The federal No Surprises Act requires providers and health plans to verify the accuracy of provider contact information every 90 days.

In preparation of this requirement, it is necessary for all network providers to complete the following steps:

1. Log into Fulcrum’s Provider Portal.
2. Simply select the Demographic Updates tab on the home page.
3. Review your current demographics on all clinic locations.
4. Add or edit any information that needs to be updated.
5. If no changes, no action is necessary at this time.

Please complete these steps no later than January 15th, 2024.

Are you knowledgeable about your patient's mental health history?

Have you had the patients complete a screening Assessment form?

Mental health issues among adults are reported to be on the rise.  According to the U.S. Census Bureau’s Household Pulse Survey, about a third of adults overall (32.3%) reported anxiety and depression symptoms in 2023. This statistic shows that anxiety and depression are common and serious mental health issues that affect many people.

Awareness of the interconnectedness of mental health, physical health, and social factors — the biopsychosocial model of healthcare – adds to the ability of chiropractors to recognize health conditions that could be related to stress or anxiety and impacting pain management.

Mental health resources available to both doctors and patients include:

• The Substance Abuse and Mental Health Services Association (SAMHSA.gov)
• National Institute of Mental Health (nimh.nih.gov)
• National Alliance on Mental Illness (NAMI.org)
• 988 Suicide & Crisis Lifeline (formerly the National Suicide Prevention Lifeline)

To view the information in its entirety, visit: Mental Health Referrals From the Chiropractic Clinic (Part 1) - ACA Today

Manual Therapy requires direct one-on-one contact with the provider and is time-based.

Here are important factors to review before billing these services:

• CMT was not performed to the same anatomic region or a contiguous anatomic region (e.g., cervical and thoracic regions were contiguous; cervical and pelvic regions were noncontiguous) as the 97140.
• Clinical rationale for a separate and identifiable service must be documented (e.g., contraindication to CMT is present).
• Description of the manual therapy technique(s) location (e.g., spinal region(s), shoulder, thigh, etc.).
• Time of services performed must be documented of a minimum of 8 minutes.
• 97140 CPT code is appended with the appropriate modifier.
• Service falls within the definition of the code.

If you are billing 98941 along with 97140, the documentation must reflect all of the previously listed factors.

Review the clinical policies on Fulcrum’s Provider Portal if you would like more information.

Going on vacation?

Need a leave of absence from your chiropractic clinic?

Make plans for the care of your patients.

Here are your options:

• Refer your patients to another Fulcrum network provider in your area.
• Close your office and have an emergency number on your answering system.
• Invite a Fulcrum network provider to cover your office and contact Fulcrum.
• Locum tenens which is utilizing an out-of-network provider and contact Fulcrum.

If you choose the locum tenens option, coverage must be 60 days or less. If an extension beyond 60 days is necessary, the provider must become credentialed and contracted with Fulcrum Health. This provider must complete a Temporary Relief Application request by contacting credentialing@fulcrumhealthinc.org and follow proper billing practices.