A Short History of How Everything Else Has Cost You Hundreds of Thousands of Dollars and (nearly) Killed Your Dreams as a Chiropractor

When you started your chiropractic practice, you took on 2 roles: “Doctor” and “Everything Else.” As your practice grew, you became busier in your role of doctor. That is what you wanted. That was good.

But as your practice grew, your role of “Everything Else” also got busier. This was a distraction from your role of doctor, so you delegated front desk, billing and therapy duties. You still kept the role of “Everything Else.”

As your practice continued to grow with more staff – your role of “Everything Else” expanded geometrically.  This concerned you.

You didn’t think about it much because you enjoyed being a chiropractor and loved your patients, but when you were very busy, you made more money. You could take a vacation with your family, put money aside for your kid’s education, and pay off debts.  Sometimes, you could see yourself producing even more, helping more people, and being even more prosperous.

These dreams didn’t last long. Your role of “Everything Else” became more demanding.  There were more “everything else’s” crying for attention.  There was too much to do and soon you saw your patient volume dropping. Patients were dropping out of care and new patients became scarce. You had lost control.

Other doctors who were experiencing lowered income blamed insurance companies. Or the economy. Or the modern culture.  All you knew was that it wasn’t fun anymore and there was just too much work to do. Work that wasn’t chiropractic.

The fact is, you were never too sure of this role of “Everything Else” and never really liked it all that much. You didn’t have any training in it like you did as a doctor.  And when all of the “everything else’s” starting coming at you, you felt like things were getting beyond your command.

You experienced some staff turnover and now with patient volume down, you didn’t need as many staff. Gradually there was less to do in your role of “Everything Else.”

This cycle may have occurred to you a few times: numbers up, then more stress, then back down. A roller coaster.

  MONTHLY OFFICE VISITS And here is where you may be now.

If you were to add up the amount of revenue you could have made had you stayed at your highest level, or been able to go even higher were it not for your role of “Everything Else”, you might be surprised how much this “Everything Else” role cost you. Hundreds of thousands of dollars.

= = = = = =  =

If this is your story so far, don’t go away. The last chapter hasn’t been written. In fact, your next one might be completely different. Here is an introduction to it:

You read about the chiropractic Executive Freedom Package and started it.

You discover that the “Everything Else” role is really the role of the business executive. It is the role of the CEO.

You realize that all major businesses have an executive and that there are certain skills and tools as a CEO to be learned. These skills have to do with leadership, management, and marketing.

So you learn these skills and get coached on them.  In time, you get better and better at applying them.

You find a staff member and give her the role of chiropractic office manager. You get her continuously trained and give her lots of your less important CEO duties. As she gets better, you give her more.

You get someone to help you coordinate all the marketing. You give him continuous training.

You have staff meetings and get the team on board with managing the office.

All the “everything else’s” are organized into systematized procedures and delegated to your team.

Numbers go up. Your team continues to improve. They are happy about this as they are sharing in the management of the office and its success. Now that all the “everything elses” are packaged up into nice neat systems, you have time to focus more on patient care, future planning,  personal studies, and other pursuits.

You are now a better leader, better manager, and a better marketer, and your business continues to grow. Your team is happier, more people are getting served, and you make more money.

If someone had only told you about the role “Everything Else” and what it really was all about years ago you would have avoided losing so much money and wasted time.

On the other hand, now that you know what the secret is, you are on your way out of the rut you have been in and on your way to greater freedom.

You can learn more about the “Everything Else” role and how to create the business structure that puts you in command with our new chiropractic business Freedom Package here.

 

Your Chiropractic Brand

A brand is the representation of you in the marketplace. Well defined, it can cut through the thousands of health messages people hear each day so that your message is heard distinct from all others.

We have said this over and over, but you have the opportunity to make and improve your own brand.  And the way you principally do this is through an active and continuous conversation that you have with each of your patients, vendors, staff, and local businesses.

You start your conversation usually on your patient’s first visit. Then you continue it on the second and on successive visits thereafter. Also through newsletters.  Also while doing a community event, letters, or even while shopping: “Hi Bob. How did your wife do at the 5K run?”

The conversation has to be two way.  You have to listen as well as communicate.  Facebook fits right into this, but you have to post more than what you copy and paste  from the American Chiropractic Association or from Mercola. Pictures of babies, puppies, recipes from a patient with photos, and anything you feel genuinely passionate about.  Anything endearing: “Aw, look at the cute baby.” Even a bulletin board with local stories of your patients let’s others know that you are paying attention.

Your brand is based upon how you converse with your select community, your own tribe.

Here is a great quote from Seth Godin’s book, Small is the New Big.

“Markets engage in conversations, but marketing often doesn’t. The reality is that most brands are actually monologues, not dialogues.  A conversation might create a better, more robust, more useful brand but, alas, most organizations can’t handle that truth. So they do their best to do it the old way.

