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Newsletter>
ARE YOU GETTING PAID WHAT YOU ARE WORTH?
July 8, 2010
ARE YOU GETTING PAID WHAT YOU ARE WORTH?
JULY 8, 2010
How much do you collect per visit? Are you getting paid what you are worth? I do not know how many docs I know who are contracted with all of the HMO's in the land, collecting $10-20/visit hoping to make it up in volume. In my last
office, if I was contracted with ASHP, I would have had to see 288 visits per week just to cover my overhead! ...and that was not even paying myself!
You are the king (or queen) of your castle. You make the rules. I recommend to my clients to GET OUT OF NETWORK with all insurance companies. For most PPO's the reimbursements are actually much greater per year out of network than in network. ...and I mean by a lot! I mean getting paid $180+/visit instead of the $46 they want to send you, and getting paid 60 to unlimited visits per year vs. 20 visits.
Many HMO contracts actually prevent you from charging cash after patient benefits run out! An out of network PPO benefit for a full corrective care protocol of 60 visits with 3 of the major commercial carriers could pay $7,000-$12,000 per case vs. $900-$1500 in network! Oh yeah, if you are not contracted, they cannot legally require you to pay money back to them if they
make a mistake! Three friends of mine who were contracted with BCBS were audited, and BCBS decided that the care they paid for up to 5 years ago was not necessary and were took back $75,000 to $100,000+ each!
Start by looking at your payer profiles and where your patients are coming from. Then look over all of your insurance contracts and your fee schedules. Then call EVERY insurance company that you get paid from and verify benefits for both in-network and out of network. If you are marketing for you own new patients (like you should be) then why would you agree to accept less than what you are worth to treat them?
Your insurance verification process should, at the minimum, inquire about coverage for:
* Commercial vs. Self Funded Policy?
* In/Out of network benefits?
* Based on Medical Necessity?
* Is Pre-certification necessary?
* Policy Limitations/Riders?
* Patient deductible/Family deductible & how much is met?
* Deductible carryover?
* Evaluation/Management Services?
* Do they cover x-rays?
* Is Physical Therapy (97xxx series codes) covered under your chiropractic
license?
* The number of PT visits vs. chiro?
Spinal adjustments
* How many per year/Number Used
* Dollar amount per visit
* Dollar amount per year/Amount Used
* Visits per doctor/Number used
Number of codes allowable per visit?
This will get you started. If you are getting low-balled on your
reimbursements, and the insurance company is not sending you the 288 visits/week that they promised, then you need to do a little thinking. And actually if you told them that you saw 288 visits/week, they would probably kick you out anyway for seeing too many patients. Hmmm..... Oh yeah, one last thing. Even if you do decide to stay in-network, your fee schedules are actually negotiable as well.
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Congratulations to client Dr. T.B. who finally started his group Report of Findings 3 weeks ago. He closed 8 of 9 new patients for a total of 384 corrective care visits in 3 reports for a total of 90 minutes and had a record collections month in June of $51,000!
Also to Dr. S.K. who DOUBLED his collections in the last 4 weeks!
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PRACTICE GIVE-A-WAY - A dear friend of mine was was injured in a severe motorcycle accident over this last weekend and needs to sell his practice NOW. Get this practice for 1/2 price! CBP/Pettibon Practice for sale in Sunny Phoenix, AZ. Very low overhead. Collected $130k last year. Sees 25 pv/day. Full CBP/Pettibon equipment suite. X-ray on site. Priced for IMMEDIATE sale. The doctor can stay for a transition, but cannot adjust due to multiple broken bones. This practice has the most comprehensive CBP rehab facility I have ever seen. Please already be licensed in AZ. Act FAST, this opportunity will not
last long and is a once in a lifetime opportunity. Contact Dr. Ereth at 602-206-9680 or ken250r@hotmail.com. You can also contact Dr. Popovics at Dr.Pop@See300aweek.com.
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EARN FREE STUFF! - We are looking for new ideas for products. If you have an idea for a product, send it to me at Dr.Pop@See300aWeek.com and if we decide to develop it, you will receive a $200 credit good for any product on the website PLUS a FREE version of the product after development.
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As a reward to those of you who read this, I have placed the following items on sale until 7/15/10:
The Full Catalog (all 19 CD's an DVD's) - Sale Priced at $749.95 from $999.95
Waiting Room 4 DVD set - Sale Priced at $129.95 for $149.95
19 Chiropractic PowerPoint Lectures Sale Priced at $199.95 from $249.95
Click HERE for our Coaching Programs.
www.See300aWeek.com www.See300aWeek.com
(760) 579-2799
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