The Value of Chiropractic
PERSPECTIVE
Ray Foxworth
DC
We know that price is important to our patients. Most of the calls coming into our office start with, “How much does it cost to see the doctor?” At a time when our profession is under increased scrutiny over being compliant and patients are demanding more access to affordable care, it often leaves us wondering what we should be charging for our services. As a result, more and more providers are lowering their fees to help those who need it. While noble, this decision results in lower reimbursements, money lost to the practice, and eventually diminishes the value of our services across the country.
Luckily, there is a way out of this self-sabotaging behavior. Focus on your value from the patient’s perspective. Value and price are not the same thing, but often we allow our staffs and our patients to think of them as the same thing. Value is the benefit our patients receive from the services we provide, but when price is the only thing the patient is focused on, we lose as a profession. And for the record, our patients lose, too.
Most consultants across the country stress the importance
“They can clearly see the value of chiropractic and now view this as an investment into feeling better and not another debit on their monthly budget. J J
of conducting a formal financial report of findings. We all know the importance of a clinical report of findings, and yet, we largely avoid having the financial conversation with our patients. After we sit down with a patient to discuss how we can help them recover from the pain or dysfunction that brought them to our office, it is equally important for us to explain how the patient will pay for these services. The best time to have this conversation is immediately after you have discussed the plan for helping the patient get better. They can clearly see the value of chiropractic and now view this as an
investment into feeling better and not another debit on their monthly budget.
You can offer your patients affordable payment options. Their concern over the price of care in your office becomes obsolete when you have an affordable way to incorporate care in the patient’s monthly budget. If you think about it, when we purchase a vehicle, most of us would be hard pressed to part with $50,000 on a visit to our local dealership. However, most salespeople rarely discuss the overall price of the car. But they quickly let us know what the monthly payment will be. If it fits into our budget, we drive away in a new vehicle. Having an auto-debit system in your office is an easy way to offer affordable payment options and to keep your patients from feeling the pain of parting with their hard-earned money at every visit.
Even better, auto-debit systems allow patients to have the designated payment amount deducted at a frequency that fits within their budget. If your auto-debit system is integrated into your practice software, this also frees up time that your staff would be collecting and posting payments. How much better would you sleep at night knowing without a shadow of a doubt that your patients’ accounts were being automatically charged whether you’re open or closed, with or without staff, on vacation or not? Always! This is all without any ongoing work to process the payments. This is a win-win for you and your patients.
Don’t forget to reinforce to your patients that regular chiropractic care shows a return on their investment. This is easily done by tracking their progress and giving them feedback at each visit. How are they progressing compared to other patients with a similar diagnosis? How are they functionally improving
^This is an excellent opportunity to improve the value of your services and maximize reimbursement. J J
between visits? Are they meeting their goals? The positive reinforcement from the doctor goes a long way toward letting the patient know that chiropractic works. It also helps solidify the relationship between you and your patient.
Here are some suggestions to help you get your fee system in order. Before implementing these steps, take the time to review your fee schedule. Determine your cost of doing business, review your provider agreements and pull published fee schedules for your state. Utilize websites such as fairhealth.org to review the average price for each service you provide in your zip code. This can be an eye-opening experience if you have not reviewed or increased your fees for a few years.
What do you do with this valuable information once you have it? Establish a new fee schedule if necessary. If you look up a code and see that the average price in your zip code is $100, and the published workers comp fee schedule in your state is $95, and your current fee is only $75, then it is time to make some changes. This example clearly shows that you are losing $20 each time this service is billed to WC, and that your
‘^Finally, if you don’t have a written financial hardship policy in your practice, now is the time to establish one. 5 5
practice is currently charging less than fair market value in your area. This is an excellent opportunity to improve the value of your services and maximize reimbursement.
What about your cash and high deductible patients? Using a discount medical plan organization is a simple and compliant way to offer affordable care to your cash and underinsured patients without de-valuing your services. DMPOs have been around for years and offer a contractual network discount similar to PPO and MCO agreements. Some allow you to set your own level of discounts to ensure that you are not charging less than your cost of doing business on the services you provide. This is a great way to keep care affordable and remain profitable.
Finally, if you don’t have a written financial hardship policy in your practice, now is the time to establish one. Discounts offered in a hardship policy should be based on state or federal poverty guidelines. A sliding scale is established based on where the patient falls within the poverty guidelines. Although we don’t want to perform a wallet biopsy on our patients, it is important that you obtain documentation from your patients to document their hardship. Once hardship is determined, it should only be permitted for a limited time. Once the deadline is over a patient should be required to reapply for hardship in your office.
Implementing these steps and overhauling your fee system will have long-lasting and positive effects on your practice. Patients have a need, and we have the solution. It is our job to help them embrace chiropractic and help them see that value, not price, should be their sole criteria when choosing your practice. If you need help speaking to patients about the value of your services, go to chirohealthusa.com/frof for resources on setting your practice up for success.
Dr. Ray Foxworth is a certified Medical Compliance Specialist and President of ChiroHealthUSA. A practicing Chiropractor, he remains “in the trenches”facing challenges with billing, coding, documentation, and compliance. He has sensed as president of the Mississippi Chiropractic Association, former Staff Chiropractor at the G. V. Sonny Montgomery VA Medical Center, and is a Fellow of the International College of Chiropractic. To request a free one-page financial policy, send an email to info frchirohealthiisa.com.
