Cash-Based Practice: Is it for You & Your Practice?

Cash-based practices are becoming the foundation of your ability to communicate value to your patients. Whether you currently run a cash-based practice, partial cash-based practice, or still an insurance based practice, looking into how a cash-based practice can benefit you is worth this read. Pivotal Health Solutions Chiropractic inquired some of our clinical doctors about how they run their practice and how to make yours succeed- cash-based or not.

Health insurance. Some people have it, some people don’t. Insurance can be terribly expensive, and some insurance doesn’t cover certain check-ups. Chiropractors, for example, used to not have theinsurance benefits most medical practitioners had. Many early chiropractors had to keep moving their offices so that spotters from the medical boards wouldn’t arrest them for practicing medicine without a license (Phil Mancuso, D.C., 1994). Some chiropractors would see upwards of 70 patients a day, living paycheck to paycheck because they were forced to wait for their insurance payments!

Nowadays, a lot of chiropractors are making the transition to an entirely cash-based practice.Chiropractic house- calls, walk in appointments, and even scheduled appointments are being paid for strictly with cash. Although the foundation of a cash-based practice relies on your ability to communicate value to your patients, chiropractors who chose this method of practice need to have the proper procedures, equipment and systems in place to collect more cash from their patients, rely less on the dependence of insurance collections, and apply the appropriate legal discounts to care.

A lot of chiropractors that choose to use a cash-based model in their practice do so because it keeps everyone’s costs down- the chiropractor’s and the patient’s. Depending on the insurance carrier, the fees are usually higher. Some chiropractors have fees as low as $20 for an adjustment. Also, medical insurance companies have strict guidelines for practitioners, resulting in higher fees, which continues to steer chiropractors away from insurance practices.

Do you have to choose between strictly cash or strictly insurance? No! Dr. Jarrod Nichols, of Nichols Chiropractic in Manhattan, KS, uses a 70%-30% model.

” 70% of my practice is insurance-based and the other 30% is cash-based. Although Nichols Chiropractic isn’t entirely “cash-based,” I like to be flexible to my patients and will serve patients who have insurance, though choose to pay using a cash plan.”

Dr. Jerad Bludorn, of Lake Norden Family Chiropractic, says he runs a primarily insurance-based practice, although he does occasionally treat patients via cash. 

“In the state of South Dakota, we are restricted by fee-for-service laws and pre-payment for services. Although “going-green” is the way to go for other chiropractors, it is not necessarily where I want to be in the state of South Dakota, although I will set a fair rate for fee-for service.”

For treatments such as laser therapy and manual therapy techniques, modalities such as Apollo Cold Laser treatments andWhole Body Vibration, as well as exercise programs by a chiropractor would most likely fall under cash payment. Why? A lot of these treatments fall outside of what is covered by insurance, not just in South Dakota.

Some doctors have been operating a 100% cash-based practice for years. Dr. Curtis Turchin has been operating a cash practice for over 20 years. 

“There are dramatically more advantages than disadvantages to having a cash practice for chiropractors, such as immediate imbursement, rather than waiting for insurance reimbursements; chiropractors are reimbursed at a much lower level than other health care providers.”

5 Reasons to “Go-Green”

Benefits to running a cash-based chiropractic practice

  • Immediate payment for services
  • Dramatically lower overhead (burden or indirect costs) than a billing practice
  • Lower staff & reporting requirements
  • Ability to develop pre-payment plans for treatment regimens
  • Lower tax deductibles for your practice

 

Although having a cash-based practice can be quite beneficial to you and your patients, cash-based may not be for you, and that’s ok! You may have a slower client base and billing insurance can open up your practice to patients who can only afford treatments if their insurance pays for their visit. Maybe you just aren’t interested in maintaining a cash-based practice, or your state has certain requirements and regulations, whatever you choose for you and your patients, always keep in mind that a cash-based payment system can eventually work into your practice!

Click below to learn more about “Going Green” and download our cash-based practice infographic!

About Author

In the chiropractic field, flexibility is the name of the game. It’s our mantra too. Since we launched in 2005, PHS Chiropractic has become a leader in beautifully designed, customizable chiropractic tables and accessories. We design our base tables to be feature-rich, meeting the needs of the student or new practitioner. Yet as you grow your practice, our tables grow with you: We’ve dreamed up every possible feature, from drops to elevating heights to adjustable head pieces—all easily added to your existing table to broaden your options. It’s all part of the thought and care that we put into each and every PHS Chiropractic product. Made right here in the Midwest at our plant in Watertown, South Dakota, our products reflect our strong values: high quality, integrity, creativity and innovation. The result is a rich line of chiropractic tables and accessories—from our groundbreaking Tradeflex series to our patented ErgoStyle drops—all offering a high level of design expertise, patented features and great value that give you the tools you need to build a successful practice.

Plantar Fasciitis? Maybe Not, So Don’t Ice It!

For athletes who are training hard, the stabbing pain of plantar fasciitis is all too common. Most often, when pain is felt into the bottom of the foot, it is instantly diagnosed as “plantar fasciitis.” I say, let’s take a hard look at all the reasons there might be pain in the bottom of the foot and try to eliminate those reasons. And, let’s not be too quick to give a medical condition to everyone who experiences pain or discomfort.