Big brands are dying. Little brands are doing great.”

Registration for Chiropractic Marketing and Management Webinars

How to Register

  • For guests (not active PM/A members), you may register for all  of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

  • For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK

Improving Team Performance and Developing Community Services for a Chiropractic Office

This month we cover a couple of import topics, both of which can bring you more income if managed correctly: Chiropractic Staff Performance and Community Relations Marketing.

TEAM PERFORMANCE

How well does your staff perform their duties?

Studies show that there are 3 primary methods to improve performance:

  • Deliberate Practice
  • Expert Coaching
  • Family and social support.

Natural talent is a factor, but is never enough by itself and is often overrated.

So, how well does each member of your team perform?  Are they experts? Are they ready to teach their own seminars?

And how about your how team? How well do all of you work as a team? Will they go to the Super Bowl or World Series this year?

Your office responds to training like any athletic team or musical group. If the scoreboard shows that the numbers aren’t where they should be, then individual performance or team performance is a likely reason why.

What is the fast and economical solution? Training. Coaching.  This is something you and your office manager, and each team member can learn.

Team training is not done by just one person; it is done by the team. One member helps the other member, and back and forth until both improve.

Our webinar this week covers just this topic.

 10 Tips on How to Be An Effective Team Trainer

Tools and Tips for Fast Team Training That Pay Off

Thursday, March 8th, 12:30 CT

Don’t miss it. Excellent for Clinic Owners (CEO’s) and Office Managers.

 ===============

 COMMUNITY SERVICES: External Marketing

We all live in caves.

We live in a cave house. Then we get into our cave car and drive to our cave office and stay in our cave rooms.

Meanwhile, there is a whole world out there with thousands of people that need your care, but don’t know it.  And the main thing you have to do is to just … SHOW UP and do something.

What’s so hard about that?

You all have done screenings and you all have done some kind of external events: workshops, school presentations, visiting medical offices. The hard part is not the presentation. The most difficult (and it is not difficult) is getting these events scheduled.

Ideally, you should have your community services calendar scheduled with a few external events of one kind or another every month.

This is the subject of our next marketing webinar.

 Scheduling Effective External Events and Generating External Referrals

Learn how to schedule effective events in this short webinar.

Thursday, March 15th, 12:30 Central Time.

 

How to Register

For guests, you may register for all  of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK

The 5 Levels of Chiropractic Business Leadership

What level of leader are you?

Join us for a unique webinar on chiropractic executive leadership. This webinar goes over the levels of leadership skills you need to be a successful chiropractic CEO in your practice.  

 We will reference the work by John Maxwell and his book on the levels of leadership. Maxwell states:”… everything rises and falls on leadership.”

Chiropractic does not fail you. Tens of thousands of chiropractors and millions of patients over the last 115 years can attest to its effectiveness.

But just because chiropractic delivers, or just because you are a skilled doctor, does not mean that you are a skilled CEO. Lack of small business executive leadership training has stunted the growth of so many otherwise prosperous doctors.

 Starting in 2012, we have begun a new program focused on freeing the doctor from practice drudgery and high stress roller coasters by beginning an executive training program. We are calling it the Freedom Package.

In this webinar, we will also review an actual consulting case, complete with stats and personnel profiles (all anonymous) demonstrating a level of chiropractic business leadership.

On our panel will be a successful chiropractic CEO of a multiple doctor office for 25 years, Dr. Tom Potisk.

Date: Thursday, February 23

Time: 12:30 Central Time

Prerequisite: Doctors must have been in practice for 4 years or more, and own their own business.

How to Register:

For guests, you may register for this webinar for $65 which includes “5 Levels of Leadership” by John Maxwell mailed to you. Go to the Registration Page below.

 For all active PM&A clients, you can register immediately at the Registration Page link below.

Once you register, you will automatically receive your special log-in access number where you can participate via computer, or by telephone only.

Registration Page

If you’d like more information visit our website HERE.

February Freedom Webinars

Freedom PackageThis is an invitation to get your motor running — and to head out on the Freedom Highway…

We have three webinars this month designed to help you get free from financial and staff stresses, and free to follow your own dreams.

You know…as long as you provide good clinical care, then all you need is effective marketing, a motivated team, and good leadership.  Just three – to be free.

So many of our offices have been surging forward over these last several years and recent months — because they have provided better leadership, team building, and marketing.

Hop on the Freedom Highway with us… and take your patients with you as well. They too want to be free … free of pain and poor health.

FEBRUARY WEBINAR SCHEDULE


**February 9th, Thursday,
  at 12:30CT, we start off with a training webinar on management and team development. We will be discussing how to hire the right team member.

