How to Cater to Today’s Healthcare “Consumers”

If you’re like most people, you probably feel time-starved, stressed out and budget-crunched. Guess what? Your patients do, too. They crave convenient, one-stop shopping for their whole families. And as much as they might understand and believe in what you are doing for their health, they want that convenience from your practice, too. More importantly, they need that convenience to be affordable.

Today, more people are “self-insuring” which makes them more like “cash patients.” In fact, with limited benefits, more patients are transitioning to cash when insurance runs out. This trend is expected to continue, and you should be prepared by having a wide range of payment options to keep care affordable for your patients. Today’s patients are health care “consumers,” and they insist on knowing what their out-of-pocket expenses will be, often even before they come in.

In chiropractic, this has always been a challenge due to the way we run the business side of our practices; one fee for PI or Workers Comp, another for insurance, and still another for cash. Our front desk teams have learned to “dance” around the subject of “How much does it cost to see the doctor?” because the fees have been based on who was paying the bill. This not only creates confusion in your office, but a negative perception by the public. We should have one fee schedule and stick with it, regardless of who is paying the bill. Can you imagine going into Ruth’s Chris Steak House and asking, “How much is a 10-ounce filet?” and the waitress replies “Well, it depends…how hungry are you?” Rightfully, you would think they had lost their minds. Imagine what our patients think when it comes to our charges.

Having a proper fee system is a critical first step. Perhaps your practice is struggling because your practice fees are purposely low because you are worried about the patient’s ability to pay. Or maybe your fees are set high to maximize the third-party reimbursement that may be available. This situation can get undermined if you are cutting special deals, encouraging no out-of-pocket expenses for patients, or setting up “time-of-service discounts” that far exceed actual bookkeeping costs which should fall in the 5%-20% according to most consultants. A sliding scale of fees can pose real problems for practice success.

Step back from the laundry list of “fees” you may now have in your office and start thinking in terms of “What is my ACTUAL fee?” for each procedure in the clinic. Break the habit of basing your fee on payer type. Insurance companies are sending letters to doctors asking if they offer any type of discounts to patients, and if so, how they are reflected on the claim form. Guess what? There is no place on a CMS 1500 claim form to show a discount. Do you smell a rat? If you are offering a discount and NOT reporting it, it could be considered a violation of the False Claims Act.

lf you have your fee system set up properly, you should be able to answer the above question like this, “I only have one fee for my clinic services and the only time that fee is discounted is when it is part of a contractual network agreement or a documented financial hardship.” This is a rock-solid way to set up your fee system and if you adopt it as your financial policy, you’ll be

able to practice with more peace of mind. The only time that you should charge less is when there is a contractual obligation or special circumstances. After you have established your financial policy, make all of your patients aware of it.  Here are some ways to set your practice up for success:

  • Do not undermine your front desk and insurance staff by talking fees with patients UNLESS that is your normal office policy. Set and follow your policy and let the patient do the talking.
  • Do not have inconsistent collection policies. Set and follow your policies on collections and apply them equally to all patients.
  • Do not tweak your coding to allow for “lower fees.” This is called “down-coding” and many doctors do this if they are trying to lower the fee for a cash patient. Consider using a proper Discount Medical Plan Organization which will eliminate the need for this improper coding and will allow you to document, code, bill, and discount correctly.

A Discount Medical Plan Organization (DMPO) is a simple solution that allows you to safely and legally discount your fees so families can afford that one-stop shopping their schedules and budgets demand. You can maximize third-party reimbursements when insurance is available while offering affordable care for the whole family through ChiroHealthUSA. Healthy, happy families are the foundation of a thriving, multi-generational practice, and those families are more likely to refer their extended family members. This creates steady, referral-based revenue for you and establishes a satisfying, family practice community that benefits patients and DCs alike. ChiroHealthUSA’s Family Plan Fee Schedule makes it easy for you to offer affordable health care so that more family members, and their referrals, can receive a lifetime of chiropractic care.

Dr. R. A. Foxworth, FICC, MCS-P

Dr. R. A. Foxworth, FICC, MCS-P