Web page link

https://thekac.org/

Membership Fees

Discounts for multiple-doctor practices with multiple KAC members. Corporate membership, also available. Multiple levels of membership based on additional benefits.

Member benefits

• Forms for insurance processing and good faith estimates, and more!

• CEUs provided

• Compliance practices materials

• SecureCare membership

• District organization, with meeting for members quarterly

Application Process

• Website to apply for license: https://kbce.ky.gov/
  Kentucky Department of Professional Licensing, Kentucky Board of Chiropractic Examiners
• License application checklist:
  https://kbce.ky.gov/Documents/License%20Checklist%20for%20Web.pdf
  • • Fees and application
    • NBCE scores directly from NBCE
    • OFficial copy of transcripts
    • Copy of Chiropractic College Diploma
    • License verification for previously held licenses
    • 3 character reference letters

• NBCE Part I, II, III, IV, PT required
• No background check or finger printing required
• Jurisprudence exam online after license is issues
• NBCE acupuncture is not accepted
• NBCE SPEC is not accepted unless to reinstate a license that has been inactive or expired for 4+ years.

Doctor of Chiropractic means one qualified by experience and training and licensed by the Board to diagnose his patients and to treat those of his patients diagnosed as having diseases or disorders relating to subluxations of the articulations of the human spine and its adjacent tissues by indicated adjustments or manipulation of those subluxations and by applying methods of treatments designed to augment those adjustments or manipulation. Any person licensed under this chapter may sign death certificates, and sign and execute all legal documents and certificates with the same authority as members of other schools or systems of treatment.

• Scope synopsis from FCLB.org
• Physiotherapy is considered an adjunctive treatment included in the chiropractic license
• Further regulatory information can be found:
  https://kbce.ky.gov/newstatic_Info.aspx?static_ID=688&menuid=226

CEU (for renewal) requirements

• Annual renewal, March 1
• 12 hours per year
• 6 distance hours maximum per renewal
• A maximum of 8 hours can be completed in one day.
• Jurisprudence course required (2 hours) for first year licensees in place of 12 hour CEU requirement
• 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

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, Ambetter, Anthem (BCBS), Molina Healthcare, CareSource, WellCare, Aetna (BetterHealth). Links below allow you to apply for participation in their networks.

• UHC (viaOneHealth) https://www.uhcprovider.com/en/resource-library/Join-Our-Network.html
• WellCare: https://www.wellcare.com/en/kentucky/become-a-provider
• Anthem BCBS: https://providers.anthem.com/kentucky-provider/our-network/join
• Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
• Molina (Medicaid) – “Passport Health” https://www.molinahealthcare.com/providers/ky/medicaid/home.aspx
• CareSource: https://www.caresource.com/ky/providers/education/become-caresource-provider/marketplace/

Map of counties based on coverage: https://khbe.ky.gov/Plans/Pages/2022-Health-Insurance-Companies.aspx

• a. 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/
• 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 Cabinet for Health and Family Services

• Type 85 (individual) or 859 (group) provider
• Providers must be enrolled with Medicare
• Must substantiate medical necessity
• Included services:
  • • Evaluation and management
    • Chiropractic manipulative treatment
    • Diagnostic x-rays
    • Hot or cold packs
    • Mechanical traction
    • Electrical stimulation
    • Ultrasound
• Limited to 26 visits per 12 month period
• Prior Authorizations may apply through MCO
• Legislative language: https://apps.legislature.ky.gov/law/kar/titles/907/003/125/
• Medicaid coverage and contact information: https://www.chfs.ky.gov/agencies/dms/dpo/bpb/Pages/chiropractor.aspx

• As defined in the legislation: section 342.019 
• Right of employees to choose the services of a licensed chiropractor 
• https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=32373#:~:text=of%20chiropractic%20services.-,A%20doctor%20of%20chiropractic%2C%20licensed%20to%20practice%20under%20the%20provisions,provisions%20of%20KRS%20Chapter%20342.