How To Hire The Right Team Member

  • How do you know if you really need more help?
  • How do you promote for another staff member?
  • What traits are best for what position?
  • What about different personality types?
  • Screening and the interview
  • The first 30 days
The presentation is approximately 30 minutes followed by a 30 minute panel discussion with two long time professional C.A. office managers.

**February 16th, Thursday, 12:30CT, we focus on tools and tips for marketing your services.

“Marketing Tools and Tips”
  • How to make Earth Day your Day
  • Powerful internal marketing scripts
  • Report of findings trick
  • Setting up Community Events (Next Month -Lots more on this subject, including screenings)

The presentation is approximately 30 minutes followed by a 30 minute panel discussion.

**February 23rd, Thursday, 12:30 CT, a special Executive Briefing

just for clinic owners.

Executive Briefing: Case Study of one doctor’s attempt to grow his business. What he did right, wrong and what you can learn from his journey.
  • We will show the graphs, report on the personnel, clinical and marketing changes, and tell you what happened and why. An inside look.
  • Learn from others mistakes and success.
The presentation is approximately 30 minutes followed by a 30 minute panel discussion with other doctors.

How to Register

For guests, you may register for all three of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808  

 

You can also download a calendar for upcoming webinars: LINK 

 

Hope to see you at our trainings and briefing.

Ed

Freedom Package Webinars for 2012

INTRODUCTION

For 2012, we will be offering an ongoing program of training and support for chiropractic marketing managers, office managers, and chiropractic doctors as CEO’s.

We are calling this the Practice Freedom Package. Its purpose is to help free the office from financial concerns, day to day managements worries, and give it the freedom to follow its greater purposes.

Over the years we have observed that the key barriers to achieving practice success are organizational.  The barriers do not lie with chiropractic. It is not a matter of chiropractic failing the office, but the office failing chiropractic.

These failings occur as a practice grows beyond its ability to effectively manage itself.  The capacity restraint ultimately stems from the doctor who is too busy doctoring to run her growing business.

This package of webinars and services is designed to help the doctor and the office overcome these organizational limits.   More information about how and why this program works can be found on by following the link below.

FREEDOM PACKAGE WEBINARS: COURSE DESCRIPTIONS

Chiropractic Practice Marketing Webinar

When. The 3rd Thursday of each month at 12:30 Central Time.

Description. You will learn principles and accompanying action steps which will help you generate new patients from other patients, from external sources, as well as reactivate former patients and better retain the ones you have.

Each webinar will cover at least 4 practical marketing procedures that are effective in generating more patients.

Who should attend. Designed particularly for chiropractic marketing coordinators and managers, doctors and office managers.

Chiropractic Practice Management  Webinar

When. The 2nd Thursday of each month, 12:30 Central Time.

Description. You will learn fundamental principles of management with specific applications to managing a chiropractic practice and business.

Each webinar will cover at least 3 practical action steps to improve individual and group performance, efficiency, and productivity. Also, tips on working with your doctor and how to provide more support for her or him as a doctor and as the CEO.

Who should attend. Designed for office managers, practice managers, and doctor owners

♦  Executive Management Webinar
The Doctor as a CEO

When. Starting in February, the 4th Thursday of every other month, 12:30 Central Time.

Description. Using actual case studies for examples, we will see what worked and what didn’t for doctors and their teams.  We will uncover the basic principles of effective leadership and management in case and see how to translate this to your business.

This is training on how to be a prosperous CEO.

Who should attend. This is only for doctors who own their own business.

Discussion Group/Share Session

After the presentation is over, we will open up the group for those who want to stay to ask questions and also to offer their experiences and advice to share with others.

This is often the most popular part of the program as other professionals really want to hear your stories and ideas. So, hang around and share and get to know your fellow teammates from other areas of the country. (Must be ready to contribute and share a successful procedure.)

Follow Up Materials

After the presentation is over, you will receive an email with a link to a private vault of marketing materials referred to in the most recent webinar.  There will also be a short summary of our discussion. Additionally, attendees will have access to our private Practice Marketing and Management Library of information and customizable tools for practice building which you can use in your practice.

Calendar of Classes [Link]

More information about how and why the Chiropractic Practice Freedom Package (Lots more info here, though not complete.) . Link

The Promise of the New Year

Lake Michigan, Milwaukee

Happy New Year! It is now 2012.

It is a New Year – fresh with prospects for new opportunities and adventures.

It will come at us fast, we know that. It will have challenges, though we don’t know what they may be exactly. There will be struggles and successes.

But we are given this opportunity, this chance, this privilege to play this game and to do our best at it. And for this, we are grateful. We can learn from our past and work to make this year exceptional – for ourselves and for all those whom we touch in body and spirit.

This year holds within it a promise for each of us – the promise for prosperity, for helping more people get healthier, and for each of us to spend more time following our own greater purposes.

