by Ray Foxworth, D.C., FICC, MCS-P

President & Founder, ChiroHealthUSA

In chiropractic, we tend to sabotage ourselves despite our desire to be successful business owners and chiropractors. Often, we forget that we are regulated by a healthcare “system,” and we must comply with ALL layers of that system. What I have learned in over thirty-five years of practice is that there are four common mistakes we make that can make it more challenging to achieve a profitable and successful practice.

1. We Lack a Simple and Compliant Financial Policy. Our financial policies, our billing and collection procedures, and how we present payment options for our patients, can be some of our greatest areas of RISK in practice. These policies can be used as a weapon against us if they are not compliant with all the layers of regulations we face today. You are MORE likely to face financial problems from audits, fines, and penalties than you are from malpractice claims. That’s not my opinion. It’s a fact. One of the top reasons complaints are filed with Boards of Examiners is not over our clinical care, but our financial policies. Download this simple compliant financial policy for your practice.

2. We Lack Structure in our Fee Systems. I remember hearing Dr. Larry Markson speak early in my career. I will never forget him saying, “My fee is my fee is my fee.” Meaning, we should only have one fee, our actual fee, in our offices. Your fee system reflects the range of fees you accept as part of your managed care agreements and your participation in mandated programs (Medicare, Medicaid, PI, WC). While all of these payers’ reimbursements may be different, they should all be billed your actual fee. Then these payers will discount according to the terms of your agreement, or according to state and or federal mandates like we see in Medicare, Medicaid, Workers Comp, and PIP.  Do you have a cash fee, family fee, or a “buy-10-visits-get-one-free” fee? Take a step back and stop thinking of your fees based on who is paying the bill. Your fee system should be structured in layers made up of your Actual Fees/UCR Fee Schedule, Contracted Fees, Mandated Fees, and Hardship Fees.

3. We Avoid Discussing Finances with Patients: You already know that a Clinical Report of Findings is key for patients to understand the need for care. Equally important is the Financial Report of Findings (FROF), since, like it or not, patients DO make healthcare decisions based on dollars and cents as well as the clinical need for care. I am surprised to hear that many of my colleagues skip this step. Today’s patients are healthcare consumers and want us to help them feel and function better physically without hurting them financially. In fact, many insured patients walk into a chiropractor’s office under the assumption that their insurance is going to cover all of the care they need with minimal out-of-pocket expense. Even patients who are your raving fans can turn angry when they receive bills several months later for care that was not covered by their insurance.

4. We Are Complacent About Compliance. These days, it seems like there are even more ways to run afoul of the regulations than there are rules. And there are oh-so-many rules, guidelines, laws, and policies that many doctors have only a general grasp of. Sadly, far too many in our profession have found themselves amid a pandemic with no OSHA policies or procedures. For years I heard from my colleagues, “I don’t want to deal with it. I just want someone to take care of it for me.” Comments like this use to concern me – until I was honest enough to admit, that I, too, wanted someone to take care of it for me – Thank you, ChiroArmor! Having a third-party compliance officer was one of the best decisions I ever made as a practice owner. Request your free gap analysis to see where your compliance program stands.

Being a Doctor of Chiropractic is a privilege. I can’t think of anything that I would rather wake up and do every morning. All of these risks in your practice can be managed and even eliminated if you carve out time to work ON your practice instead of just IN your practice. And, more importantly, work on things that can GENERATE  income, not cost you income. The reality is, time, frustration, and negativity cost you a lot more than the cost of outsourcing many of these aggravating, but necessary, functions in your office.   Focus on one task at a time, and don’t forget to ask for help. There are consultants across the country that can help you become more compliant and more profitable.