So before you pull out that cold pack, ask yourself: What about trigger point therapy?

Trigger points, or contracted areas in muscle, are common causes of aches and pains, but are woefully under-diagnosed. Knowing which trigger points can cause or refer pain into the bottom of the feet can mean the difference between spending time on the bench or competing. Athletes or other clients who present with pain in the bottom of the foot are often told that they have plantar fasciitis even if there was no MRI performed. But if the plantar foot pain is actually due to trigger points in the gastroc or soleus muscles, these clues can help you determine if this is the case:

  1. The athlete may feel a loss of strength or power when pushing off or jumping.
  2. The athlete may report a feeling of tightness in the calf or the feeling of being on the verge of a calf cramp if they point their toes strongly.
  3. The athlete has restricted range of motion in the ankle and/or in straight leg dorsiflexion.

 

If foot pain is due to a trigger point, most athletes and clients experience real and rapid relief once trigger point therapy is applied. Here’s how to get started.

1. Invest in an elevating electric table.

To spare your back and to help further athlete comfort, an elevating electric table is essential.

Some athletic training rooms only have static tables at one height, but I would promote having at least one elevating electric table in the training room. The ability to bring the table up to the height of the practitioner during trigger point and other therapies helps mitigate the impact of treatment on a provider. Also, athletes in pain will appreciate that a table that can be lowered so that they can more safely get on the treatment surface.

As a side note, if your practice or training room works with athletes who are physically challenged (such as paralympians or para-athletes), elevating electric tables help ensure that you are ADA compliant and mobility friendly.

2. Provide support with a bolster.

During treatment, your athlete will typically lay prone on your table. But while in this position, you don’t want them to be maximally resting on the top of the foot, which could cause calf cramping and additional pain. Make sure that your training room has sturdy bolsters that are easily accessible (not tucked away in a storage room) to provide support for the lower leg and ankle.

3. Assess the ability of the ankle to bend.

Full, pain-free dorsi flexion and plantar flexion are required for the lower leg muscles working properly. Key indicators of trigger points (besides taut, ropey fiber sections) can be any restrictions in the range of motion of the gastroc or soleus muscles. Many athletic trainers may not realize that those two muscles—which are located in the calf just above the Achilles tendon—harbor trigger points that can refer pain into the bottom of the foot.

By using a bolster to support the ankle while the calf is available to be treated, it’s easy to feel for dysfunctional fibers in the medial, uppermost gastroc and the lower one-third of the soleus.

4. Use the trigger point illustrations to help locate the most probable location of taut fibers and then apply trigger point pressure release or other manual therapy techniques.

Athletic trainers may already be familiar with these trigger point locations, but for a comprehensive guide, refer to Myofascial Pain and Dysfunction: The Trigger Point Manual, a two-volume set by Drs. Janet G. Travell and David G. Simons. Other helpful publications include the most recent addition to the trigger point family, The Trigger Point Therapy Workbook, Third Edition or my book, Trigger Point Therapy for Low Back Pain (see chapter 14).

5. Athletic trainers should instruct athletes to continue careful active range of motion and home self-care. Self-applied trigger point pressure release may need to be done by the athlete during workouts, and before or after competition.

After treatment, athletes can resume regular activity with care and should also use at-home applications of compression. Many excellent tools are available for self-care compression into the gastroc/soleus muscles, including the Jacknobber, Knobble or The Original Backnobber.

As athletic trainers, you care about ensuring your athletes’ peak performance. Trigger point therapy is one way to help you get there. Trigger points can reduce athletes’ running speed, endurance and jumping abilities that are used in many different sports. With or without the presence of pain, they can also be the cause of athletes hitting a plateau, despite great training. But once a trigger point is deactivated and the muscle has been brought to its normal resting length, athletic performance improves almost instantly.

Mary Biancalana, owner of Trigger Point Sports Performance and the Chicago Center for Myofascial Pain, runs her own educational program for Advanced Trigger Point Education. She is a BOC- and NCBTMB-approved provider for athletic trainers as well as for massage therapists. For more information, visit www.chicagotriggerpointcenter.com.

About Author

In the chiropractic field, flexibility is the name of the game. It’s our mantra too. Since we launched in 2005, PHS Chiropractic has become a leader in beautifully designed, customizable chiropractic tables and accessories. We design our base tables to be feature-rich, meeting the needs of the student or new practitioner. Yet as you grow your practice, our tables grow with you: We’ve dreamed up every possible feature, from drops to elevating heights to adjustable head pieces—all easily added to your existing table to broaden your options. It’s all part of the thought and care that we put into each and every PHS Chiropractic product. Made right here in the Midwest at our plant in Watertown, South Dakota, our products reflect our strong values: high quality, integrity, creativity and innovation. The result is a rich line of chiropractic tables and accessories—from our groundbreaking Tradeflex series to our patented ErgoStyle drops—all offering a high level of design expertise, patented features and great value that give you the tools you need to build a successful practice.

