Blog, Chirosecure Live Event January 10, 2023

2023 – It’s the New Year – Where are your patients?

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Hi everyone, it’s Sam Collins, your guy for coding, billing, documentation, everything, chiropractic. But today’s program, I’m gonna jump a little bit away from the typical coding and talk a little bit more about just patients and where they come from and give you a little bit of my experience and some things I think you may wanna look at for the new year.

And by the way, very happy New Year to everyone. This is gonna be a good year. It’s a good year for chiropractic. Do know that a couple of states have made some mandatory chiropractic for 2023, Oregon last year, of course mandated chiropractic, and now Colorado. . Now, let’s not get too excited for six visits, but I’ll take it.

So again, we’re moving forward, but let’s talk about what’s going on in your practice. What really makes a practice thrive? What really sets us up? Of course, patience. How many patients do we have? What’s our volume? How much are we making? We are a business. So let’s go to the slides. Let’s talk about where are your patients?

How do we eliminate the barriers to. Here in your office, and I want you to think of this in a few fold and give you some ways of rethinking and resetting yourself for the new year. Obviously everything we have to kind of plan, I would like all of you to write down, okay, what are my plans for this year?

Have something a little more concrete because with everything that you’re going to do, you have to somehow visualize it. And I think a good way of visualizing it is writing it down. Cause without writing it, As it hit, that cliche says, A failure to plan is a failure to plan. So let’s talk about where are our patients and what’s going on with chiropractic care.

What I mean by this is why do people choose chiropractic care? Think about it. . When you choose a service or a business, why do you choose it? Where does it come from? I think obviously people choose chiropractic because we’ve built a good rapport. People get good results. So the why part is one thing, I think getting people in, but you gotta think of when you look at your website, if you look at any of your marketing, if you look at how you present yourself, is it welcoming?

Do people want to be part of that? Do they want to come in the office? Do they want to be helped by you? I’ve learned something from my mom that sticks with. . She always used to say, people buy what they want and beg for what they need. And I wonder at times do we always think of, does someone absolutely need chiropractic?

And I believe so. Of course all of us in chiropractic do. But is that really the thing? Do they really need it or is it something they have to. . So I go with the why not is more than the why. Why do people not come in? What are we doing to eliminate that barrier? Some of it could be fear. Let’s face it, some people go, I don’t know, those back crackers and snapping.

It’s very popular now on social media sites, Instagram, where people will watch people getting adjusted and they love the sound. Obviously, as most chiropractors know, a good sound doesn’t necessarily mean a good adjustment by no means, but nonetheless, that sounds sometimes is fearful. People hear these rumors like, oh, I hear people are getting strokes, and all those things, which of course we know are not true, at least in the levels that they.

is it often just a lack of understanding of how can that really help me anyway? What is it going to do? And I think in many ways that’s often what people have is that what are we doing to educate them on how it helps? And we’ve done a much better job. I’ve been around chiropractic my entire life, my goodness, I’m 62 and I’ve seen it in the infancy at least of the sixties, where people thought, what is that?

A quack chiropractor? And think of how much that’s changed. However, there’s still a lack of understanding. However, I wanna focus on one thing. . I think often the biggest barrier to any healthcare often is just affordability, as you can tell from almost any types of diseases. We have people dying from diseases that we have absolutely cures for, but we don’t have the funds to get that care.

And in fact, to tell you how much we don’t look at this diagnosis code. This, by the way, is a 2023 new. This is a new code for 2023. What does that tell you about healthcare in the US there’s a code Z 91.190, which is literally a diagnosis for a patient who’s non-compliant with healthcare due to financial hardship.

Oh my goodness. We see it all the time. This is where I think chiropractors. Can bridge that and I think we traditionally have and will continue to do and how do we do that? By offering people better access. We’re not as expensive, frankly. It’s more accessible for that reason. Here’s something interesting too, cuz people think do I have to bill insurance?

And I wanna look at this as a very big picture. We know based on National Institutes of Health, they’ve even studied, that showed insurance coverage for chiropractic is not as good as regular. Medical care. We get that. That’s always been true. It’s much, much better. As I mentioned at the beginning, Oregon and states that do have mandatory chiropractic now, but still data suggests from the Department of Health and Human Services that people are more willing to increasingly pay out of pocket for chiropractic care.