It also holds a promise for all those who will look to you this year for help.

As the days of this New Year continue to dawn, we wish you success in achieving your goals in chiropractic and in life. We are all in this together – and you can count on us to work with you and to give you our best efforts and knowledge to make this a winning season and a winning year.

New Medicare ABN Form for Chiropractic Offices

Below you can find a link to a  sample version (in pdf)  of the new Medicare ABN Form that all offices must use starting January 1, 2012. Please download, review, edit name & address, and have your Medicare patients complete this form starting Monday.

If you have questions, see below. I tried to answer them the best I could, but contact me if you are unsure.
Thanks, and Happy New Year!
Dave

NEW MEDICARE ABN FORM – PDF

What is an ABN Form?

“The ABN is a notice given to Medicare beneficiaries to let them know that Medicare is not likely to provide coverage in a specific case. The patient must complete the ABN as described below before providing the items or services that are the subject of the notice.”

What do we need to do with this form?

First, you must put in your clinic name, address and phone number on the form. This is Medicare’s requirement. Have each Medicare patient review the form, check one of the three options, and sign the form. Keep a copy in the patient’s chart for the most current course of treatment.

Why are exams, xrays and therapies noted on the form?

The ABN can be used for both covered, but not medically necessary services (such as a wellness adjustment billed without the –AT modifier) or for non-covered services. Adding non-covered services, such as therapies or exams, helps Medicare patients better understand what will and won’t be paid.

Why is the “Estimated Cost” line left blank?

Because this will vary depending on what you are doing with the patient, whether the patient has a secondary, supplement, or alternative financial agreement with your office. This will be different for different patients. You can either estimate a “per visit” cost or the total cost for care. (per page 4, Form Instructions, ABN).

Please get rid of your older, blank ABN forms. More Questions? Ask Dave!

Cal Jam Special Offer for Chiropractors

Come on down to Cal Jam 2012!

Our great consultant and coach, Ms. Phyllis Frase, will be speaking at the 5th Annual California Jam, presented by the Dead Chiropractic Society in Costa Mesa California.  Register before January 15th and mention the Promo Code of FRASE for the special discount mentioned in the flier below.

All registration is handled through Cal Jam by calling the number below.

Call Today 949-250-0600

for more information: http://www.caljam.org/

Chiropractic Prepayment Plans in South Dakota? Think Again!

If you’re a chiropractor in South Dakota and you believe patients benefit from ongoing regular chiropractic care, or you think that you know what an appropriate treatment plan might be for your patient, AND you want to offer your patient a prepayment plan, guess again. You’ll find yourself before your State Chiropractic Board for unethical behavior.

That’s what happened to Dr. Josh Biberdorf, who has a few clinics in that State and also is the president of the South Dakota state chiropractic organization. Here’s a great article: http://rapidcityjournal.com/news/state-board-reprimands-chiropractor-for-billing-practice/article_e3b0eb8e-2f4d-11e1-815e-0019bb2963f4.html.

This is yet another example of State Chiropractic Examining Boards going after local DC’s for practicing their business within their scope of practice. Wisconsin and Minnesota continue to do this.

This begs the question of what the role of the state chiropractic board is. They are created to protect the public – that’s what the State law says. But more and more it seems that the State Boards like to determine what chiropractic is – whether patients, the public or chiropractors agree.

This is bad for patients, bad for the public, bad for chiropractic. No other profession does this to itself.

When, we ask, are chiropractors going to stop going after one another? It seems the biggest crime a chiropractor can commit within his or her own profession is to be successful. If you are, some piss-ant DC is going to report you to the board.

It’s time for the National Board of Chiropractic Examiners to make a clear statement on this and ensure that local Boards are doing what they are supposed to – protect the public. Not protect unhappy chiropractors.

Chiropractic Promotions for the New Year

Seems like every office we talk to or visit these days is busy – crazy busy – with patients and computers and Christmas.

But the New Year is approaching – fast. 2012 only has 12 months and the first one starts in just about two weeks. And then, before you know it, it’s February and you are wondering what you should be doing for marketing and getting the word out about your services.

 

So as not to be left behind, you should begin the New Year with a strong marketing strategy.

 

Below are some fast tips to help get you started:

 

But first… PROJECT X-3. We are finishing adding the final components into our new 2012 program, temporarily called the Project X-3. This is just the working title and we will be announcing the new program soon with all the details. It is designed to help lift you and your practice onto and into a whole new level of prosperity and fulfillment in the New Year.

 

**Schedule Patients Now. Health Never Takes a Holiday. Poster. If you are active with PM&A, you can also find a customizable version on our Members site, along with other promotions under “monthly promotions.”

