The end of third-party reimbursement is around the corner. It was a great run. There is little evidence that the erosion you’ve seen in the last couple of years will slow, much less reverse. If you don’t adapt, you’ll jeopardize your practice and your livelihood.
Welcome to the future.
This is the first of several posts exploring patient financial education and the transition into a self-pay practice. Will you make the turn? Can your practice thrive in this brave new world? Ask yourself these vital questions:
1. Do you take assignment, submitting the patient’s claims on their behalf?
Yes. Originally offered as a personal service to patients, today you may be inadvertently reducing their coverage and inviting claims cutting!
No. Great. That means you’re distracted by fewer off-purpose tasks, enjoy a lower overhead and a more predictable income.
2. Do insurance companies routinely cut your claims?
Yes. It’s because they can. In actual fact, you’re the third party. You’re not to be trusted. You may be trying to “sell” their policyholder unnecessary care.
No. Apparently you don’t take assignment. Excellent!
3. Do most patients discontinue their care when their carrier cuts off benefits?
Yes. This is an example of the Golden Rule: he who has the gold, rules. Attempting to serve two masters is pure folly.
No. Fantastic! It’s obvious you explain chiropractic powerfully and see it as a way of life, not merely a short-treatment for episodes of back pain.
4. Do you believe that better coding would reduce the amounts by which insurance companies cut your claims?
Yes. These days, this is merely an adult version of a summer camp Snipe Hunt. Better coding simply prolongs the inevitable.
No. It was great while it lasted. But that was then. This is now.
5. Have you added services or procedures in the hopes of offering something that would still enjoy decent reimbursement?
Yes. Whether these services are good or bad, helpful or not, what’s your plan when these services are no longer paid for?
No. Good for you. The “dark side” can be very enchanting...
6. Have you signed a “gag order” as part of an HMO agreement that prevents you from telling patients how useless their coverage is?
Yes. Begin extricating yourself from agreements that demote you from a doctor to a mere “provider.”
Don’t know. Many are surprised to learn they’ve surrendered their free speech rights in exchange for the promise of a constant flow of bargain-hunting patients!
No. Great! You either read those agreements or didn’t sign any.
7. Are you confident with how your staff responds when asked on the telephone, “Are you on my plan?”
Yes. Just make sure it doesn’t involve tap dancing, playing coy or a version of “You’ll-need-to-come-in-and-talk-to-the-doctor.”
No. Start here. Any attempt to free your practice from the bondage of third parties begins on the telephone with a prospective new patient.
8. Do you feel so uncomfortable talking about money that you’ve delegated this to someone else?
Yes. When you were working for insurance companies and getting well paid, it made sense to delegate this task to someone else. But not now.
9. Are you carrying so much personal debt that you’re only making the minimum payments?
Yes. Getting your own financial house in order is essential. It’s a spending problem, not an earning problem.
No. Excellent. You have the maneuvering room necessary to make changes to your practice financial policy.
10. Do you think chiropractic has such marginal value that patients will only come in if someone else pays for it?
Yes. Then you’ve either been attracting “the wrong crowd,” believe what the detractors of chiropractic have been saying or both.
No. Then there’s hope!
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This is not a drill. You have limited time to make some overdue changes. More research, lawsuits or better coding are not solutions. There is hope, but you must begin the process now. Consider Converting to Cash to help you on your way.