Why is that? I think part of the reason is if it’s not as well covered, people will pay more or will pay for it because it otherwise is not covered. I also think though we have done a good job in our profession of making people independent, not dependent upon insurance for the type of care we give cuz we can afford it.

meaning a chiropractic visit, that’s 60, 70, $80 a visit. People can afford that. That’s something they can go, okay, that’s reasonable. I can make that happen if you tell them it’s thousands of dollars. Maybe not. Here’s something interesting. The American Physical Therapy Association put this out and it was something that intrigued me.

They said higher co-payments that were $30 or. Decreased the likelihood of a patient coming in. In fact, they found that they basically lost a third of their patients. So I thought does that fit for our profession? Does that work for chiropractic? But I couldn’t even finish the article. And part of the article, it actually said at the end, this association was not evident for chiropractic.

And to me, it made me realize going, oh, there’s our difference because of our lack of dependency on insurance and copay. , we’ve made people more akin to the value of chiropractic. And that’s what I want you to start to think of. How have you set up the value of your service? Notice people are always willing to buy if there’s enough value, if it’s giving them what they’re looking for.

And here’s the good part, how many people go to our chiropractor and they’re like, wow, I can’t I, that, that worked. It’s a unique thing. We do Think of how often a person comes in your office in a lot of pain. Maybe they’re very, IM. They get a treatment and all of a sudden, wow, it’s 50% better. Maybe it’s gone.

That’s unique. Does that help in any place else? No, it doesn’t. In fact, so much so with this, the American Physical Therapy Association actually also said the same thing in their article. They said, we’re a little jealous. Of chiropractors because we feel a twinge of resentment because of the way chiropractors have branded themselves.

We’ve made people understand we’ve not been dependent upon that medical model. So I want you to start to think of where are my patients gonna come from this year though? How do I get them? Can I offer discounts? How about waiving copays or hardships? What about just a prompt pay or a cash discount? You understand, of course, you can’t waive copays at least generically or all the time.

Which means you can have an occasional hardship and there are some things you can do for discounts that varies a little bit. State to state, states like California have a much bigger leeway, Minnesota, but most other states pretty limited. You can’t offer much. So where are our patients gonna come from?

I’ve broken it down to really 12. This is my opinion. I think someone can argue a few more, but I think this is where your patient’s gonna come from. Either someone’s coming in, paying out of pocket, paying cash. Meaning just straight out of pocket. But what about you doing things like, have you set up a prompt pay plan?

Meaning do you have a discount for someone paying at time of service? It may not be much, but could that be enough for a person to say, Ooh, okay, it’s a little bit more affordable. Think of how many things sometimes you buy cuz it’s on sale. Just make sure it’s within legal bounds. But a bigger picture would be, what about prepaid plans?

Have you ever thought about doing? Is that another way of accessing a patient to your office? Because you have to think of why is a patient not coming in if it’s money, how do we make that better? Think how someone sells a car. Notice when they advertise a car, they actually never tell you the price of the car.

They always tell you the monthly payment because if they told you the car was $80,000, you go, oh my God, I can’t afford it. So it’s a matter of breaking it down to see the. And understand what you get in that value. So for cash, we’ll talk a little bit more about it, but that’s gonna be three ways of how have you done that this year?

What are you thinking? How do I make this work for me? Do I have a way for people to access and do they know I even offer it? Let’s face it, someone who doesn’t know have no idea to come in. And then of course, there’s nine different ways of other patients with insurance. Not all of these are good.

Some of these pay horribly. Let’s take number eight, medic. or in California we call it Medi-Cal. That pays horrible. When I say horrible, as little as $17 a visit. I can’t run a practice on that, but what about Medicare? Remember? Ooh, everyone over 65 Medicare. How many people now have Medicare Advantage plans?

I’m gonna say this year will be the tipping point. I haven’t seen the numbers yet, but in 2023, I won’t be surprised if more people have Medicare Advantage plans over regular Medicare part. . Now, Medicare Part B pays only for manipulation, but what about the advantage plans? Could this be a place to access new patients?

Let’s face it. How many of you have a Medicare patient that becomes a very good referral source? They know a lot of people. What about the va? Is that a place you might work? Depending on the part of the country. Could be with Optum or potentially with TriWest, but as do you have access there, those can pay quite well.

What about workers’? , have you taken a worker’s comp patient? I would say I have no problem taking a worker’s comp patient if it’s authorized. What about auto accidents? What are you doing there to market? What if someone’s in an accident? Let’s face it, we’ve had some pretty bad weather across the United States.

Are there more accidents? Should that mean you get more patients involved in accents? It should, unless you’re not out there accessing them. Do people know They can see. . I know one of the things my dad learned early on, my dad was a chiropractor. Some of he learned early on that personal injury case is paid better.