 

**External Referral Sources and Event Locations. Make a list of every location where you participated in a promotional type of event. Include any business or professional that sent you a referral or helped you in some way. Then, make sure you send each a card or a gift, or just stop by and wish them well and that you look forward to continued relationship with them in the New Year.

 

**Marketing Meeting. Schedule a thorough marketing meeting soon, maybe right after Christmas. Spend a couple of hours making a list of what has worked and what you want to do and then schedule these things over the next several months. One example we recommend is:

 

**Be an Authority and Educate. People want health care information.  This is proven by the fact that 80% of Internet users search for health information on line, according to PEW Research.  8 out of every 10 people at some time are looking for health information when they go to the Internet. That is significant.

…2 ways to do this is to schedule workshops and health “awareness weeks” for the New Year. People want to know the latest. This gives you an opportunity to teach. Yes, you do have to do your homework and it takes time. But it is time well spent because as you study and prepare, you will find that you will become motivated about your subject. Besides, at least 1/3 of your presentation can be your spinal care class, so this saves you time. These types of community education programs or services not only help you generate direct new patients, but give you an excuse to promote your office and services. Sample Poster Clients can find many more customizable posters and fliers on the Members site under: Marketing Materials/ Community Education.

You can find more ideas about upcoming promotions to start your New Year here. Link

 

Best wishes for a high volume 2012!

 

Ed

“Thank You” to All of You Who Work in the Chiropractic Profession

It is that time of year when we take a moment to give thanks and in so doing, we want to say “Thank You” to you.

Thank You Very “Doggone” Much as a matter of fact. Thank you for all you do to care for and help your patients.

You all are part of a great profession that helps millions of people each day. And because of you, chiropractic and the chiropractic way of life has persisted and grown and is now more accepted than ever before.

You are braver than most, work harder than most and genuinely care more for your patients than perhaps other care professionals are allowed to. It could be said that you are the best defense against a drugged zombied society, but it is definitely true that your loving care helps much more than you have been recognized for.

So, just a note to say that we are grateful for all you do.

“THANKS”

Handling Insurance Company Refund Requests of Chiropractic Patients

More and more, insurance companies are doing post payment audits or hiring outside firms to conduct payment reviews and requesting money back from your chiropractic office.

Refunds should never be automatically sent out based on a request from an insurance company.  Each request needs to be individually reviewed and processed and the patient’s account should be audited to determine if a refund is actually due and to whom.

Sometimes, a refund is due. Examples may be when an insurance company has double paid dates of service, or when two insurance companies both pay on the same date of service. These are legitimate refunds – ie: you have been paid more than you billed or were due for services rendered. These should be refunded.

Often however, a refund is NOT due and should be disputed. Examples might be when an insurance company or third party does a “post payment review” and determines that the care was not medically necessary, or when insurance pays but later determines that work comp or PI were primary, or when an insurance company decides that the patient did not have a particular benefit or coverage for what they already paid.

Essentially, when you have delivered quality services to a patient that were medically necessary and in the best interest of the patient, and the insurance company pays for those services, you have NOT been overpaid and no refund is due. Even if the insurance company later decides they overpaid or paid in error. These refund requests should always be disputed.

Legally, you are not obligated to repay the insurance company when you have been paid in good faith for services rendered and they paid in error. These should always be disputed.

This will not stop some insurance companies from ‘recouping’ the payment, but you should still attempt to dispute the refund request first. Our experience is that by disputing the refund you will avoid 85% of all refund requests. It is well worth the time and effort to do so.

The exception to the above involves government programs such as Medicare and Medicaid. We generally advise refunding these right away and THEN disputing the request. Remember that you must use the approved Medicare refund form and mailing address (check on line with yur local Medicare carrier for the latest form and address).

Points that can and should be used whenever disputing a refund include these (use any and all reasons that are applicable to each case):

– All services were medically necessary for the health of the patient. Our review indicated that the care was medically necessary; therefore no refund will be issued.

– This request is for a patient no longer active with our office. We have no alternative methods of collecting on these accounts. Because of a supposed error on your part, you are asking us to refund monies to you for services rendered to your insured without a foreseeable ability to collect for said services.

– We called/verified benefits on line with (Insurance Company) on each of these patients prior to the delivery of care and verified coverage for services rendered by our office. Had we been informed, we or the patient could have made a more informed decision regarding the delivery and payment for care.

– It is our understanding that (Insurance Company) has maintained a policy of not reimbursing for services if they are submitted for payment one year or longer after delivery. You are requested a refund for services over two years after their delivery and payment. It would seem that the policy should apply both ways.

– Your letter mentions that 98940 and 97140 are mutually exclusive. This is not the case when they are performed in different regions of the body as defined by the AMA. You also state that manual traction and mechanical traction are mutually exclusive. Again, this is not stated in the AMA CPT codebook and the services were performed by different providers, as our chart records show.

