Each ChiroCare network provider is placed into a UM tier based upon the provider’s network experience, patient volume, and practice pattern. The tier is used to determine the level of Fulcrum monitoring and the authorization requirement for the provider. The intent of this approach is to lessen administrative burdens for providers that demonstrate a clear ability to manage patient cases effectively and within the health plans covered benefits.

GOLD TIER

• Providers who perform below 150% of the network average frequency of patient cases exceeding 15 visits OR below 150% of the network average frequency of patient cases exceeding 10 visits per tiering year AND The Provider has a Visit average + Service per visit average [V+SV] below the [network avg + 1 Std. Dev].
• There are few prior authorization requirements.
• Encouraged to submit functional outcome assessment data in QConnect

SILVER TIER

• Providers that surpass 150% of the network average frequency of patient cases exceeding 15 visits OR surpass 150% of the network average frequency of patient cases exceeding 10 visits per tiering year OR The Provider has a Visit average + Service per visit average [V+SV] greater than the [network avg + 1 Std. Dev].
• These providers require prior authorizations in order to prevent denials.
• All authorizations end December 31st. New authorizations must be entered beginning after January 1 when eligibility is available.
• Required to submit functional outcome assessments in QConnect for ongoing care approval. 
• Providers who are new to the network and are not in a low enrollment location. 

BRONZE TIER

• Providers that have less than 15 patients in the ChiroCare network per year. 
• There are few prior authorization requirements.
• Encouraged to submit functional outcome assessment data in QConnect. 
• Providers with locations where there is low enrollment in contracted health plans. 

Please Note: Network providers that are new to Fulcrum due to the HSM/Evolent acquisition have been placed into the Bronze Tier.

As a provider, what do I need in order to access my customized portal?

• Each provider is required to provide Fulcrum with a unique email address which will become your username to log into the portal. This email address cannot be shared with other providers.
• If you would like to add a billing company, admin, or anyone else to view your portal account, please use the Add a Team Member feature available within the portal.

Why do I need a unique email address to access my provider portal?

• For privacy reasons, each provider must have his/her own username and password for logging in. The portal uses the unique email address you provided to Fulcrum for the provider portal username.
• Since the portal is customized to each provider, it is critical for privacy reasons that the provider decides who is allowed to access and view his/her account.
• Additional team members identified by the provider can view the customized portal by allowing permission in the Add a Team Member feature inside the portal. This feature also allows the provider to remove any or all permissions at any time.

If I need to change my email address that I have already provided to Fulcrum, what do I do?

• Please email Credentialing@fulcrumhealthinc.org for a change to your email address and then once you receive a confirmation of the change, please create your portal account.

When should I create my portal account?

• Please create your account as soon as possible to view the most up to date resources including plan summary reference sheets, fee schedules, and much more!

How do I create a Fulcrum Provider Portal account?

Its easy! Just follow these steps:

• Step 1: Go to fulcrumproviderportal.com
• Step 2: Enter your business email address

(this needs to match the unique email address that you have provided to Fulcrum.)

• Step 3: Follow the prompts to create your secure password
• Step 4: Familiarize yourself with the portal, customized for you!

Please email us at providerservices@fulcrumhealthinc.org with any questions.

In accordance with regulatory requirements of the Minnesota Department of Human Services (DHS) and the Centers for Medicare & Medicaid Services (CMS) regulations, all payors, including Fulcrum Health, Inc. (Fulcrum) must collect and maintain information regarding disclosure of ownership and cultural competency from all providers in its network on an annual basis. To learn more about the cultural competency requirement, click here.

Fulcrum is requesting that each clinic complete the online form by March 28, 2024. 

Click here to access the Cultural Competency online form.

Click here to access the Disclosure of Ownership online form.

The online forms are located on a secure, encrypted webpage.

Contact us with any questions at providerservices@fulcrumhealthinc.org.

We are now accepting applications from ChiroCare network providers who believe their clinics meet the Centers of Excellence (CCoE) criteria. The application period is open until March 31, 2024.

Fulcrum is excited to announce that the CCoE Self-Assessment, Application, and Attestation can now be completed online for administrative ease.

Please log into fulcrumproviderportal.com, go to Learning Hub tab and then the CCoE tab to access the necessary documents to apply and take the self-assessment.

If you have completed the CCoE self-assessment and received a passing score of 20 or higher, please consider completing the CCoE application.

Current CCoE's do not need to re-apply. Verification review of records begins March 2024.

We encourage you to take a close look at the CCoE program overview.

If you have any questions about the ChiroCare Centers of Excellence program, please contact Dr. Vivi-Ann Fischer v.fischer@fulcrumhealthinc.org.

THANK YOU!

Fulcrum would like to thank the 78 ChiroCare network providers that have been trained and are now able to refer to the federally funded, statewide MN RETAIN study.

We would especially like to thank the following providers that have had patients referred and/or admitted to the study: Art Volker, Hans Thurmer, Molly Magnani, Martin and Matthew Caron, Doug Broman, Rohin Sachdeva, Gavin Spennewyn, Darrick Dierkhising, Jonathon Taffe, Timothy Hammer, Jacob Conway, Sam Lezon, Tim Graff, and Chad Hendrickson.

The study will conclude on May 16th of 2024.