If you are interested in joining the Participating Chiropractic Network, complete the Participating Chiropractor Application and Participating Chiropractor Agreement. To obtain certification for chiropractic visits, view the Chiropractor Visits Certification Form.
Chiropractor Advisory Committee
The Chiropractor Advisory Committee was created to serve as the principal liaison between network chiropractors and Blue Cross and Blue Shield of Alabama. The Committee is most valuable for its ability to represent the chiropractors in their district by giving advice and making recommendations to Blue Cross concerning:
- Medical treatment criteria,
- Utilization management policies and procedures,
- The course and direction of the Chiropractor Network in relation to professional matters involving the practice of medicine, and
- Other matters involving professional medical expertise and judgment of quality care issues.
Advisory Committee members are elected by chiropractors in their district and serve a three-year term.
Advisory Committee Meeting Summaries are available for meetings over the past two years.
Medical Policies Online
In addition to the policies found in the Participating Chiropractor Manual, our website contains medical policies that apply to providers of all specialties. Links to medical policies are located under Policies & Guidelines on the left side of the page. Examples that might interest you are:
- Spinal Manipulation of Non-Neuromusculoskeletal Conditions
- Medical Criteria for Physical/Occupational Therapy and Osteopathic/Chiropractic Manipulative Treatment
- COPES Scoliosis Treatment Recovery System
- Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies
If you would like to receive emails informing you of updates to our medical policies, email firstname.lastname@example.org and request to be added to the medical policy distribution list. Please include your National Provider Indentifier (NPI).
Preferred Radiology Program
For information about precertification requirements for advanced imaging services, view the Preferred Radiology Program page.
Temporary/Locum Tenens Coverage
As a general policy, the chiropractor rendering a service should bill with his or her individual provider NPI. In temporary coverage/locum tenens arrangements, the chiropractor should make an effort to ensure the covering chiropractor is part of the Participating Chiropractic Network.
Chiropractors should keep in mind the following:
- If a non-participating chiropractor must be used, the participating chiropractor may bill for the non-participating chiropractor under his/her provider NPI if the services are provided on a temporary/non-routine basis such as locum tenens.
- If the locum tenens (or covering chiropractor) replaces the chiropractor for more than two weeks, or on a regular, ongoing basis (for example, every weekend), the covering chiropractor should be credentialed through Blue Cross to bill (file claims) under his or her own provider NPI. In this situation, the patient’s medical record should reflect this signature style: “Doctor X covering for Doctor Y.”
The modifiers below may be submitted with the procedure codes on a claim to indicate that someone other than the primary chiropractor is involved in patient care. Although we do not require these modifiers on the claim, any information that can communicate involvement by another provider is helpful in processing.
- Q5 - Service Furnished By Substitute Physician Reciprocal
- Q6 - Service Furnished By a Locum Tenens Physician
Treating Family Members
Professional courtesy does not apply when a provider is treating his/her own family members. Blue Cross and Blue Shield of Alabama does not provide benefits for the professional services of a provider rendered to a member who is related to the physician by blood or marriage or who lives in the provider's household. Payments made in error on these claims are subject to refund recovery.
For more information on chiropractic billing, view the Participating Chiropractic Manual