The 7 Secrets To Making Money
by Dr. Miles Bodzin, D.C.
The topic of having a cash practice is really hot right now. Doctors across the country are finding that insurance coverage is getting worse every year. And the recent explosion of doctors doing additional non-covered services such as massage, decompression, and laser therapy is driving this trend even further. So to help sky-rocket your collections while building your dream practice, let’s review The 7 Secrets to Making Money with Cash Practice® Systems.
Secret #1: The #1 secret to making more money is keeping your patients longer. New patients are great. But keeping patients is even greater. And, unfortunately, chiropractors have been lead to believe that all you have to do is educate your patients and they’ll get the big idea and, therefore, stay. Well, we know for a fact that this is just not true. Every doctor (including you) has patients who really got the big idea and still dropped out of care. Have you ever asked why? We have. What we discovered is patient retention has almost nothing to do with patient education. But that’s a topic for another article. Just know that, although patient education should be done, it alone will not lead to increased retention.
Secret #2: Recommend long-term corrective care plans (assuming they need one). This whole idea of telling your patients in a Report of Findings, "Let’s see how you do for a while and then I’ll let you know what we need to do," is a bunch of garbage.
Patients expect you to know how long they’re going to take to get correction. Stop being afraid and just tell them the truth. "Mary, based on the findings of your evaluation, it’s going to take twelve months to get a full correction."
Now, there’s an easy way to tell patients how long their program will be without confronting them. After you go over their X-rays, show them some before and after films of other patients and tell a short story about each case. "Mary, this is Jake when he first came in and this is Jake twelve months later. Can you see how his spine is normal now whereas, before, it was XYZ?" Show four to five cases and then turn to your patient and ask, "Mary, would you like to correct your spine like these other people?" She’s already heard you tell her how long these other people took to get well. Why would she think she was any different?
Secret #3: Have a written service agreement to sell your care plan. We often refer to these service agreements as Cash Plans, Corrective Care Plans, Wellness Care Plans, universal chiropractic care at a fixed fee (or UCCAFF Plans for short), etc. It is important to make sure the plan you are using is compliant and legal. For example, in California, the Chiropractic State Board requires any cash plan be submitted and reviewed by the CA Dept. of Managed Care. Check your own state laws as to what you can and cannot do when it comes to cash plans. We recommend using The Cash Plan Calculator™ for generating customized cash plans for your patients. The plans have been reviewed by attorneys as well as the CA Dept. of Managed Care. They’re professional and easy for patients to understand. To date, nearly 100,000 patients have been placed on these plans.
Secret #4: Offer payment options for your cash plan. Most chiropractors automatically assume that a cash plan is the same as a pre-pay plan. It’s not! Pre-pay is simply one payment option that a lot of chiropractors mistakenly use as the only form of payment for their cash plans. I say mistakenly, because offices that do only pre-pay have one thing in common—hard sales closes with scare care tactics. Call it what you want, but that is what’s generally done. Most of the patients who get scared into pre-pays will not renew their pre-pay the following year. Some do, but most don’t. We have found that, if you offer your patients three payment choices for your cash plan, and then let them choose which is best for them you will no doubt have a much higher percentage of your patients sign up for care as well as a huge increase in the numbers that transition to wellness care the following year. The absolute best three choices you can offer are (1) monthly payments, (2) down payment with monthly payments and (3) pre-pay. Since they choose the payment option, those who end up choosing pre-pay do so because that is what’s best for them, not because they were scared into it. By far, the best payment options for creating life-time patients are options 1 and 2. (See secret #5)
Secret #5: Picture this. Your patient is done with the initial 12 month care plan. You’re now going to go over their follow-up X-rays and let them know they’re ready to go onto a wellness plan. By far, this is where more doctors who are doing care plans lose the patient than anywhere else. Even that patient who really got the big idea will be lost at this stage, if not handled correctly. First of all, if the patient has stuck with you this long, we’re making the assumption they want to stay or they would’ve disappeared long before. So here’s the magic. Which would you rather say to a patient (or hear if you were the patient) at the end of their initial corrective care plan? "Mary, you’re ready for wellness care. Last year’s plan was $3,600, and the new plan will run you $1,800 a year." Doctor, how does that feel to you? How do you think your patient feels hearing that?
Now say this. "Mary, you’re ready for wellness care and the good news is your monthly payment is going down from $300 to $150." How does that feel?
My experience with thousands of chiropractors and patients tells me that the monthly payment scenario blows the doors off any other option when it comes to transitioning a patient from corrective care to wellness care.
Secret #6: This next secret is so powerful, but taught nowhere. This will probably be the first time it has ever been shared to the profession as a whole. Here it is. Never ask your patient to pull out their wallet once they’ve started care with you. Once they sign-up for care, you should keep their credit card or bank account info on file so you can auto-debit their payment. The repetitive physical act of paying for services will most certainly decrease your retention. We have found, across the board, that offices that place their patient’s monthly payments on auto-debit have a higher retention. You don’t want to keep reminding patients that they’re paying. So it’s not just monthly payments that’s key, it is monthly auto-debits. And for anyone not on monthly payments, you can still keep their info on file and process the one-time payment without having them open their wallet. We recommend using the Auto-Debit System™, a Payment Card Industry Data Security Standard (PCI DSS) compliant program that allows you to do both one-time and recurring auto-debits. It also works with the Cash Plan Calculator System™. You need to legally store the credit card data. One of the common practices we see is a doctor’s office storing credit card data in a readable format and then key-entering the numbers into their terminal each month. You are not allowed to store credit card numbers in a way that reveals their numbers. This is 100% illegal. That’s another reason we recommend using the Auto-Debit System™.
Secret #7: The next secret is another one that most of you have not really paid attention to. It is common for chiropractors to know what it costs them to collect insurance money. But how many of you have looked at what it costs you to collect money from your patients? If you’re still sending out billing statements to collect your patient balances, figure out how many staff hours are spent every month doing so. How much postage? For your in-house cash collections, how much time is spent asking your patients to stop at the front-desk and have your CA collect the money? Five minutes? Ten minutes? How much lost CA production is there because she has to stop what she’s doing and ask Mary to pay. Just so she can hear Mary say, "I forgot my wallet. I’ll just pay next time." Just multiply your monthly patient volume times five to ten minutes. Overall, we see most offices are paying fifteen to twenty payroll hours.