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Hi everyone, this is Sam Collins, your coding and billing expert for chiropractic, ChiroSecure, and the profession. You know what we need to focus on is where are your patients? Where do they come from? How do we get them? And I want to focus a little bit on the VA because I think it’s a very underserved potential patient that you have that many times you’re not getting them because you’re not aware, or maybe more importantly, they’re not aware.
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So let’s get into a little bit of how to diversify your practice, how to probably increase your bottom line. Let’s go to our slides. Let’s think of where do you patients come from? You’re really going to have, I would say, 12 different types of patients, whether they’re cash patients, which I think there are three types, and then insurance patients.
And the one I want to focus on insurance patients, would be the ones under the VA, under the Veterans Administration. This is one that I think has been underserved by the chiropractic population. It’s because it’s misunderstood, and I think it’s underutilized. By people who have access to it. So let’s talk about where do we get VA patients?
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One thing for sure, think of it this way. How do patients even know their benefits for chiropractic through the VA? Where have you ever seen any type of commercial or any marketing at all? Actually the VA posts these on their website where you can use these on your website, you can badge onto your website or business card or make a sign, but think of it as someone’s driving by your office, how do they know you even treat veterans?
Without having a sign, maybe not. Think of it. Chiropractic, I think, has done a phenomenal job of marketing for people for what you do well. How often do you see chiropractors talking about they treat personal injury? They treat workers comps, sports injuries. If someone doesn’t know, they’re not likely to access it.
I would say if you ask the average veteran, are there benefits directly for chiropractic? Most are going to say, What are you talking about? There absolutely isn’t. When there is and has been for quite a while. It’s through a program we call VA or is called VA Community Care. It provides medical care to eligible veterans and their dependents.
Now, let me be clear, this part is not for dependents, but ultimately for dependents in some instances, for community providers, for something that’s not offered at the VA office itself. Now, realize a lot of VA facilities now do have chiropractors within them, and that’s the first place they would go should they need it.
But realize many times these chiropractors are so busy, they don’t have the wherewithal or the time To see them, which means they get to go to someone outside of it. And frankly, most don’t have it. So please take special note under the VA. Look at the things that are covered and you’ll see here, I’ve highlighted chiropractic services, but it includes things like physical therapy, occupational therapy, and so forth, but chiropractic, a big part of it.
Notice though, so much that the VA even covers this and I bet many of you had no idea. They cover massage therapy. Now I’m not talking massage. done in your office. Yes, they do cover that, but this is massage. They could just go to a massage therapist. They could go receive acupuncture and get this Tai Chi.
How many know that you can go take a Tai Chi class? Why? To deal with maybe PTSD, back pain, you name it. So there’s a lot of access, but unfortunately not a lot of use. Realized VA community care chiropractic services are part of the standard medical benefits package available to all eligible Veterans.
Like other specialties, access to chiropractic services by referral, so that’s true, it’s referred for everything, and these services can be on site, and if they’re not on site, they get direct access to see you. The difference is you do have to join and be part of it, but this is a patient I think you’re going to like, because the VA has expanded this.
Non pharmacologic treatment of pain is where chiropractic lands. In fact, It’s been shown that a person that seeks care through a chiropractor within the first 30 days is 50 percent less likely to fill an opioid prescription. So certainly we want to look to see that we need a high prevalence of pain, as the VA points out, as veterans have a high prevalence of pain and musculoskeletal condition, continue work to assess and achieve optimal levels of chiropractic use in the population as warranted.
And this is where I want to bring it up. Are we doing enough to really make people aware that we can get them out to it? I’m not sure we are. We’re treating a very small portion of the population. However, what do they cover? This is what a lot of people, what are they going to pay, Sam? Is it going to be very low?
Is it a lot of work? Not really. They cover chiropractic manipulation. They cover E& M codes. They cover therapies of all different types. Including laser. It’s the one insurance I would tell you, they will cover laser. In addition, if your state allows it or you’re so licensed, you can actually provide acupuncture as well, including dry needling.
What do they pay? They pay at Medicare rates. You’re gonna think, oh, that’s not very good. Hold on. Medicare rates, frankly, are better than most of your PPOs. But let’s remember Medicare rates are going to be for all those services. So let’s take an initial patient where you’re going to do an adjustment in an exam, plus maybe one or two therapies.
That’s a 200 plus visit. What about a day to day visit? Assuming an adjustment in 2 3 therapies, maybe about 80 to 100. That’s pretty good. That’s way better than most. I will say this is almost not quite a personal injury patient, but a pretty consistent one. Here’s the downside, or a part you have to go through, is you do have to be a member.
And the membership is not what people think. You’re not joining the VA directly. You have to go through the intermediary. So you’ll see everywhere that’s Texas and West of Texas, they use a company called TriWest. If you’re going to join East of Texas, if you will, it’s OptumHealth. So you would have to enroll through any of those two.
There’s no cost to joining. Why would I not want this? The worst case is you don’t get a patient. The best case is you get a patient. They will authorize care. And I’ll say generically, most chiros are getting about 28 visits a year for most of these patients, sometimes more. But they’re always going to give you 12 to start.
They’re going to give you eight subsequently for every 30 days. And if it’s just supportive care, now notice a subsequent continuation care is the eight visits every 30 days. If you reach a point to where the patient has reached kind of an MMI, maximum medical improvement, they’ll approve update visits in 180 days to use it as needed to prevent it.
So realize the VA could be a really good spot, but it’s a matter of understanding. How does the VA work? How do I join? How do I make sure to get access? Because here’s what they’re looking for. You know what the purpose of care is to the VA? And this is what they state directly in their guidelines. The expectations for chiropractic care.
Significant durable pain intensity decrease. Okay, so it would make the patient have less pain. But as a consequence, it’s not just the lesser pain. Notice it says, functional improvement demonstrated by clinically meaningful improvement on validated disease specific outcome instruments. So in other words, your oswestries, your general pain index, and so forth.
Show me they’re better. That’s the end of the day. That patient needs less medication. That’s part of it. They’re in lesser pain and they have greater function. That’s not hard to demonstrate. That’s exactly what chiropractic does. Would I want to be part of that? Absolutely. You can attest that probably every VA patient you’re going to get is about $2, 000 of reimbursement.
Why would you not want to access even a handful? But what if you got a handful a month? Become a place where people know that you have care. If you don’t have a sign up that says I treat VA, why would I know you do it? Realize, if you don’t highlight what you don’t assume people know it. Take a chance.
Get out there. Get more patients. Because what makes a practice thrive is doing the thing you like to do, which is helping people, but you need patients to do that. The VA is part of it. It’s something that’s guaranteed coverage. In addition, there’s no out of pocket for the Veteran. Give them access. I’m Sam Collins.
I’m the expert. Do you need expert help? Notice this and more. We do seminars on this topic as well as day to day help. I wish you all well. Don’t be afraid to reach out. Talk to you soon.
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