– The time and effort to have our office pull charts and research services from 2009 and 2010 is considerable and cannot be done without prior reimbursement, nor can these records be forwarded to (Insurance Company) without prior consent from the patient.

– We would also like to know if you have informed this patient, in writing, that due to the error on your part, that they are now liable for their medical bill from 2009?

– Our feeling is that the following court cases concluded that the insurance company is responsible for knowing their policy limits prior to paying and therefore must bear the responsibility for their own mistakes.

  1. City of Hope National Center vs. Western Life Insurance Company, 92 Daily Journal D.A.R. 10728, Decided July 31, 1992. (In this case the hospital obtained standard assignment of benefits from the patient and submitted claims, which were paid by the carrier. The insurance company later decided the treatment was experimental and requested the money back. The California Court of Appeals stated that if it’s your mistake you have to pay for it.
  2. In Federated Mutual Insurance Company vs. Good Samaritan Hospital (Neb. 1974) 214 N.W.2d 493. (The carrier contended that it mistakenly paid claims beyond the policy limits. The court held that the insurance company could not recover the money as it places an undue burden on the providers of service to subject them to retroliability.)
  3. Lincoln Nat Life Ins vs. Brown Schools (Ct.App. Tex 1988) 757 S.W. 2d 41 1. (In this case the carrier mistakenly paid claims after its policy had expired. The court denied recovery stating “Here the insurer knew it’s own policy payment provisions, but failed to notify the health care providers as to these provisions and the insurer alone made the mistake of paying beyond its responsibility . . . in the normal course of such business, the hospital has no responsibility to determine if an insurance carrier is properly tending to its business.”)
  4. National Ben. Administrators Vs. MMHRC (S.D. Miss. 1990). (Similar case as #3 with same conclusion.)

– Our office made no misrepresentations in filing claims for your insured. We extended valuable services based on preverification of benefits and assignment of payment by the insured. We were not unjustly enriched, and simply had no reason to suspect that any of the payments for services rendered were in error. Refunding the monies at this time would place an undue burden on our office.

As always, send a copy of your letter to the patients involved. The insurance company will send a letter to the patient (if we don’t send them a check) saying that “we are not cooperating and therefore the patient may be responsible”. So, strike first by presenting our side and preparing the patient.

Situation: The insurance company paid twice on one date of service and missed payments on another. They are now requesting repayment on the double payment.

Solution: Send them a letter explaining that the payments were posted to the unpaid dates and no refund will be made.

 

Situation: The insurance company claims that the work comp carrier is responsible for payment and is asking for all their money back.

Solution: Send them a letter explaining that you will bill the work comp carrier and if and when payment is received, you will refund any duplicate payment.

 

Situation: The insurance company paid for the first eight visits, then denied the next five and now wants a refund on what they paid.

Solution: Dispute the refund as per the above points and request immediate payment on the five denied visits.

 

Situation: The insurance company paid for care, but then came back and stated the patient didn’t have an active policy or coverage.

Solution: Dispute the refund as per the above points. It is the insurance company’s job to pay within the limits of their plan; you have been paid for services rendered.

If you have questions, feel free to contact me.

David Michel

Chiropractic Patient Service

Remember Me?

I’m the fellow, who goes into a restaurant,
sits down patiently and waits while the
waitresses do everything but take my order.

I’m the fellow who goes into a department
Store and stands quietly while the sales
Clerks finish their little chit-chat.

I’m the man who drives into a petrol
Station and never blows his horn, but waits
Patiently while the attendant finishes
Reading his comic book.

Yes, you might say I’m a good guy.

But do you know who else I am?

I’m the fellow who never comes back, and
It amuses me to see you spending
Thousands of dollars every year to get me
Back when I was there in the first place…
And all you had to do was show me a little courtesy.

~Author unknown

Printable Version

Your Chiropractic Root System and Patient Retention, Referrals, and ROI

Updated: April 2016

When people go to the grocery store for produce they are mostly just interested in their plump cucumbers, zucchinis, or other vegetables.  They don’t much care about the garden that actually produced these nutritious wonders of nature.

But a lot of work goes into a well managed garden. If you don’t take good care of your garden, you won’t have its fruits and vegetables.  It’s that simple. And a good part of a garden takes place underground in a network of roots.  Roots provide water and minerals to the plant, and keep it in place when the wind blows.  The top part of the plant, its stem, can get mowed under by a lawn mower (I have done this) and the plant comes back to life – because of its strong root structure.

Your office is kind of like a garden.

It produces healthier people. You take care of your team, polish up your systems, do some training, and you will continue to have a productive “health garden” that produces healthier people.

And the roots? 

In this analogy, the root system is the loyalty and good will of your patients. Here’s how:

Many offices struggle to get new patients.  Even offices that have been in business for years and years.

