Million-dollar Practice: Top healthcare reimbursement strategies

Tips to take your practice over the $1 million mark with the leading healthcare reimbursement strategies

The doctor I externed with was a great influence over my life and practice. This doctor taught me more about chiropractic practice than I learned from just about anywhere else in life. This is why I give back, having interns and coaching other doctors, especially when it comes to healthcare reimbursement strategies.

This doctor was phenomenally successful by any stretch of the imagination in practice and life. But he always fell just short of a million dollars in collections. He was obsessed and just could not quite get over this hurdle. So, when I started a practice this became a de facto focus of mine, to break $1 million. It took over 10 years to get there, and I never went back below that collections mark. It felt good to get over a million and it is a sign of business success, but it does not mean everything.

Here are some tips to maximize healthcare reimbursement to increase collections, no matter how large of a practice you have:

Insurance analysis

The first step we do on all new patients is a thorough insurance verification. Before we develop a treatment plan with a patient, we want to know exactly what is covered.

Do they have DME coverage, is there a visit limit, do they need pre-authorization? We need to know exactly what is covered up front. I also would rather charge the patient for deductibles and copay up front, rather than try to collect it months later after treatment has ended.

Get the information up front. Some things to check include DME coverage, deductible, copay/co-insurance, visit limit, pre-authorization, out-of-pocket max, etc.

Durable medical equipment

Not all areas of the country have a DME benefit, but many do. A lot of insurance policies cover DME that patients want, will use, and will help them get better and stay better.

DME benefit is usually different from chiropractic benefit. Sometimes we will find that a patient has mediocre chiropractic coverage but has excellent DME coverage. Get some training in this — my biller is a certified DME specialist and I have attended many seminars.

Some DME to look at for a chiropractic clinic include orthotics, back braces, TENS units, knee braces, and wrist and cervical braces.

Healthcare reimbursement and cash services

I do not believe in turning a chiropractic office into the local pharmacy. Has everyone else noticed they seem to sell everything but medications?

I think a chiropractic practice should be about chiropractic. But look for other related areas of revenue. We offer spinal decompression as a cash service, DOT physicals, CBD products, drug testing, breathalyzer testing and more.

Don’t overwhelm your practice, but look for other services you can offer and charge cash for.

Collections — front desk and billing

Again, the key to good collections is a proper verification up front — that solves 90% of collection problems. Other tips include billing daily or weekly, and keeping collections coming.

Review the aging report with your biller weekly. Make the time to do it. Call on delinquent accounts and make sure to keep up on the lawyers. If you are doing PIP, no-fault, workers comp., etc., we all know how shady some lawyers can be.

For my clients and my own clinic, we separate out front-desk collection from insurance collections. Front desk is literally everything that comes across the front desk such as copay, deductible and cash services. Besides adding cash services, we can increase front-desk collections by making sure copay and deductible are handled up front. The majority of our patients will pre-pay for care and deductibles. If they choose to pay as they go, they pay on the way in; no sneaking out after a visit without paying.

Add retention and you’re golden

These are some tips to increase collections. Besides the strategies above, working on retention is a key to getting total collections higher.

If a practice can get every patient to come in 2-3 extra visits over time, those visits add up quickly to big numbers for collections. Also, a handful of extra new patients per month can really add to the bottom line.

Do not forget the three metrics to measure in practice:

• New patients
• Patient visit average (retention)
• Office visit average (collections)

A 25% increase in all three numbers will double a chiropractic practice. Keep growing and keep measuring.

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.