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Cash or Insurance Practice? Why Choose One?

Wednesday, January 11th, 2017

Mark Sanna, DC, ACRB Level II, FICC 

The expansion of Obamacare has made insurance policies with $10,000 to $15,000 deductibles  commonplace. Savvy health care consumers are making more cautious decisions about where  to spend their discretionary healthcare dollars than ever before. This leaves many chiropractors  struggling with a choice of being a cash or insurance‐based practice. They wonder if the  increased demands upon their and their practice team members’ time that come with  accepting insurance is a viable business model for their practice future.  Many chiropractors  facing this dilemma feel that they must choose either cash or insurance as an “all in” or “all out”  strategy.

The Either/Or Scenario 

Chiropractors who choose to opt out of insurance reimbursement do so because they believe  that removing the burdens of dealing with third party reimbursement will reduce their daily  level of stress and free them to offer patients more affordable payment options. Many times  these practices offer services at reduced fees. Due to their lower fees, seeing a high volume of  patients is often the way that these chiropractors can generate a level of income that will  support their overhead and lifestyle.

Chiropractors who choose to focus solely on the insurance‐based model of care confront a  different set of problems. With increased limitations on chiropractic coverage, including the  number of visits allowed, these practitioners often times tailor their patient recommendations  to the level of services covered by third party payers. Practicing to meet the requirements of  insurance payers takes the focus away from the patient’s health needs.

I’ve seen chiropractors place themselves and their practice in jeopardy because of their lack of  knowledge of the significant regulatory and compliance requirements that remain in place  whether they decide to accept insurance or not. The “let’s make a deal” payment plans offered  by both cash‐only and insurance‐based practices walk a fine line between what is legal and  what is not. Offering the same service for different fees is considered a dual fee schedule and is  illegal.

Blend the Best of Both 

No wonder chiropractors are confused. Let me assure you that it is possible to create a practice  that blends the best of both cash and insurance. Your practice can deliver affordable care to a  high volume of patients while meeting the requirements of insurance reimbursement.                                            This may be easier to achieve then you may think. The first step is to establish a compliant fee schedule  that allows you to accept limited insurance coverage while at the same time offering your  patients legal discounts. This can only be done by joining a recognized Discount Medical Plan  Organization (DMPO) and creating a cash‐based fee schedule that is published and available to  all patients regardless of their level of (or lack of) insurance coverage. A DMPO allows you to  blend covered and uncovered services into an affordable payment plan that fits the financial  requirements of care into the patient’s family budget. It also allows you to inform patients what  their financial responsibility will be from their very first visit. This removes stress from  providers, practice team members and patients.

Moments of Truth 

Along with compliant patient financial procedures, the blended practice has a system of  compliant patient care procedures that begin with a new patient’s first interactions with your  practice. How your practice team handles these moments of truth is essential to your success.

Patients make both conscious and subconscious decisions as to how much they are willing to  spend when they purchase care from you. You can build the perceived value for your care by  creating an extraordinary first visit experience for your new patients. When delivered correctly  you should regularly hear the words, “That was the most thorough examination that I have ever  received—I feel like I’m in the right place!” To consistently achieve this high level of perceived  value requires you to take a fresh look at the services you provide on a patient’s first visit.  These include: your consultation and examination procedures.

Build Value with Your Consultation & Examination 

New patient procedures begin with the consultation. During your consultation, let patients  know that you’ll be listening closely to the answers that they provide to the questions that you  ask them while taking their history. Let them know that their answers will guide you in the  choice of which tests you will perform and which instruments you use during their examination.  Let them know that this allows you to customize their examination to specifically look for the  cause of their condition. Custom‐designed items and services carry a higher perceived value  then their off‐the‐shelf, generic counterparts. By letting patients know that they will be  receiving a customized examination you increase the value that they place upon your service.

You can add tremendous value to your examination procedures simply by recording them with  a digital recorder. Inform the patient that you record all of your examinations and get their  permission for the recording. Recording your exam accomplishes several goals. Most people  don’t like to hear themselves recorded. For this reason, patients tend to be quiet during your  examination and this allows you to proceed with your examination without extraneous  comments and conversation.

