You graduated, now what?
As we near the end of the year, the new year brings opportunities to many new graduates. Congratulations on your upcoming graduation. Although it is a time for celebration, it is also time to get the machinery rolling to get you "Started into Practice."
Unless you are going to go backpacking in Europe, the time to begin the credentialing process is now. Here, in order, are my recommendations to get you to the point of seeing a patient.
- First, apply for your state license as soon as possible. Many times states will let you apply prior to graduating, and then they will place your application on hold until your transcripts are sent over by your Chiropractic College. Request that your chiropractic college send your transcripts ASAP.
- Call NCMICto get your malpractice insurance. Once you get your policy number and/or the declaration page you can then move on to the next step.
- Apply for your NPI number. The application will take about 20 minutes to fill out and it is best to do this online. Type 1 NPI is for you, the individual practitioner. If you are going to incorporate, then you will also need a Type 2 NPI number.
- Once you have all of the above, apply for your Medicare approval. Before you see a Medicare patient, you must apply for approval from Medicare. It is illegal for a chiropractor to opt out of Medicare. If you see a Medicare patient, you must be approved by Medicare to do so. The 855i is for you and if incorporated, also submit the 855B for your corporation. If you are going to be an employee associate you would get the 855R. It is illegal to work under another doctor's numbers. The application is 30 pages and must be downloaded, filled out and snail mailed in to CMS. The approval will take three to five months, however while your application is being processed you can see Medicare patients. Hold all claims for the Medicare care until you are officially approved. Once you get your numbers from Medicare, then you can send in your claims.
- Call the customer service department for any PPO contracts you wish to participate. Read the contracts carefully. Do not off-handedly sign every contract. If the contract is not to your liking, then forget them. Check the in-network coverage and the out-of-network coverage. I have found a major PPO carrier that actually has better coverage for out-of-network than in-network!
- Last, check back frequently to the Starting into Practice blog to stay informed and involved!
Good Luck!


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