresource.com/providers/education/become-caresource-provider/
  • Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
  • Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network

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. 1. 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

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: administered by the Department of Healthcare and Human Resources / Bureau of Medical Services 

• Treatment is limited to manual manipulation for subluxations of the spine, and diagnostic radiology related to chiropractic services
• Must be related to a significant neuromusculoskeletal condition
• Maximum 20 treatments per calendar year without prior authorization
• X-ray reports must be submitted with prior-authorizations for additional visits
• Adjunctive therapies are not covered
• Handbook: https://dhhr.wv.gov/bms/Provider/Documents/Manuals/Chapter%20519%20Practitioner%20Services/Policy%20519.7%20Chiropractic%20Services%20FinalApproved.pdf