As you examine the patient, call out your findings to the recorder. Rather than the typical  silence on the part of the examiner, which can be confusing and unsettling to the patient, you’ll  be providing value‐building information. A patient undergoing a Lasègue test may think that  you are simply lifting their leg until it hurts. Calling out the finding “Lasègue test positive on the  right hand side at 45 out of 90 degrees for L5 nerve root tension” lets the patient know that you  have found something wrong with them. This will limit much of what is covered in a traditional  Report of Findings. The patient has listened to your Report of Findings during the examination  process. This raises the value of the entire procedure and lets the patient know that you are  actively examining them to uncover the cause of their problem.

Build Value with Your Report of Findings 

I counsel my clients to avoid adjusting their new patients on their first visit. Providing palliative  therapies to decrease pain and inflammation is encouraged. Adjusting the patient immediately  following their examination decreases the perceived value of your care exponentially. How  significant could the patient’s problem be if you determined the cause and applied the  correction within minutes of meeting the patient? If you feel that you absolutely must deliver  an adjustment on the patient’s first visit, I encourage you to send the patient home for several  hours to rest while you review your examination findings and create your plan of care. Have the  patient return later in the day for their report.

Having the patient return for their Report of Findings and first adjustment gives your practice  team time to verify insurance benefits. You will know the patient’s level of coverage and the  doctor will have created an initial plan of care. You can now estimate the patient’s financial  responsibility for their course of care and create a payment plan without the stress of having to  do it on the spot, while the patient is waiting to receive care. You can deliver a financial  consultation to the patient immediately following their Report of Findings.

Begin your Report of Findings by confirming to the patient that your examination uncovered  the cause of their condition and that you have the ability to provide them with the care that  they need. At this point patients will be concerned with two primary questions: they want to  know how long it will take and how much it will cost. The blended practice, utilizing a compliant  DMPO fee schedule can make a recommendation for care based upon what the patient needs  and not what their insurance does or doesn’t cover. This allows you to give the patient your  recommendations for care based upon your estimation of how long it will take for their  condition to resolve and not their financial circumstances.

Increase Case Acceptance 

Add these steps to your new patient procedures and you will increase the value of your care in  the eyes of your new patients. Handling patient finances skillfully, upfront by blending
insurance benefits and cash in a unified payment plan decreases stress and increases case  acceptance. Patients are more likely to follow through with your recommendations when their  financial commitment has been taken care of in advance when their perceived value of your  service is at its highest level.

 

At Scrip Hessco, chiropractors can find the products that they require, easily, conveniently, and affordably. Scrip Hessco’s massive inventory allows chiropractors to search for specific items, or browse for new and exciting options. The most successful chiropractors are the ones that are constantly evolving and taking necessary steps to keep business fresh and interesting for the patients, as well as for themselves.

For more than 40 years, ScripHessco has been the leading full-service distributor of chiropractic supplies such as Biofreeze and equipment to the chiropractic industry. Rely on ScripHessco to help you serve your patients and grow your business with popular resale items.

 

Improve Patient Health by Offering Vitamins and Supplements

Friday, July 26th, 2013

In order to keep things diverse and interesting, many chiropractors choose to sell health-related products to their patients.  This is beneficial for many reasons.  Offering unique products and services is one of the easiest and most effective ways to gain new patients, and keep the old ones coming back in again and again.  Not everyone gets chiropractic adjustments on a regular basis, so offering other health products is a great way to give them a reason to come in more often.

It is always a good idea to offer products that help to improve a chiropractic adjustment.  Cleansing teas like Chiro-Klenz are an excellent way to compliment a chiropractic adjustment.  This tea will help to cleanse the body of toxic buildup, which will in turn make the chiropractic adjustment work better. (1)  The body is interconnected and taking a full wellness approach to patient’s health is always going to make the end results better.

Another great idea is to offer natural, safe dietary supplements.  There are plenty to choose from, and it is definitely important for you to do some research before you offer them to your patients.  There are dietary supplements out there that may not be safe, so it is important that you seek out only the ones that you truly believe in.  Some dietary supplements are for appetite control, others are for colon cleansing, and others help to improve the digestive system.

