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Dear Bill | A Cash Practice

Q: I love the idea of a cash practice but to be honest I am scared to death of attempting this, especially in this economy and after just being slammed by Hurricane Sandy.

Do you have any other docs on Long Island that have successfully implemented your program that I can talk to?

Thanks for understanding my concerns and I hope I can go through with this. I'm mostly bald and pulling out the rest of my hair trying to get paid from insurance!

A: Unfortunately, I don't get notified when customers implement the principles of Converting to Cash. (Since we extend a money back guarantee and have gotten few such requests, I assume there is a high level of satisfaction with the material.)

However, far more significant is your observation that you're "scared to death" by the prospect of making the move.

There are only a few things that would cause you to entertain the spirit of fear. Perhaps exposing these would address the real barriers to courageously taking a step forward:

Fear that patients don't value your care – For patients who have little or no financial breathing room in their lives, getting someone to accept assignment of their insurance benefits is far more important than what is done to them or even who does it. These appear to be practice members, but actually have little or no loyalty to you or your practice. So yes, you will lose some of these patients.

Fear that patients you're currently seeing will leave – Make your migration to cash too quickly, and yes, you can put your practice into shock. Bad idea. Take six to nine months to introduce your new, non-assignment policy, and then, only to new patients.

Fear that you don't really have a practice – If you've depended too heavily on insurance reimbursement, and you currently have only a small percentage of "once-a-monthers," it's easy to imagine that you don't really have a practice except for the support of insurance carriers. Your concern may be well founded. Begin today to attract people who actually value their health. It's a different group than those who merely want pain relief. You can get some ideas here.

Fear that your service isn't worth the fee you charge – Would you pay what you charge patients? Out of your own pocket? Chiropractors are notorious for undervaluing their adjustments. Perhaps because they've never paid for their adjustments. (I know. You "paid" by having to endure four winters in Davenport and are still making student loan payments, but that's not what I mean.) You can repair this issue by actually paying for your adjustments.

Fear that you'll make a mistake – There aren't too many mistakes you can make. You can convert to cash too quickly. You can neglect to market to people who value their health. And you can assume that your documentation requirements vanish because you're not longer taking assignment. Oh, and you can make the mistake of not having enough money in savings to support you during the temporary downturn in your income while you make the transition. That's about it.

Fear that you'll have to work harder – Yes, you will almost certainly have to work harder. You'll need to have great clarity about what chiropractic is. You'll need to be a better communicator. And you'll need to become attractive to people who value their health—which is far different than patching up patients based on their limited insurance coverage.

Fear that you'll be successful – The danger here is, "Why didn't I do this sooner?" But regret isn't the real problem with success. Fear of success is usually accompanied by feelings of increased responsibility. As in, "to whom much is given, much is expected." Being proactive and no longer a victim of insurance carriers can be scary indeed. (It's the same fear that prompts parents to vaccinate their children (just in case) or embracing some other herd behavior simply because of the increased personal responsibility that results from going it alone.)

Naturally, if patients have insurance, they'll want to use it. However, the day is long gone in which it makes sense to "accept" a patient's insurance in place of payment!

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From June 17, 2013 7:17 AM

This page contains a single entry from the blog posted on June 17, 2013 7:17 AM.

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