Web page link

▶︎ CLICK HERE

NYSCA District Breakdown

▶︎ CLICK HERE

Application

• Practitioner Application Form
  • Mail-In
  • Digital
• Student Application Form

Membership

• Member Landing Page
  Contains; Event Calendar, upcoming CE opportunities, upcoming webinars and other resources
• Member Benefits

NBCE requirements

• Parts I*, II*, III* and IV*: Required – PASSING SCORE IS 375
• Physiotherapy: NOT Required
• ▶︎ CLICK HERE

NONE

• Fee: $294 (subject to change)
• Fill out forms

1. Application for Licensure*
2. Certification of Education*
3. Verification of Chiropractic Licensure in Another Jurisdiction**
4. Verification of Experience**

*NECESSARY FOR ALL NEW PRACTITIONERS

**NECESSARY FOR PRACTITIONERS TRANSFERRING FROM ANOTHER STATE OR TERRITORY

Scope Modernization

Doctors of Chiropractic are required to have 36 CEs every 3 years

• Breakdown of required CEs:
  • 12 Category 1 (Ethics, Documentation and Patient Communication)
  • 24 Category 2 (Clinical)

Note: These are the base requirements, they can be exceeded but must be met every 3 years

Note: Attain and keep a record of all CEs, auditors will ask for proof of completion

Note: Some Insurance Companies require more than these 36 CEs for participation. Check with NYSCA for details

Note: New practitioners are exempt from CEs for the first three years they are in practice. This is true to maintain a license but may not be true to maintain participation with certain Insurance Providers

Note: NYSCA offers CEs at a discounted rate for members year-round, including fall and spring CE conferences. Visit https://www.nysca.com for details.

Step by step instructions

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Step by step instructions

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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

• OUM

• ChiroSecure

• PRI

• General Liability Insurance

• ChiroFuture

• SDN Insurance

• CoverMD

• Insureon

• MBS Insurance Services

• USA Business Insurance

• CM&F

• MACARIO Insurance Group

• Chiroprefered

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.

NYSCA Region Breakdown

▶︎ CLICK HERE

NYSCA REGION 1 (THE 5 BOROUGHS)

DISTRICTS 1-5 (NYC/5 BOROUGHS)

• Aetna (Blue Cross/Blue Shield)
• Cigna
• United Healthcare Oxford
• United Healthcare
• Magnacare
• EmblemHealth (formerly known as GHI)
• Hip/1199/MPN

NYSCA REGION 2 (LONG ISLAND)

DISTRICTS 6 (NASSAU COUNTY) AND 7 (SUFFOLK COUNTY)

• Northwell UHC – separate credentialing
• United Healthcare
• United Healthcare Oxford
• Empire Blue Cross/Blue Shield – Call 1-800-450-8753 and put in a request with the Provider Services department. They will submit your inquiry on your behalf, a representative will then contact you to complete credentialing
• Aetna
• Magnacare
• Multi plan – CAQH
• GHI
• HIP
• Oscar
• Meritain health (uses Aetna network)
• Humana major medical uses GHI network
• Cigna
• 1199

NYSCA REGION 3 (EASTERN NY)

DISTRICT 8 (WESTCHESTER COUNTY)
Coming soon

DISTRICT 9 (MID HUDSON)
Coming soon

DISTRICT 10 (CAPITAL REGION & NORTH COUNTRY)

• Aetna
• Capital District Physician’s Health Plan (CDPHP)
• Wellcare
• Empire Blue Cross/Blue Shield – Call 1-800-450-8753 and send in a request with the Provider Services department. They will submit your inquiry on your behalf, a representative will then contact you to complete credentialing
• GHI
• Cigna
• United Healthcare
• MVP Liberty Mutual

DISTRICT 11 (MOHAWK VALLEY/UTICA AREA)
Coming soon

NYSCA REGION 4 (WESTERN NY)

DISTRICT 12 (CENTRAL NY/SYRACUSE AREA)

• Empire
• Excellus Blue Cross/Blue Shield – CAQH as well as a contract application
  
• MPN (Optum)
• MVP – CAQH

DISTRICT 13 (BINGHAMTON AREA)
Coming soon

DISTRICT 14 (ROCKLAND COUNTY)
Coming soon

DISTRICT 15 (FINGERLAKES/ROCHESTER AREA)

