Don’t Put All Your Eggs in the Insurance Basket!
PRACTICE MANAGEMENT
Todd Singleton
If you bill your patients’ services through insurance companies and you are reimbursed sufficiently, then congratulations. I wouldn’t ever suggest that you stop doing something that is working. However, I would recommend that in this volatile insurance climate, it would be unwise to put all of your eggs in the insurance basket.
After years of billing services through insurance companies, and dealing with the repercussions of denials, redundant record requests, and even audits, I decided to go in a different direction with my practice. It has been my experience that insurance companies play by their own rules, which are often unfair. Because of this, I decided to get out of the insurance rat race.
How Insurance Companies Make Money
Insurance companies aie in business to make money, and they make more money if they don't have to pay for your chiropractic services. They determine what services they will cover and how many visits they will cover for a patient. Many healthcare providers complain that insurance companies make money three ways:
• They collect insurance premiums.
• They reject claims from doctors.
• They audit and ask providers for money back that they
have already paid them.
The goals of insurance companies just didn’t align with my goals. If they don’t align with your goals either, you ought to consider investing in more cash-based solutions for your office. It will make you less reliant on insurance and better able to serve your patients as you see fit.
While it may seem convenient to have insurance cover your services, the reality is that it will rarely cover the care your patients need. Patients see this in all areas of health care. Offering patients cash-based services helps you and the patient—not the insurance company—determine the level of care the patient will get. This will allow your patients to feel more in control of their health care and able to make decisions without the fear that insurance will reject their claims.
Transitioning from an Insurance-Based Practice to a Cash-Based Practice
You may find it daunting to change the way your practice produces income, but you can always make the transition slowly. Again, if insurance companies are compensating you fairly, I wouldn’t suggest that you completely stop billing insur-
^If they don’t align with your goals either, you ought to consider investing in more cash-based solutions for your office. ï Ï
ance. I advise that you augment your income with cash services because the odds are you will not always be compensated fairly.
For the first 13 years of my practice, I billed insurance for all services in my office. Now 13 years later, I love being all cash, and I would never go back! Yes, leaving the insurance arena made me very nervous at first, but it was the best move I ever made.
I decided when I went all cash that I needed to broaden the services I offered to patients. I dislike the statistic that says only 7 to 12% of the population seek chiropractic, but as I contemplated that percentage, it made me realize I needed different ways to get new patients into my office, especially since I was going all cash. I knew I would need to find something more universally relevant. I’ve always been passionate about nutrition, but I wasn’t sure how I could build a practice on that. My wife actually suggested that I take what I knew about nutrition to help patients with specific conditions like weight loss and neuropathy.
Offering different nutritional programs in your clinic will make a huge difference for your patients and your income. Intimidated by the process? Start by providing a few extra services in your office. These changes can make a huge difference even in a small office. The best approach is to provide a combination of treatments, supplements, and nutritional programs.
Offering Nutrition-Based Services
Nutrition is a natural addition to your existing wellness
services. D. D. Palmer said that chiropractors should not only pay attention to subluxations, but also to toxins. What your patients eat affects their health and the efficacy of your chiropractic treatments. When you focus on what your patients need, including a good nutritional plan, your patients will heal faster and return to you for guidance. Nutrition can be added easily right into your report of findings. There are specific nutrients that will help with each of the three phases of care:
• Pain-relief phase of care.
• Coll ective phase of care.
• Maintenance phase of care.
In addition to back pain and standard chiropractic care, you can help your patients nutritionally with other symptoms such as:
• Neuropathy
• Weight loss
• Knee pain
• Insomnia
• Hormone balancing
• And the list goes on.
A nutritional program is a set of dietary standards that your patient agrees to follow for a given time. There are many different ways to ensure their success, including offering them coaching, dietary journals, and other services. Nutritional programs will dramatically change your patients’ lives for the better, and they’ll also boost your practice’s income. Weight loss itself is a $60.5 billion-dollar industry and has been rapidly growing over the past twenty years. Your patients are already looking for help, and you can offer them easy, simple, and effective options.
It’s a good idea to consider doing a nutritional program yourself before offering it in your clinic. This will give you an idea of what your patients will go thr ough when they change their diets, and will help you advise them when they come across the various challenges that come up. This will also help you see if the program works, which is essential if you aie going to offer it in your clinic.
Even if your office is small, it is very simple to offer supplements and nutritional programs to your patients. Start simple by adding nutrition in your
report of findings with your patients. There will be patients who want more than adjustments, and you can help them. Who better than their chiropractor to help them with their nutritional needs? Incorporate a simple system to ask your patients what they are looking for regarding health, what things they struggle with, and what their health goals aie.
As your nutritional programs and experience begin to blossom, you can reach out to more members of your community and expand your practice. Holistic nutritional programs can appeal to a wider audience than traditional chiropractic alone, and will bring in many more patients. Your practice will grow as you reach a wider audience, which allows you to help more individuals with their health.
The quality of supplements you choose to sell in your practice is of vital importance. Many supplements produced in the United States aie full of fillers and minuscule amounts of the actual herbs that help the body. Make sure you choose supplements that aie 100% pure and potent with no fillers or additives.
Creating a cash-based practice may take time and effort, but in the long ran, it will be worth it. It will allow you to achieve the goal you had when deciding to become a chiropractor—to change patients’ lives. As you begin to see incredible changes in your patients’ lives, you will be further inspired to reach new goals with your practice, and you won't have the added stress of relying on insurance companies to pay you!
Dr. Todd Singleton, D.C., is an author, speaker, and consultant who has been a practicing doctor for more than 20 years. He ran the largest MD DC PT clinics in Utah before switching to an all-cash nutrition model in 2006. He created a very successful cash practice in Salt Lake City and now spends his time consulting and visiting other offices all over the United States. Today, he ’s helped over 900 doctors implement a wide variety of nutritional systems, rangingfrom simple plug & play protocols to full-fledged nutritional programs.
