The Biggest Scam In The Chiropractic Industry [Don't Buy The Hype]

Hey doc, have you seen what’s going around our industry right now? It is the biggest issue, and I don't want you to get caught up in the scam of this thought process that you have to be connected with every insurance company out there. Don't buy the hype.

If you're spreading yourself thin across every insurance provider, you're setting yourself up for burnout. I mean, you're essentially putting your whole practice on the line.

This doesn't just mean you. It's your family, it's your team, and the families they support.

So if you're serious about running a sustainable profitable practice that truly delivers incredible results for your patients, then read on because it might just save your practice.

Whether you're a new doc just coming out of school, anxious to get on an insurance provider list so that you can start getting new patients, or you've been in the industry for a long time, and you're just used to what you get paid, I want to shake you.

I want to wake you up and say before you blindly accept all insurance payments, I want you to do this one thing that is critical for your practice and the sustainability of your practice, which is what we call implementing the insurance bible.

No. 1 - Implementing The Insurance Bible

I mean think about a bible — it's nice and thick, and it has the answers to every question in life, right? Your insurance bible is creating a spreadsheet, and I want you to create a tab for every single insurance that you are a provider for.

Now your practice has a list of billable codes that you bill on a regular basis, and it's probably the same for almost every insurance company. What I want you to do is create a column for the code, create a column for what you should be charging for that code, and then I want you to create a column for the allowable (what the insurance company allows you to bill).

Now remember that when you sign up to be a contracted provider for insurance companies, you're basically agreeing to offer your services at a reduced rate. And that discounted rate isn't always consistent. You need to be watching those payments.

Your billing team member needs to be on top of this. But more importantly, you need to review that insurance allowable on a regular basis. At least annually if not, more often. This way, you can see what you’re actually agreeing to by accepting a particular insurance.

And every state has that “hated insurance company” because they have just whittled you down to literally almost pennies on the dollar. I mean what other profession out there do you go into and say I'm going to work harder and get paid less?

If you went to any of your team members and you said, hey, each year, you're actually going to make 15% less. How many team members would you have sticking around? But yet, you're doing it.

You're accepting these patients year after year, and the reimbursements are going down. Why? Well, because the insurance is a broken model, to begin with, and our entire healthcare system is so broken. I know you align with that.

So the next thing is you're going to calculate the discount. How much am I actually discounting my fees to be a part of this insurance network?

Oftentimes, I looked at that discount and I “calculated” it as a marketing expense because I would have to go out and market to attract new patients, and maybe I'm now getting more new patients through this network - maybe you are, maybe you’re not. You have to make that decision.

But as you begin to really look at that, I want you to identify the contracts that are robbing you. They are not paying you what you deserve.

The next thing I want you to take into account is what percentage of your collections is actually coming from this provider. One of the coolest things that the blueiq software does for you is it shows you a breakdown of the actual payers. Month by month, year by year, it breaks down who’s contributing to your collections. You can actually see what percentage that payer is pitching in.

Your collections might be a lot smaller than you think. But by knowing that number, you can start making solid strategic plans on how to deal with this insurance company.

No. 2 - Pick The Insurance Companies That You Need To Fire

Step number two is what would you do if you fired those insurance companies? How good would that feel? in fact, I remember writing a letter to the insurance companies myself where I fired three of my major carriers because they were literally robbing us blind. I was done being robbed, and it felt so good to finally fire them.

Naturally, I was nervous about how my patients would respond. But you know what? Their response was amazing. I reached out to those patients who were under those insurance plans, laying it all out for them. I shared the hefty percentage their insurance carrier was requiring us to discount our fees. And then, I extended an offer - a super bill they could submit for reimbursement, but we’d no longer be part of their network.

Now we did a lot of research on these insurance companies. We looked at their out-of-network benefits. We identified that a lot of them had out-of-network benefits that were way better than the in-network benefits. There were some deductibles, but for a lot of them, they weren't that big.

So by working through the patient, we were able to work out new agreements. We didn't lose many patients, and we ended up seeing a major impact on our collections month after month. The best thing I ever did was fire those insurance companies.

No. 3 - Focus On A Proper Profit Lever

So now that we have our bible in place, and we've fired our insurance company, the next step is to focus on the proper profit lever. Let’s think about the marketing lever.

If you were able to invest in your marketing, or if you had control over your new patient acquisition cost, you'd have a lot more confidence in this.

So let's start by looking at the math behind these numbers so that you can see the insurance math versus the cash math might be a little bit more attractive.

So, if you bring in 30 insurance case patients with an average case value of $800, you’re looking at about $24,000 coming in from the insurance company.

Now imagine those same 30 patients, but this time, they have a higher cash value, let’s say $1,400 each. That bumps up your total to $42,000.

Well, if we have a new patient acquisition cost of $46, that means that we're going to spend about $1,380 on marketing to acquire $42,000.

So if you take that $42K and minus the ad spend, you're left in your bank account $40,620. Compare that to the $24K that you got from the insurance company.

What would you prefer? The insurance check or the cash check? You see, it's just a math problem. It's not emotional. We just take all of that subjective data out of it. When we look at the objective data, we are so much better off with that cash in hand.

Now there might be some insurance companies in your bible that you determine are worth keeping. The ones that are paying well, that patients are staying longer and paying cash after they get through their insurance benefits. So keep those, but fire the others that are robbing you blind.

I challenge you to do it. If you need some support in this, if you need a community that can support you through this process, that's what we're here for. We are a group of data-driven docs helping you drive six-figure months. If you're ready to see the step-by-step process of how to do that, then come join our free community on Facebook, The Data-Driven Practice.

We’ll show you how to generate more profits in less time. We will show you how to move through your provider value ladder to get to the role where you love running a practice and building the vehicle that’s transforming patients' lives. Let’s build your dream practice.