Web page link

https://anjc.info

Membership Fees

Member benefits

• F4CP membership
• Educational events
• CEUs online, on demand
• Monthly digest “The Back Channel” 
• Insurance support
• Directory listings
• Advocacy efforts and PAC 
• Internal classifieds

Website to apply for license: https://www.njconsumeraffairs.gov/chi/Pages/default.aspx

• $350 for biennial renewal (paid in halves for first two years)
• $125 application fee 
• Criminal background check required, no finger printing
• Online jurisprudence exam $75
• Students may NOT sit for the exam prior to graduation. 
• Application process phases: https://www.njconsumeraffairs.gov/chi/Pages/Phases-and-Timelines.aspx

NBCE Requirements:

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

NBCE Physiotherapy is not accepted.

NBCE Acupuncture is not accepted.

NBCE SPEC is not accepted unless to reinstate a license that has been inactive or expired for 5+ years.

Optional certifications in electro-diagnosis at an additional fee.

STATE SCOPE OF PRACTICE:

Contact State for precise definition by state law.

Refer to N.J.A.C. 13:44E-1.1: The practice of chiropractic means a philosophy science and healing art concerned with the restoration and preservation of health and wellness through the promotion of well-being, prevention of disease, and promotion and support of the inherent or innate recuperative abilities of the body. The practice of chiropractic includes the reduction of chiropractic subluxation and the examination, diagnosis, analysis, assessment, systems of adjustments, manipulation and treatment of the articulations and soft tissue of the body. It is within the lawful scope of the practice of chiropractic to diagnose, adjust and treat the articulations of the spinal column and other joints, articulations and soft tissue and to order and administer physical modalities and therapeutic, rehabilitative and strengthening exercises.

Synopsis taken from FCLB.org

CONTINUING EDUCATION:

• Biennial, by August 31st of odd numbered years
• 15 hours per year (30 per renewal)
• 6 hours per year allowed at a distance
• Required 2 credits in nutrition
• Requires 2 credits in ethics, record keeping, or NJ law
• 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 – 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.

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 from Wellcare NJ, Amerihealth (HMO), Horizon BCBS, Oscar Garden, Oxford Health Inc., United Healthcare.  Links below allow you to apply for participation in their networks. 

• Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
• Ambetter: https://ambetter.wellcarenewjersey.com/provider-resources/join-our-network.html
• Amerihealth https://www.amerihealth.com/resources/for-providers/become-a-provider/index.html
• Horizon (BCBS): https://providerenrollment.horizonblue.com/?root_id=352a6413e16126cff34c58bb148affce
• Osgarr Garden: https://www.hioscar.com/joinournetwork
• 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: administered by the Cabinet for Health and Family Services

• New Jersey Family Care (Medicaid) and Horizon plans may be examples of Medicaid programs.
• Example coverage from Horizon: https://www.horizonnjhealth.com/for-providers/resources/policies/health-services-policies/utilization-management/chiropractic#:~:text=Horizon%20NJ%20Health%20(HNJH)%20will,amount%20of%20twelve%20(12).
• CPT codes 99201-99205, 99211 – 99215, 98940 – 98943 when medically necessary.

• Within scope of practice.