Point-Counterpoint: Insurance vs. Cash practice for chiropractic

Chiropractic Economics’ Point-Counterpoint is where doctors of chiropractic and health care industry professionals debate the industry’s hottest topics.
This issue: cash practice for chiropractic vs. insurance.

POINT: All-cash is very tough; make sure you know how to deal with insurance

THIS IS A COMMON QUESTION AMONG CHIROPRACTORS and many pundits on either side. I think it’s a complicated question and needs a detailed analysis. I think pulling the plug on an insurance-dependent practice can kill a practice very quickly.

I think for most chiropractors, if they really want to serve people, the answer is both. Many insurance-based doctors lose patients after their benefits run out.

For example, if a patient has 12 insurance visits, and they use them all up, many docs don’t know how to get them to self-pay and lose them. So, if you are insurance-based, or accept insurance, how you deal with patients with no insurance, little insurance, high deductibles, etc., is a large part of how you succeed in practice.

You cannot survive on insurance only. With many co-pays in my own clinic at $70, you are treating many insurance patients like cash as well. On the other side, I believe for many docs, all-cash is very tough. I know of only very few who have done it successfully.

You should certainly attract cash patients and know how to deal with people after insurance runs out, but running only a cash practice for chiropractic business is an uphill battle.

Many patients have benefits; although they may be limited, they want to use them. The key points I would say are to make sure we know how to deal with insurance, which plans to take, how to bill, charges, codes, etc., but also we have to deal with straight-cash patients, and the multitude with limited benefits who are mostly cash anyway.

JAMES R. FEDICH, DC, owns a large multidisciplinary practice in northern New Jersey. He is also the author of “Secrets of a Million Dollar Practice” and host of a popular chiropractic podcast, Dr. J’s Path to Success. To find out more or to contact Dr. J, visit drjamesfedich.com.

POINT: With cash practice, you don’t have to get rid of insurance, but you can be free of it

LET’S DEFINE WHAT CASH-BASED PRACTICES AND INSURANCE PRACTICES ARE, and more importantly, what they are not. Many people think that simply not accepting insurance means they are an all-cash practice and have a chiropractic cash business plan. This may not necessarily be accurate.

Do you accept personal injury or worker’s compensation cases? That’s insurance. Do you provide patients with a superbill for them to submit to their insurance for reimbursement? That’s insurance. Even without an assignment of benefits, these scenarios mean a person is not necessarily 100% cash. And that’s OK — it is even more of a reason to be compliant in coding, documentation, collections and discounting.

There are a ton of benefits to being cash-based — it’s more fun, more profitable, better for retention, and the list goes on. But make no mistake: Being “cash-based” requires expertise and knowledge.

A successful cash practice for chiropractic business plan depends on having a high retention rate, a large enrollment rate and healthy collections.

Keep in mind that the end game is to ultimately be free from insurance dependency. I did not say get rid of insurance — I said be free from dependence on it. You can have a stress-free, fun practice, increasing quality of life for as many patients as possible.

MILES BODZIN, DC, is founder and CEO of Cash Practice® Systems, and became known as “the king of patient retention.” He has appeared in the Wall Street Journal and on The Brian Tracy TV Show; contributed to the best-selling book SuccessOnomics with Steve Forbes; and speaks internationally on the topic of client retention. Learn more at CashPractice.com or call 877-343-8950.

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