• Aetna
• MVP/Cigna
• Well care
• Independent health
• United Healthcare
• Empire Blue Cross/Blue Shield – Call 1-800-450-8753 and put in a request with the Provider Services department. They will submit your inquiry on your behalf, a representative will then contact you to complete credentialing

DISTRICT 16 (SOUTHERN TIER/CORNING AREA)

• Empire Blue Cross/Blue Shield – Call 1-800-450-8753 and put in a request with the Provider Services department. They will submit your inquiry on your behalf, a representative will then contact you to complete credentialing
• Aetna
• United Healthcare
• MVP/Cigna

DISTRICT 17 (WESTERN NY/BUFFALO AREA)

• Aetna
• American Specialty Health: CAQH
• Blue Cross Blue Shield of WNY: CAQH
• Empire Blue Cross/Blue Shield – Call 1-800-450-8753 and put in a request with the Provider Services department. They will submit your inquiry on your behalf, a representative will then contact you to complete credentialing
• CIGNA Empire
• Evicore: CAQH
• Humana – CAQH
• Independent Health – CAQH
• MagnaCare
• Multiplan: CAQH
• MVP: CAQH
• Optum (ACN group and Managed physical network (MPN))
• United Healthcare
• Univera – CAQH

Note: This list may not be a fully comprehensive list of ALL Insurance companies in New York. For additional insurance companies see health.ny.gov.

▶︎ CLICK HERE

Medicare Enrollment

Medicare Revalidation: PECOS

Tips For Medicare Audit/Record Request Tips

Type Of Audit And Record Requests

Targeted Probe And Education (TPE)

Medicare Training For The Chiropractic Office

How To Bill Secondary Insurance Plans

Which Insurance Pays First

New York State Of Health Insurance Policy (Nyship)

This is a state-run Medicaid program. By credentialing with Medicaid, you can choose to accept NYSHIP.

Note: Medicaid coverage for Chiropractic care varies depending on the provider. Some plans do not cover Chiropractic care.

• NYSCA Workers’ Compensation Fax Cover Sheet
• Workers’ Compensation Exacerbation Documentation
• Workers’ Compensation Maintenance Documentation

MEDICAL FEE SCHEDULE

• District Offices
• Optum Coding Resources

MEDICAL TREATMENT GUIDELINES

• Non-Acute Pain Medical Treatment Guidelines
• Mid and Low Back Injury Medical Treatment Guidelines
• Neck Injury Medical Treatment Guidelines
• Medical Treatment Guidelines FAQs
• Categories of Treatment

FREE ONLINE TRAINING

• Medical Treatment Guidelines Online Training

IMPAIRMENT GUIDELINES (SCHEDULED LOSS OF USE)

• 2012 Impairment Guidelines (Beginning on page 52)
• Impairment Guidelines Overview

NEW YORK STATE WORKERS COMPENSATION BOARD

• Health Care Providers
• Contact Information

AUTHORIZED PROVIDERS

• Authorization Application Information

WORKERS’ COMPENSATION FORMS

• All Forms
• Health Provider Forms

EMPLOYER/CARRIER INFORMATION

• Carrier Contacts & Participation
• Employer Coverage Search

ON-LINE SERVICES

• DTN Lookup
• Health Care Provider Web Forms
• CMS-1500 Initiative
• XML Submission Information
• System Availability

INFORMATIVE LINKS

• Subject Numbers
• Regulations
• Board Announcements

ADDITIONAL QUESTIONS

• Submit Your Questions

Note: For additional information reach out to your local NYSCA District representatives: ▶︎ CLICK HERE

NO FAULT FORMS

• Verification of Treatment by Attending Physician or Other Provider (NF-3)
• Verification of Hospital Treatment (NF-4)
• Assignment of Benefits Form
• Dr. Lein No-Fault Documentation Guidelines

NEW YORK INSURANCE LAW

• Insurance Law Article 51
• Insurance Law Article 52

CIRCULAR LETTERS AND DEPARTMENT OPINIONS

• No-Fault Regulation 68 Opinions

REGULATION 83 – THE NO-FAULT FEE SCHEDULE

• Regulation 83 FAQs

OTHER LINKS

• American Arbitration Association
• New York PIP Arbitration Program

Starting into Practice Guide: The Business Side of Chiropractic by NCMIC 
▶︎ CLICK HERE