Web page link

https://www.virginiachiropractic.org
 

Organization of association

5 districts – NW Virginia, N Virginia, SW Virginia, Central Virginia, Eastern Virginia

Application

• https://members.virginiachiropractic.org/ap/Membership/Application/XpjKqEPG
• Student: $35 per year
• Regular: Prorated based on years in practice, newer doctors get significant discounts.
  • Premier Membership (not prorated): $1400/year
  • This includes your registration for CEUs and attendance at their annual conferences. This translates to mean that if you are a premier member, your CEUs for the year are paid for/included.

Member benefits

• Discussion posts, discounted CEUs and staff training, directory listing, classified advertising
• Two conferences per year, that if you attend will cover your required ceus per renewal.
• Discounts with Member Affinity Program for additional brands/companies that partner with the association

NBCE requirements

• Parts I*, II*, III* and IV*: Required – PASSING SCORE IS 375
• Physiotherapy*: Required – PASSING SCORE IS 375
• Acupuncture: NBCE boards not required; instead requires 200 hours of instruction with at least 50 hours clinical experience supervised by a person legally authorized to practice acupuncture (18VAC85-131). This is not an additional fee when licensing, but you will need to provide materials to the board and they will approve you for this or not. This can be done via email.

NONE

Application Process

1. Online application via the Virginia Board of Medicine: http://www.dhp.virginia.gov/Boards/Medicine/ApplicantResources/ApplyforLicense/
2. Follow this link for “what you’ll need”: https://www.license.dhp.virginia.gov/apply/Forms/medicine/Chiro_instruct_forms.pdf
3. Actual step-by-step list of what you need:
   • Exam scores (certified copies from NBCE sent directly)
   • Transcripts (official) from your school; must be in a sealed envelope
   • Malpractice claims history (If you’ve had any in the past 10 years, or pending cases, you must provide supporting documents.)
   • Employment history from your professional school to present.
     • This should not be a CV. The website says this will be returned. This should instead just be a chronological list of work experience. It is suggested to use the following supplemental form for this but is not required.
     • https://www.dhp.virginia.gov/media/dhpweb/docs/med/forms/SupplementalForm.pdf
     • Pro tip: you will need this for the past 10 years for insurance applications later, so be sure to save this.
   • NPBD Self-Query
     • Found here: https://www.npdb.hrsa.gov/ $4 charge
     • This is used to verify your identity. You will submit this form, it will be mailed to you, and then you either send a digital confirmation to the board or you can mail your paper form to the board. Be sure that if you mail this, it is unopened/sealed. Tracking for mail is suggested.
4. Fees: $277
   1. You CAN start this process while you are still a student, and wait to submit your final documents (ie/transcript) when you graduate.
   2. You have 12 months from when you start the application before fees must be repaid and your application will reset.

“Practice of chiropractic” means the adjustment of the 24 movable vertebrae of the spinal column, and assisting nature for the purpose of normalizing the transmission of nerve energy, but does not include the use of surgery, obstetrics, osteopathy, or the administration or prescribing of any drugs, medicines, serums, or vaccines. “Practice of chiropractic” shall include (i) requesting, receiving, and reviewing a patient’s medical and physical history, including information related to past surgical and nonsurgical treatment of the patient and controlled substances prescribed to the patient, and (ii) documenting in a patient’s record information related to the condition and symptoms of the patient, the examination and evaluation of the patient made by the doctor of chiropractic, and treatment provided to the patient by the doctor of chiropractic. “Practice of chiropractic” shall also include performing the physical examination of an applicant for a commercial driver’s license or commercial learner’s permit pursuant to § 46.2-341.12 if the practitioner has (i) applied for and received certification as a medical examiner pursuant to 49 C.F.R. Part 390, Subpart D and (ii) registered with the National Registry of Certified Medical Examiners. (From FCLB.org)

Telehealth is considered an approved form of practice.

