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Information for Chiropractors

Essential resources for those who provide chiropractic care to patients.

Manuals

Preferred Radiology Program

The PRP web page explains the requirements and details of obtaining pre-certifications for PET Scans, CTs, and MRIs.

Frequently Asked Questions

1. Referrals to Other Providers

Section 3.5 of the Participating Chiropractic Agreement states that Chiropractors are expected to refer patients to other Participating Chiropractors or Participating Providers. This would include Participating DME (Durable Medical Equipment) providers, Preferred Physical Therapy and Occupational Therapy providers, Preferred Medical Doctors (PMD), and any other specialty for which there is a network. To find a provider in their respective network, from the main page of our website, use the link at the top of the page to find an Alabama Provider.

2. Licensure Issues

Sections 4.2, 4.6, and 4.13 of the Participating Chiropractic Agreement pertain to licensing issues. Chiropractors agree to maintain in good standing all licenses required by law, and to notify the Corporation in writing within seventy-two (72) hours of any action against the chiropractor’s licensure, whether temporary or permanent

3. Professional Courtesy and Collection of Co-Pays and Deductibles/Treating Family Members

Professional Courtesy and the requirement to collect co-pays and deductibles is addressed in section 4.5 of the Agreement. Chiropractors may waive a particular co-payment or co-insurance amount for reasons of professional courtesy. If the Chiropractor, except in cases of professional courtesy, does not bill the patients these amounts or does not make a reasonable good faith effort to collect, or if the chiropractor waives or represents that he waives these amounts, the Agreement has been breached and participation may be immediately terminated.

Professional courtesy may apply when a chiropractor treats his own employees or family members of his employees, or other health care providers. This list is not intended to be all-inclusive, but providers should use professional courtesy at his/her own discretion. It should not be used as a marketing tool by applying it to selected “groups” of people. When professional courtesy is extended, the fees for the physician treating the patient is usually made at a reduced rate, or the co-payment may be waived.

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.

Medical Policies Online

In addition to the policies found in the Participating Chiropractic Manual, our website contains medical policies that apply to providers of all specialties. To find these policies, go to our website, www.bcbsal.com. Click GO at I am a Provider, then under the Guidelines and Policies section on the right hand side, you’ll see the link to medical policies. 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 , and Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies.

If you would like to receive a email informing you of updates to our medical policies, e-mail your provider number and e-mail address to provider_notify@bcbsal.org.

For additional information contact your Network Services Representative or e-mail us at prov@bcbsal.org.