So he made a focus on that in his practice because he realized why wouldn’t I get paid more per visit than not? And I see a lot of doctors now going, wait a minute, if I have one PI patient, I’m getting paid well over a hundred a visit. Why am I fighting for this PPO plan that’s paying me 25? I agree.

What about health savings? . How about an hmo? Not a big fan, but some HMOs can be. Okay. Just remember, if you’re in an hmo, what does that mean? You’re limited with how much you get. I look at HMOs as the 99 cent store of a chiropractic, meaning I have to do a lot of volume. Now, that may not work for you, and that may not be something you want.

And don’t be afraid to say, you know what? I’m not gonna take any of these. I wanna work this way. But you have to really set that up to put yourself in a. that allows you to make this work. Like, how am I gonna get this patient? What about a PPO or standard insurance? Notice there’s lots of different ways.

Some are better than others. What are you emphasizing? Think of it for the new year. Where are my patients? Look at last year’s stats. Were one of these areas lacking? Was it lacking because of a lack on your end or was it because there’s a change in the climate? So we wanna start to make sure to start to access one area.

I would like you to think of, You are running a business and this is nothing else from today. I’d like you to take this away. How are you running that business? I’ve learned, and one of my great mentors has always talked about adaptation and changes. If you’re not adapting and changing, you’re gonna perish, so you always have to change a bit.

Think of those of who have been in practice for 20 years, 30. Are you doing the same things you did then? Of course not. There’s always some updates, so think of it much like any other business. We remember the store Sears. Remember Sears? Everybody went big store. What happened to Sears? They didn’t adapt. If you think of it, Sears probably had the easiest adaptation, was not Sears.

Think of it, they had a catalog. They went to the stores, but why didn’t someone like 20 years ago, wait a minute, we already have a catalog. Why don’t we put it online and let’s get and ship things to people? They didn’t adapt. They’ve closed. Think of what’s happened. Have you noticed now if you go to Target, if you do almost any big store, Walmart, do they all have shipping now?

Yeah, just like Amazon. They’ve adapted. What about Target? That’s an interesting store. If you go into Target, have you ever notice. when you first walk in, they have about three to four aisles of 99 cents. Store items. Now, why did Target do that? Target realized people liked the 99 cents store, so therefore they would offer some things like that to satisfy both ends.

So think in your practice, what have you done to adopt? So I put up this company to join. . Now the joint is very popular. What if they do pre-pay plans? Have you ever thought of doing it? Might it be helpful to you? Could it be something that might increase the volume to your practice? Because patients have access.

Let’s face it. What’s the number one reason people don’t come? Money? Could doing a pre-pay plan help you do that? It could. Now it varies a little bit. State to state, most states, you can simply offer a prepay as long as it’s set up. You bought a certain number of visit. and when you use the visits that, just takes away part of that, if they don’t use the visits, they get a refund.

Some states like Florida, Montana, you have to put money into a trust and it can’t be over a certain amount. But I certainly think, why wouldn’t I use that a little bit? What I’m thinking is I want patients from a lot of places. Your business should be like your investment portfolio divers.

Whenever you put your money all into one thing, is that always a good thing? No. You can get lucky and hit a hot moment. But isn’t it always better for diversity over time? So I want you to think along the lines of what am I doing in my practice this year to eliminate barriers for patient coming in? Am I educating people?

What does my website say about me, about my practice? How do people find me? If someone’s involved in an auto accident, was looking for a chiropractor, would you show up in their. . What if they’re looking for a VA doctor or a doctor who takes Blue Cross or whatever plans you do, whatever you’re doing can work, but you’ve gotta make it work.

So think of what am I planning? Failure to plan. Planning to fail. So think about this new year. What’s gonna change for you? What’s going to update? Obviously it’s up to. But you’ve gotta set something aside. And again, I will say, write it out. Now. I’m the coding and billing expert. I’m gonna suggest you always need continuing education.

You’re gonna always need updates. Come to our complete ICD C P T update to figure out all of these factors. What’s the new codes? What’s the changes? Give yourself a place to go where you’re getting expert information. We have seminars all this month, different time zones. All virtual will be easy for.

Here’s my goal. Have access to the data. Cuz from data then you can make decisions. In fact, I can be there to help you as a staff person. If you join our network, I become part of your office, call me, email me, zoom me. I’m here to help you know what your success is. My success as well. This profession thrives on us all.

I wish you all the best success this year in continuing, and I want you to start to get out and make those things happen. Don’t sit and. Plan it out. Until next time, everyone. Thanks so much. This is Sam Collins.