Vitamins are one of the most common supplementary products found in chiropractor’s offices.  There are certain vitamins that are designed for specific purposes.  For example, the Total Joint Complex vitamin supplement has ingredients that make it highly effective as a treatment for osteoarthritis. (2)

Fish oil is another excellent supplement to offer patients who are looking for a way to get omega-3 fatty acids, which is high in vitamins, minerals, and protein.  Studies suggest that fish oil is highly beneficial for many common diseases, including cardiovascular disease, cancer, asthma, and depression, just for starters. (3)

Echinacea is a powerful herb that has many extraordinary health benefits.  Taking Echinacea supplements on a daily basis will boost the immune system, and will also treat or prevent common illnesses like the common cold and the flu. (4)  This incredibly versatile supplement is used to treat a myriad of afflictions, including acid indigestion, pain, tonsillitis, strep throat, and much more.

There are plenty of other wonderful vitamins and supplements that a chiropractor can offer.  It is very important to take some time to learn about each one, so that you can stand behind your products.  Being able to recommend various supplements based on a patient’s specific needs will help to make you a more reliable source of information, and thus a better healer.

For more than 40 years, Scrip Hessco has been the leading full-service distributor of supplies and equipment to the chiropractic industry.  Rely on Scrip Hessco to help you serve your patients and grow your business with popular resale items.

(1) – http://www.claremont.com/story/Chiro-Klenz-Tea-for-the-Best-Results/1231208

(2) – http://www.webmd.com/vitamins-supplements/condition-1442-Osteoarthritis.aspx?query=

(3) – http://www.webmd.com/diet/features/what-to-know-about-omega-3s-and-fish

(4) – http://www.medicalnewstoday.com/articles/252684.php

Kinesio Tex Precut Tape

Thursday, July 7th, 2011

ScripHessco – Chiropractic equipment provider

ScripHessco now carriesKinesio Tex Tape Precut Strips

Available in:

  • Kinesio Pre-Cut Back – designed to support over stretched back muscles, lower back pain, lumbago and sciatica.
  • Kinesio Pre-Cut Neck – designed for neck pain caused by muscle strain or ligament sprain.
  • Kinesio Pre-Cut Shoulder – designed to provide support for shoulder muscles, treat rotator cuff injuries and relieve shoulder pain.
  • Kinesio Pre-Cut Knee – designed for runner’s knee, provide knee and patella support, and alleviate associated pain and swelling.
  • Kinesio Pre-Cut Wrist – designed to provide support for carpal tunnel syndrome, provide wrist support and alleviate associated pain.
  • Kinesio Pre-Cut Foot – designed for plantar fasciitis, support of the arch of the foot and alleviate associated pain.

What is Kinesio® Tex Gold™ ?

By now, many people have been able to observe the highly visible athletic uses and the familiar colors and taping patterns used by successful Olympic and professional athletes. But Kinesio® Tex Gold™ is more than an athletic tape. It is a unique therapeutic tool that has provided new options in rehabilitation and sports medicine throughout the world.

This amazing elastic therapeutic tape has been designed and engineered by Dr. Kenzo Kase for more than 30 years in Japan. Since then, Kinesio® Tex Gold™ has become the standard for therapeutic and rehabilitative taping.

Kinesio® Tex Gold™ sets the standard for elastic therapeutic taping.

  • It creates a lifting effect on the skin’s surface, which improves circulation and relieves pain.
  • It may be applied using different amounts and directions of tension, so the tape has the ability to relax or stimulate muscles.
  • It is made of gentle cotton fiber.
  • It features a 100% medical-grade acrylic adhesive.
  • It is totally latex free.
  • It does not limit the wearer’s range of motion.
  • The distinctive wave-pattern weave moves with the wearer’s movements.
  • It allows for 3 to 5 day wear time to provide 24-hour results to the patient and to provide for an economical treatment.

The Kinesio Taping® method utilizes Kinesio® Tex Gold™ to facilitate the body’s natural healing process while allowing support and stability to muscles and joints without restricting the body’s range of motion. It is used to successfully treat a variety of orthopedic, neuromuscular, neurological and medical conditions. Both Kinesio® Tex Gold™ and the training protocol have shown results that would have been unheard of using older methods and materials.

 
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