Bob Levoy’s Success File

If you hate discussing fees with patients, you’re not alone. Many chiropractors dislike the task. And patients who want to know why their insurance doesn’t pay for everything, or who complain about fees — or worse, want to “bargain” — can be particularly distressing. As a result, an increasing number of chiropractors are delegating the responsibility of these discussions to staff members — and reaping many benefits.

Those benefits include:

• Many patients actually seem to be more comfortable discussing fees with someone other than their doctor, especially when you are in a hurry because you are trying to stay on schedule seeing patients.
• Employees are less likely than doctors to overlook charges or offer discounts to old friends of the doctor. Most chiropractors and staff members agree: Total income is invariably higher when staff members make financial arrangements.
• Collections also improve when the person making the initial financial arrangements is the one to ask for payment. This policy avoids the “He/she said I shouldn’t worry about the bill”-type excuse for not paying on time.

Action step: The best way to delegate fee discussions and collections is to explain your clinical findings and recommendations to patients. After reviewing the report of findings, refer the patient to a staff member, who will go over the costs involved, insurance coverage, payment arrangements and answer any financial questions.

Reality check: Before delegating the task of fee discussions to a staff member, try to determine if by any chance, that person thinks your fees are on the high side. If so, he or she may unintentionally send the wrong message when discussing fees with patients. For example, if a patient complains about a fee and the staff member responds with a “what-can-I-do-about-it” shrug, it could be construed as tacit agreement. Even saying nothing can come across badly.

Ask each staff member: “How do you feel about our fees? Too high? Too low? About right?” Be prepared for some surprises — at both extremes. There are many staff members who actually put a higher value on the doctor’s, time, skill and knowledge than the doctor does. Take the input from your staff into consideration when evaluating whether your fees are where they should be.

Mr. Levoy, a management consultant based in Roslyn, N.Y., has conducted more than 2,500 seminars for health-care professionals. Those seminars have included programs for the American and Canadian chiropractic associations and numerous state and provincial chiropractic associations.