Further regulatory information can be found at: http://www.dhp.virginia.gov/Boards/Medicine/

• Annual requirements for license: $312 biennial renewal
  • 30 hours per year (60 per renewal).
  • Accepts PACE CEUs
• Due dates: In your birthday month, every two The first time that you need to renew, you do not need to supply CEUs.
  • Type 1: CCE approved CEUs – You need at least 30 hours of this type, but can all be this type
  • Type 2: Up to 30 of your hours can be this. This subtype includes things like teaching or providing services to low income areas (volunteering). This requires more documentation, but allows more freedom in what you are doing for providing education.
  • Renewed at the same site that you apply for your initial license.

Note: These can be the CEUs that are supplied by your UVCA membership. If you attend the annual conferences of UVCA, you will receive enough CEUs per renewal cycle by attending these alone.

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

State specific rules

• Link to state specific starting a business: https://www.virginia.gov/state-government/business/

• You need to have a physical address, PO boxes do not apply for address qualifications.
• File your business here: https://cis.scc.virginia.gov/
  • You will need to reserve your name, and can do so before you are ready to actually file your business
  • You will file your articles of organization and registered agent
  • You will also need to register for your business itself for future tax purposes here. In Virginia, chiropractors may file under either PLLC or LLCs, as well as other organizations. However, depending on who reviews your materials, they may want your LLC to be a PLLC or vice versa. Legally you can file for either.

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.

• Common private insurance companies are United Health Care (via Optum), Anthem (BCBS), Aetna, Kaiser Permanente, and Cigna
  • There are many FEDERAL plans that have private health insurance names, based on Virginia’s locality to the Washington, DC area and housing a number of other military facilities. Sometimes, these will require additional “opting-in” criteria when moving to be in network with certain insurance companies. You may want to ask which specific policies you are participating in when you are accepting insurances.
• Links to state specific credentialing
  1. Cigna: https://www.cigna.com/health-care-providers/credentialing/join-medical-network#:~:text=Please%20call%20Cigna%20Provider%20Services,guidelines%20to%20apply%20for%20credentialing.
  2. Anthem: https://www.anthem.com/provider/credentialing/
  3. Aetna: https://www.aetnabetterhealth.com/virginia/providers/join-network.html
  4. Kaiser Permanente: https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/community-providers/mas/2023/healthchoice-practitioner-ancillary-application-for-participation-en-2023.pdf
  5. UHC: https://msrha.files.wordpress.com/2017/03/credentialing_faq.pdf

Note: This list may not be a fully comprehensive list of ALL Insurance companies in Virginia.  For additional insurance companies, consider reaching out to UVCA for more resources.

• 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

UVCA resources on other state-specific tips and tricks: https://www.virginiachiropractic.org/members-only/insurance/

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

In some cases, chiropractic coverage may be included in Medicaid policies but this is not a blanket statement as some documents indicate “alternative medical services” are not considered covered services. The state’s Medicaid booklet also lists chiropractic services as non-covered services.

Link: https://www.dmas.virginia.gov/media/5019/medical-assistance-handbook-final.pdf

See Insurance links of UVCA if different from private enrollments.

https://www.virginiachiropractic.org/members-only/insurance/

See: “Workers Compensation” section for various links on state specific options including limitations on claims, medical providers, and the Virginia Workers Compensation Commission

This is only accessible as a UVCA member

https://www.virginiachiropractic.org/members-only/insurance/

See: “Personal Injury Cases” for various links on state billing and coding details and a guide to PI work
1. Requires UVCA membership
2. Includes a procedural step by step for claims

UVCA Documentation and Coding help (including outcome assessment forms):
https://www.virginiachiropractic.org/members-only/coding-documentation/

Cash Practice resources
https://www.virginiachiropractic.org/members-only/cash-practices/

UVCA’s new practitioner guide
https://www.virginiachiropractic.org/members-only/for-new-practitioners/