Answers to commonly asked questions about ChiroSource & Chiropractic Health Plan of California
How many lives does CSI/CHPC cover and who do you contract with in my area?
Through our contracts with most of the largest PPO’s in the nation, over 128 million Americans potentially have access to our contracted chiropractors for health benefits, over 97 million for workers’ compensation and approximately 33 million for personal injury and automedical policies. Most of our clients do not maintain information on the geographic distribution of their insured lives. The best information that is available to us is provided in our membership application package. Please click
here to request an application.
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Why does CSI/CHPC charge a fee to participate and why is it a good investment for my practice?
Collection of provider fees off sets costs associated with credentialing and provides funding for our marketing efforts to further expand your patient base. While some managed care companies do not collect fees up front, be assured that they are collecting fees elsewhere, usually by taking between ten to forty percent of your claims which costs much more than our modest fee. Additionally, we work with PPOs and not HMOs, so our providers are paid about three times higher than HMOs pay.
Unlike when people used to look in the phone book for a chiropractor, most people now look to their health insurance plans for referrals to health care providers because they will pay less money out of pocket and have better benefits if they see a participating provider. As a participating provider, you will become available for referral. When compared with the
cost of a phone book advertisement..., well, that says it all!
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Is there an annual fee - how much?
Yes, the fee is half of the first year’s full membership fee. In some regions of the country the renewal fee is charged only once every two years.
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Is the membership fee negotiable?
There are certain situations when we will offer a discount from our normal fee. Please call (800) 995-2442 to inquire with a network development representative.
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What happens to my fee if my application is not approved for membership?
The entire application is returned, including payment. No processing fee is held.
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I don’t include all types of insurance in my managed care practice, can I choose the types of insurance plans I want to participate with?
Yes, included with our application is an addendum, all you need to do is sign up for the products that you want to participate in. Please be aware though that a few of our PPO clients may not accept you unless you agree to participate with all types of insurance plans. Please call our toll free number to find out which, if any PPOs in your state do not permit providers this option.
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What is the fee schedule for CSI/CHPC programs?
Fee Schedules are available in the CSI/CHPC application. Please click here to request an application. CSI/CHPC negotiates fee schedules with each client independently. Benefit structures are defined by each payor.
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Can I have the names of CSI/CHPC providers in my area for reference?
CSI/CHPC does not release provider names to anyone but CSI/CHPC clients. We do not feel it is appropriate to ask our providers to interrupt their busy schedules for this purpose.
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When will my name appear in the provider directory?
Most CSI/CHPC clients are now using 800 telephone and online
computer directories. You can be available for referral through those electronic directories within 4 to 6 weeks from our receipt of a complete application. Printed provider directories are usually released annually by CSI/CHPC clients, each with their own issue date.
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Is there any guarantee that I will see patients?
CSI/CHPC cannot control the patient’s choice of provider, therefore we cannot guarantee that patients will choose to be treated in your office.
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Are providers exclusive by geographic area?
CSI/CHPC does not assign geographic areas to providers in our PPO, EPO or POS programs, however we do set maximums for every city in every state. Many HMO plans do assign specific areas to providers. In cases where assignment is given, existing providers are given priority.
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Is my area opened to new providers?
Memberships with CSI/CHPC PPO, EPO, and POS plans are open to qualified chiropractors in most cities. In many areas of the nation, however, our network is complete and has been closed to new applicants who are not affiliates of existing CSI/CHPC providers, unless nominated by a member of a participating health plan.
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How long does it take for my application to get approved?
Approved applications are made effective on the 1st or 15th of each month following approximately one month of processing time. Only complete applications will be considered. All others will be returned to you for completion. Please do not submit incomplete information!
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What are the administrative requirements for providers?
As a participating provider, you must agree to accept assignment of insurance benefits. Upon approval of your application, CSI/CHPC will forward you a ChiroSource or Chiropractic Health Plan of California Provider Manual which will explain how to verify eligibility, send claims, and if it is required, how to obtain authorization for treatment. The CSI/CHPC “Initial Report” is a very straight forward, one page, one sided form that is reviewed by a chiropractor. If a patient requires additional care, there is an additional one page, one sided “Supplemental Report”.
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How long has CSI/CHPC been in business?
ChiroSource, Inc. was incorporated in May of 1997 and was founded by the owners of Chiropractic Health Plan of California which was incorporated in 1986, as a regional chiropractic network in California, Nevada and Texas. Preferred Utilization Management, Inc., our utilization management company was incorporated in 1984.
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