RE: Was Accepting insurance and is now also busy practice/quality care

[Guest guest]

Insurance reimbursement works pretty well in the Pacific Northwest, in my

experience. Washington has an " Every Category of Provider Law " that

requires every in-state insurance company or insured to get coverage for

every licensed provider, including acupuncture. Sometimes, you have to

remind the insurance company of the law if they try to deny claims, but by

and large, it works fine. Mostly, you have to appear to know what you're

doing and not be intimidated by the insurance companies. My co-worker (a

chiro) went to a billing seminar taught by a woman who had been an insurance

insider for 25 years who said that every practitioner had a little icon next

to their name in the computer. A " hot dog " meant they were a push-over and

the insurance company could avoid payment. A " bulldog " meant to pay and

not even wrestle with the practitioner. It takes about a year to become a

bulldog. I've had few problems these past several years. It's not fun,

but neither is doing the work and not getting paid.

 

 

 

I have my observations of you chiropractor with the " running around like a

madman " type of practice. I've worked with chiropractors for about 20

years, currently sharing my practice with two for the past 10. There comes

a point in any busy practice (chiro or acu) where you have to recognize when

it's time to get help, whether it be in the form of a receptionist, a

billing person/service or an assistant. Every successful and busy

practitioner I've known has said that once you take that leap-of-faith and

hire someone, things tend to fall into place and you begin to get busier but

less hectic. I struggle with that line because I am probably busy enough

to have a receptionist, but don't want to part with, or stress over, paying

someone a salary and managing a person. So, I try to be as organized as

possible, always thinking of the flow of practice, do my phone calls when

I'm not in the office, and focus all my attention on the patient when they

are in front of me. I don't know that I want to get busier. If I hire

someone, I have to get busier just to pay that person, too, and of course I

think of that. My measuring tool for when the time to ask for help would

be: 1. Am I, or my patients, unhappy with the quality of care I provide

because I am too busy?

 

 

 

It sounds like the chiro you described doesn't have enough help(?). He

probably needs a chiropractic assistant.

 

 

 

There are, too, those chiropractors who see upwards of 100 people a day,

spending 2 or 3 minutes with each patient just to " crack 'em " and send them

on their way. It's not about " I can't get reimbursement from the insurance

company and am therefore forced to see 100 people a day to make $100. "

It's more about when is enough money, enough money? Personally (and this

is just my opinion, so please don't pick up your flame-throwers), I am

repulsed by the " mill " practices like this, and I never send patients to

that type of practitioner. My co-worker (chiro) interviewed a chiro last

year and saw, in his treatment room, his financial goal for the next year

clearly posted for all to see. It read, " In 2007, I will make $1,000,000. "

As a consumer, I would be more than a little put off by that person. Not

completely because that was their goal, really, but because they would feel

that it was okay for everyone to KNOW that was their goal. My

co-worker/chiropractor spends 20 minutes minimum with each patient. She

listens, she confers with me when we share patients, and the patients feel

cared for, and are. THAT's what we want to provide, and yet we still make a

good living.

 

 

 

Just my 2 cents.

 

 

 

_____

 

Chinese Medicine

Chinese Medicine On Behalf Of

anne.crowley

Saturday, July 14, 2007 6:32 AM

Chinese Medicine

RE: Accepting and billing insurance

 

 

 

Andrea:

 

I really believe this insurance issue is state specific. There is a

practiioner here in MD who takes every insurance under the sun. Started her

business just a not long ago and is doing very well. She is offering a

workshop for practitioners on how to do this. I know other practitioners who

became very busy right away by taking insurance. I don't take it, and will

probably go to her workshop just to see what goes on when my patients file

it. There is so liitle training on this.

 

I ran into an acupuncturist from FL recently who bills and gets reimbursed a

handsome rate from insurance. He gave me the name of his insurance biller

(and he pay 10% but had no problem with it), but somehow I don't think FL

and MD will be the same. I hear the practitioners in FL are viewed more like

primary care physicians. Is this true also in CA?

 

I have to admit, every chiropractor or MD (practiicing acupuncture) I have

met gives the advice - If you don't have to take insurance, don't.

My chiropractor is also running around like a madman - good analogy. He does

appear in control of the madness. His only staff is the receptionist and the

biller (and a wife at home running the business end). He does all the chiro

work. He uses some tool (that drill punch look) that looks like an activator

but it is more high powered. I actually like it. Better than neck bones

crunching. He also uses the cold laser (on my plantar fasciitis). Then he

puts you on the water bed for 8 mins. No electrobes, no ultrasound.

 

Anne

 

-------------- Original message ----------------------

< (AT) (DOT) <%40> com>

> Hi Mike,

>

> Thanks for your post. Actually, this chiropractor has low-rent offices and

no

> staff, and is rushing like a madman all the time to get through his

patient

> load. I have referred patients to him, who complain about his rushing and

> seeming to " forget " them while they are on the table with e-stim or

whatever, so

> I no longer refer to him. It seems like he is doing something wrong (other

than

> over-scheduling), but I don't know what it is.

>

> By the way, I have also heard of a naturopath in Sedona who went out of

business

> because she couldn't receive payment from insurance companies to the tune

of

> $250,000. Perhaps the insurance game is harder in Arizona than it is where

you

> are.

>

>

>

> mike Bowser <naturaldoc1@ <naturaldoc1%40hotmail.com> hotmail.com>

wrote: Andrea,

>

> There are many business models and ways to be successful. I have worked

> with and billed for insurance (auto) and been paid quite well. I have a

partner

> who has also done well and built her business mostly off of auto cases and

 

> routinely

> receives about $100 per patient visit. Your DC must have a very high

overhead

> (mall locations and staff). As a small practitioner one can do much of

this

> themselves if they are organized and schedule time well. Many of us just

do not

> seem to understand how it works. Mike W. Bowser, L Ac

>

>

> Traditional_

<Chinese Medicine%40From>

Chinese_Medicine: (AT) (DOT)

<%40Date> comDate:

> Thu, 12 Jul 2007 08:02:07 -0700Accepting and billing

insurance

>

>

>

>

> Hi All-I thought I'd pass this along for all those weighing whether or not

to

> sign on with health insurance companies as a provider. A friend of mine

who is

> an chiropractor in the same town where I practice, strongly recommended

that if

> I can manage to build a sustaining practice without accepting insurance,

then

> that is what I should do. He said he has to bill $130 per treatment in

order to

> receive only $30, and it eats into his $30 to have to pay someone to do

the

> billing and follow-up. He has a busy practice, in two different cities,

works 6

> days a week, and is struggling to make ends meet, despite how hard he

works and

> how busy he is. In the end, he says, insurance doesn't " pay " .What he tells

me

> matches what I heard in one of the practice management seminars I took

after I

> finished acupuncture school, FYI.,

> L.Ac.Building a website is a piece of

cake.

> Small Business gives you all the tools to get online.[Non-text

> portions of this message have been removed]

>

>

> ________

> Local listings, incredible imagery, and driving directions - all in one

place!

> Find it!

> http://maps. <http://maps.live.com/?wip=69 & FORM=MGAC01>

live.com/?wip=69 & FORM=MGAC01

>

>