ROAD TO PRACTICE:
Maine
1. Join State Association
Web page link
Membership Fees
Membership Type | Fee |
1st Year Providers | $187.50 |
2nd Year Providers | $330.00 |
Full Membership | $700.00 |
Member benefits
- CEUs
- Annual conferences
- Find-a-Chiropractor directory
- Marketplace and Career resources
2. License Requirements
Website to apply for license:
https://www.maine.gov/pfr/professionallicensing/professions/chiropractic-licensure
- Fingerprinting, and background check required
- Note: Chiropractors are mandated reporters
- Initial fee: $100 +21 for Maine Bureau of Investigation for criminal background check
NBCE Requirements:
Parts I*, II*, III* and IV*, PT: Required – PASSING SCORE IS 375
NBCE Acupuncture accepted.
NBCE SPEC required
STATE SCOPE OF PRACTICE:
Contact State for precise definition by state law.
Scope: See 32 MRSA Chapter 9, http://www.mainelegislature.org/legis/statutes/32/title32ch9sec0.html “Chiropractic” means the art and science of identification and correction of subluxation and the accompanying physiological or mechanical abnormalities. The term subluxation, as utilized within the chiropractic health care system, means a structural or functional impairment of an intact articular unit. Chiropractic recognizes the inherent recuperative capability of the human body as it relates to the spinal column, musculoskeletal and nervous system. Doctors of Chiropractic are health care providers functioning within their scope of practice as provided by this chapter. Chiropractic methodologies utilized for the identification or correction of subluxation and the accompanying physiological or mechanical abnormalities include diagnostic, therapeutic, adjustive or manipulative techniques utilized within the chiropractic profession, excluding prescriptive medication or surgery. See new board rules for precise description of “Chiropractic Adjustive/Manipulative Technique”.
Synopsis taken from FCLB.org
CONTINUING EDUCATION:
- Annual renewal by Dec. 31
- 24 hours per year
- Accepts PACE
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
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 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
-
NCMIC – https://www.ncmic.com/malpractice-insurance/how-to-apply-online/
-
ChiroSecure – http://chirosecureform.com
-
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.
6. Participating with Insurance Providers
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:
- Standard authorization release; updated every 120 days
- Professional liability insurance verification (proof of insurance)
- State license (copy)
- W9
Common insurance companies include Aetna, Anthem Cigna, Community Health Options, Harvard Pilgrim Health, UHC (Optum)
Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
Anthem: https://www.anthem.com/provider/credentialing/
Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network
Community Health Options: https://www.healthoptions.org/media/3316/health-options-providercredchange-form.pdf
Harvard Pilgrim HealthCare: https://www.harvardpilgrim.org/provider/
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 Participation
MaineCare program
- Coverage includes spinal manipulation, evaluation and management examinations, and physical therapy services when licensed appropriately
- https://legislature.maine.gov/legis/statutes/22/title22sec3174-CCC.html
- Legislation previously passed by MCA to allow chiropractic reimbursement for their full scope of practice
- Language: https://legislature.maine.gov/statutes/39-A/title39-Asec206.html