Why?  No roots.

If some doctors spent the same time and attention – and money, on giving extra care and service to their existing patients as they did on trying to hustle up new patients, they would have more patient visits than they would know what to do with.

Why?  First, because the service and care was SO extraordinary, patients would refer their family and acquaintances because they would want them to receive similar treatment as they had.

But more obviously, existing patients would never drop out of care. (Some would, of course.) They would continue to come back for wellness visits. How busy would your office be now if all the new patients you ever started still came in for services? You couldn’t handle…there would just be too many patients!

Over the years, there have been many studies to support the fact that it is more expensive to chase after new patients than it is to keep the ones you have.

 “A common rule of thumb is that the marketing costs of landing a new customer runs three to five times the costs of retaining an old one.” (Total Customer Service, Davidow)

Some articles talk about it costing 10 times the amount to get a new customer as to keep the ones you have.

I am all for getting new patients, but do you also keep your existing patients? And do they refer family and friends and work associates? And why do your patients leave? An interesting survey pointed out that most companies believed it was because of price, or that the needs of the customer changed. However, from the point of view of the customer, they left because of poor service. (The Loyalty Connection: Secrets To Customer Retention And Increased Profits By Bob Thompson, CEO, CustomerThink Corporation Founder, CRMGuru.com, March 2005)

 

There are a number of procedures to improve your services to patients – to help generate stronger and more productive “roots”, or healthy patient relationships. Let’s focus on the most fundamental: Communication.  To put it more accurately, let’s call it “conversation.”

BEGINNING THE CONVERSATION

A conversation is a dialogue, a giving and receiving of communication back and forth. It is an interactive exchange of thoughts. It shows that you respect the other person and that you are interested in them and what they have to say.

Many patient conversations are one-way, from the staff and doctor to the patient. They are also rote, robotic, and too scripted to be genuine.  Do an audio recording of how the front desk answers the phone or how you do a consultation and you might be able to see room for improvement.

The conversation usually starts with the first phone call. Does the prospective patient feel that the front desk is listening – really? Is she interested, or just reading her script and trying to get to her next task and hang up the phone?  Does she introduce herself and show interest and even gratitude for the call?

It is these little things that make such a big difference.  Think about how you like to be treated when you contact a business…

In the consultation, do you really listen and seek to understand the patient, even though it is like the 5 millionth time you heard about someone’s low back pain?

In your report, do you have a conversation with the patient, or do you just rehearse your script to the patient while they are nodding in appeasement?

You see so many patients… and have so many tasks… that real conversations are too often sidelined.  You don’t have much time, usually. But in the time that you do have, you have to be present. You have to be THERE, with all of your attention on the patient, and not on your next task.  That moment with that one patient will never happen again. It is its own time that just you and that person share.  The Japanese have a saying for this: “Ichego Iche.”  One time, one moment. This is a plaque that is often found in tea rooms in Japan.

You have started to create a relationship.  Now, you have to continue to nurture it. This is done by continuing the conversation – and of course, great clinical and administrative service and care.

With each patient encounter, you have to be interested, attempting to understand and then get understood. Improve this and you are well on your way to better patient retention and referrals.

CONTINUING THE CONVERSATION

But when your patients are not with you, you have to find ways to continue the conversation.

How?

Your Newsletter.
You can easily set up an email newsletter with an a provider such as Constant Contact or Mailchimp. Send these out monthly or even twice per month. The most important aspect of these letters is to keep them real, personal, as if you were writing to a friend.  It could simply be a few paragraphs from the doctor relating a recent case success, or a home health tip. You can also include patient testimonials and a review of a recipe.

But we are inundated each day with hundreds of emails so keep in mind that old fashion snail mail still works, and in fact, works better.  It does cost, of course, but the return on investment makes it worth it.  A hard copy newsletter will have “shelf life,” and can be read and reread.  Most emails are overlooked -there are just too many of them.  Send out a hard copy newsletter every 4-6 months.  It can even just be a one page foldover, self-mailer.

Other Mail.
Cards are very considerate. Just think about the few you receive. You may still have them! A system can be set up to send out birthday cards, welcome cards, humorous reactivation cards, bereavement cards, and congratulation on starting your “wellness program” cards, as well as other cards each month.  These all help keep the conversation going.

Social Media.
Facebook is your primary social media with your patients. This can be similar to your newsletter.  Like email, it has become glutted with ads and “content” information.   Ask your patients to “LIKE” your page so that they can stay in touch with the office and receive new information about health and upcoming office events.  Some offices even hold special contests only for their Facebook “friends.”  Then, post regularly fun and education information. For example:

 “Our patient, Burt, just got accepted back into his hockey league thanks to chiropractic. Here is a photo of Burt and Dr. Smith and his new puppy eating apple pie made by Rose, a long time patient who can’t stop bringing us apple pies!” (Of course always get patient approval to post their picture.)

