ROAD TO PRACTICE:
North Carolina
1. Join State Association
Web page link
Membership Fees
Membership Type | Fee |
Student | Free |
Recently Licensed DC’s | $10/ month |
2nd Year | $20/ month |
3rd Year | $30/ month |
4th Year | $40/ month |
Annual Membership | $680 |
All inclusive | $100/ month |
Member benefits
- State ACA compliant insurance rates, including vision and dental for individuals and groups
- Discounts on brands
- Classifieds
- X-ray certification
2. License Requirements
Website to apply for license: https://ncchiroboard.com/
- License fee: $300
- Certificate of good moral character (3 letter references)
- Certify having read general statutes
- Government ID
- National Practitioner Data Bank self-query
- Jurisprudence exam: online
- Coveres NC laws and statutes
- NC rules and regulations
- Board position statements
- Fingerprinting and background check required
NBCE Requirements:
Parts I*, II*, III* and IV*, PT: Required – PASSING SCORE IS 375
NBCE Acupuncture accepted.
NBCE SPEC only for reciprocity if did not sit for part IV (and passed)
STATE SCOPE OF PRACTICE:
Contact State for precise definition by state law.
Scope: he science of adjusting the cause of disease by realigning the spine, releasing pressure on nerves radiating from the spine to all parts of the body, and allowing the nerves to carry their full quota of health current (nerve energy) from the brain to all parts of the body. Any person obtaining a license from the Board of Chiropractic Examiners shall have the right to practice the science known as Chiropractic, in accordance with the method, thought and practice of Doctors of Chiropractic, as taught in recognized chiropractic schools and colleges, but shall not prescribe for or administer to any person any medicine or drugs, nor practice osteopathy or surgery. Licensed Doctors of Chiropractic may practice in public hospitals. A licensed Doctor of Chiropractic may have access to and practice chiropractic in any hospital or sanitarium in this state that receives aid or support from the public, and shall have access to diagnostic x-ray records and laboratory records relating to the Doctor of Chiropractic’s patients. Free choice by the patient is guaranteed. No agency of the State, County, or Municipality, nor any commission or clinic, nor any Board administering relief, social security, health insurance or health service under the laws of the State of North Carolina shall deny to the recipients or beneficiaries of their aid or services the freedom to choose a duly licensed Doctor of Chiropractic as a provider of care or services which are within the scope of practice of the profession of Chiropractic as defined in this chapter. A Doctor of Chiropractic, for all legal purposes, shall be considered an expert in his field and when properly qualified, may testify in a court of law as to etiology, diagnosis, prognosis, and disability, including anatomical, neurological, physiological, and pathological considerations within the scope of Chiropractic.
Synopsis taken from FCLB.org
CONTINUING EDUCATION:
- $300 per renewal
- Annually, January 1
- 18 per year, 10 must be in-person or live-online
- 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
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NCMIC – https://www.ncmic.com/malpractice-insurance/how-to-apply-online/
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ChiroSecure – http://chirosecureform.com
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General Liability Insurance – https://generalliabilityinsure.com/small-business/chiropractic-insurance.html
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ChiroFuture – https://chirofutures.org/online-quote/
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SDN Insurance – http://sdnins.com/chiropractor.html
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CoverMD – http://www.covermd.com/chiropractor-malpractice-insurance.aspx
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Insureon – https://alliedhealth.insureon.com/resources/cost/chiropractic
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MBS Insurance Services – https://www.mbsinsure.com/solutions/malpractice-insurance/
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USA Business Insurance – https://www.businessinsuranceusa.com/chiropractor-professional-liability-insurance
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CM&F – https://www.cmfgroup.com/professional-liability-insurance/chiropractic-assistant-insurance/
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MACARIO Insurance Group – https://www.macarioinsurance.com/who-we-cover/all-classes-of-business/
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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.
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- 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, Ambetter, AmeriHealth, Anthem, Cigna, UHC (Optum)
Aetna: https://www.aetna.com/health-care-professionals/join-the-aetna-network.html
Ambetter: https://www.ambetterhealth.com/en/nc/provider-resources/join-our-network/
AmeriHealth: https://www.amerihealthcaritasnc.com/provider/join-our-network/index.aspx
Anthem: https://www.anthem.com/provider/credentialing/
Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network
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
- North Carolina coverage for manual manipulation of the spine, office visits are included as part of this benefits package
- X-ray is covered if required to document the neuromusculoskeletal condition (one within a 6 month period without additional documentation of medical necessity)
- Coverage: https://medicaid.ncdhhs.gov/providers/programs-and-services/medical/chiropractic-services
- Fee schedule and covered codes: https://medicaid.ncdhhs.gov/providers/fee-schedules/chiropractic-fee-schedules-archive
- Covered in part of a worker’s compensation law for usual and customary fees.
- Language: https://www.ic.nc.gov/ncic/pages/newchiro.htm#:~:text=Chiropractic%20care%20IS%20covered%20under,to%20state%20or%20imply%20otherwise.