 

Upload patient testimonials, in writing or even videos. If they are interesting, other patients can comment, or even share.  And if anyone does comment, make sure that you comment back.

Delegate these types of communication to your team, but you have to be the one to ensure that the conversation continues.

If you have good roots, there is nothing to fear.  Insurance reimbursement can decrease even more, the economy can decline, staff changes can occur, but if you have taken good care of your patients, they will take good care of you.  Conversations with your patients will help nurture a strong “root system” that will keep your office productive, no matter the storms that may come.

SUMMARY – TAKE AWAY:

 When the patient is on the phone or in the office:

  • Be present and attentive.  (Present Time Consciousness “PTC” as Jimmy Parker would say.) Be genuinely interested.
  • Seek to understand the patient.
  • Get your point understood and have a conversation.

When the patient is out of the office – continue the conversation:

  • Snail mail real newsletters and cards mailed.
  • Emailed newsletters.
  • Get Facebook “fans” and post local/personal news.

Zucchini’s and Chiropractic Businesses

Home grown zucchini's

It has been a good summer.  The crops are coming in.

Growing a practice and developing a business is much like farming. It takes nurturing, care, and just the right about of help at the right time.  A plant can seem to be dormant while underground its roots are growing and getting strong.  Sometimes practice improvement seems to occur slowly even though we may be working hard.  It could be that that you are just developing the “root” system before your practice is more productive.

Your practice follows natural laws – it has its own innate life force.

Just like a zucchini does.

You have to trust in your own goodness as you do in the power that made you and gave life to your patients. That Power — it also runs through your office and eavesdrops on your thoughts and intentions.

You have to smile about the truly awesome benefits your patients and you receive with chiropractic, which we all too often overlook.

It’s not about insurance or money or policies and procedures or schedules or management or marketing or meetings – which we all can use at the right time to the right degree. In the end it’s about the help we provide and that help should not be separated from the love in which it is given or the joy that it produces.

There is truly a lot to celebrate.

It’s a good procedure to look for and have many celebrations with your patients and those you are close to. Don’t be shy about it.

Keep nurturing your practice and it will continue to produce happy patients.

Billy DeMoss Shakes Up Appleton Wisconsin at Petty Michel Seminar

Billy DeMoss, ChiropracTOR

Dr. Billy DeMoss gave a heated and edgy presentation for 3 hours to chiropractors and their staff in Appleton, Wisconsin, Friday night, Aug. 19th. Full of anecdotes from his own practice, along with statistics, slides and videos, “Billy D” reminded everyone what chiropractic and natural health care is all about.

He talked about how providing chiropractic care is actually fun and how you should have fun in your office. He stated that patients want to come to a place that is enjoyable, where staff and doctors are having a good time in a positive atmosphere.

But he also explained that it takes a great deal of work to have a successful office. He recounted the days that he had to do manual odd jobs just to make it through school. He works hard at his office but keeps it fun.  “If you want a more successful and profitable practice you are going to have to work for it.”

“The days of the $200 dollar office visit are fading,” he said.  Workers Compensation reimbursement in California has been cut back and some money motivated chiropractors have abused the system. But money is not the goal, and never has been, he said.  Serving people will always be rewarded financially, but that is not our primary objective.

He emphasized that our main goal should be to teach and adjust. Some doctors complain about doing screenings or lectures, but Billy asks the audience: who do we do it for?  Are we worried about inconviencing ourselves or do we want to help people get healthier?

He discussed issues such as vaccinations, diet, United States health statistics relative to other countries, and said that the chiropractors were the ones best poised to take a leadership role in the health care of the U.S.

After 3 hours of Billy’s high energy, the mesmerized and energized crowd gave him two standing ovations.

One member of the audience who owns a small farm and who was not a doctor or staff member, said he wished there were more people speaking out like Dr. Billy DeMoss. He said it was one of the best presentations he had ever seen.

The next morning,  Phyllis Frase spoke to staff and doctors about how to be a “Rock Star” C.A.  Phyllis also gave a dynamic talk and will be speaking at the Cal Jam in California, February 24-26.

PM&A encourages all who can make it to Cal Jam to do so.  I attended 2 years ago and it was absolutely the most unique and refreshing chiropractic seminars I’ve attended in 20 plus years. Well worth the time and money.  More info about CAL JAM.

Dave Michel, Billy DeMoss, Dana Pittner, Phyllis Frase, Ed Petty

 

CATCH DR. BILLY DeMOSS SPEAKING MONDAY NIGHT, AUGUST 22 AT LAKE GENEVA, WI.  FOR MORE INFO, CALL: 262-275-5005

Video here

Photos here