Pivotal Health Solutions Proudly Unveils New Chiropractic Bench Series

Watertown, South Dakota: Pivotal Health Solutions (PHS), a leading manufacturer of premium quality health and wellness equipment for over 20 years, proudly presents the new EB8000 and EB8020 chiropractic adjusting benches. The new bench series offers uncompromised stability and style, plus a firm, workable adjusting surface for your patients – all at an affordable price. PHS Chiropractic, a branch of Pivotal Health Solutions, has developed chiropractic adjusting tables used by thousands of doctors of chiropractic throughout the world, as well as many of the most prestigious chiropractic colleges. In addition to their dedication to quality, many of PHS’s chiropractic customers value the unique and patented features available only from PHS Chiropractic products.

Chris Hockert, owner of Hockert Sales in Isanti, MN, said, “Through years of experience working with chiropractors, we realized there was a need for an affordable, sleek, durable adjusting bench with optimal comfort, strength, and versatility. These features were in demand in the chiropractic profession. Pivotal Health Solutions saw the opportunity and that became the basis for the EB8000 and EB8020. The addition of the new bench series helps broaden our product offering and allows us to more effectively support the chiropractic professionals.”

EB8020.png         EB8000.png
EB8020 Fixed Bench  EB8000 Bench with Adjustable Headpiece

PHS Chiropractic offers the streamline designed chiropractic bench in two models: EB8020 fixed top bottleneck design and the EB8000 with an adjustable face rest. The EB Series is elegant and simple, yet affordable with great features such as:

  • Leveling feet
  • Shipping weight of 80 lbs.
  • Weight capacity of 600 lbs.
  • Dimensions: 22″ fixed height x 24” wide and 73” long
  • Black powder coat steel frame
  • Seamless cushions with folded corners
  • Extended arm rests
  • Paper roll holder and cutter
  • 2″ firm foam cushions

 


About PHS Chiropractic

PHS Chiropractic, by Pivotal Health Solutions, was formed with the mission to be the leading, global manufacturer of quality built, ergonomically sound chiropractic adjusting tables. The growth of our trusted brand began with the launch of Eurotech Tables and the acquisition of the Chattanooga ErgoStyle table line in 2008. Over the course of eight years, Pivotal Health Solutions Chiropractic division blossomed into one of the most comprehensive, quality built and ergonomically sound chiropractic adjusting table lines in the world today.

PHS Chiropractic will start distributing the new EB8000 and EB8020 benches June 1, 2016. To locate a dealer in your area or to pre-order, please contact our customer service team at (800) 743-7738, or via email at [email protected].



Download the Introduction to Whole Body Vibration eBook

 

About Author

PHS Chiropractic

In the chiropractic field, flexibility is the name of the game. It’s our mantra too. Since we launched in 2005, PHS Chiropractic has become a leader in beautifully designed, customizable chiropractic tables and accessories. We design our base tables to be feature-rich, meeting the needs of the student or new practitioner. Yet as you grow your practice, our tables grow with you: We’ve dreamed up every possible feature, from drops to elevating heights to adjustable head pieces—all easily added to your existing table to broaden your options. It’s all part of the thought and care that we put into each and every PHS Chiropractic product. Made right here in the Midwest at our plant in Watertown, South Dakota, our products reflect our strong values: high quality, integrity, creativity and innovation. The result is a rich line of chiropractic tables and accessories—from our groundbreaking Tradeflex series to our patented ErgoStyle drops—all offering a high level of design expertise, patented features and great value that give you the tools you need to build a successful practice.

Whole Body Vibration for Every Patient in Your Practice

WBV-1After having been in practice for over 30 years, I have noticed some significant changes in the way patients behave. I think it is no surprise for you to hear that people the more stressed out than ever.

What does that mean for your office? The patient is overwhelmed, rushed, on the phone or texting until the moment they walk into the treatment room. I even had patients answer the phone while getting a treatment, despite a ban on cell phones in our office. It blew me away!

How ready is the body and it’s neurological system to receive a chiropractic adjustment? Often their brain/computer is so locked up they hardly notice the impact we are making on their system with the adjustment.

Let me share with you a simple way making a difference.

In my office we have every patient step onto the A3 Whole Body Vibration unit as soon as they step into the office. We have them do some simple balance exercises. We do this because their brain HAS to focus on posture and balance. Theneurologic input of the vibration plate creates what I call a massive “afferent barrage” neurologically and proprioceptively, which inevitably lets the patient forget about everything else. They have to be present and focused in order to not fall over.

Since I have been implementing this little trick, my patients are much more aware during the actual chiropractic treatment because we challenged and stimulated the neurologic pathways that effect change via neuroplasticity! I have noticed that patients take the adjustment better and generally become more involved with their own care again.

This little trick literally takes only 3 to 4 minutes! Without needing a staff member to attend to the patient, it is a extremely cost-effective way getting better results with every patient.

The A3 Whole Body Vibration plates are very affordable, have a small footprint, and consequently are a worthwhile simple investment for any chiropractic office!

I have recently written a book outlining the various reasons for integrating whole body vibration into your practice. Please contact Pivotal Health Solutions to get your free download e-book and read more about this phenomenal therapy.

I am certain you will be intrigued!


WBV_request

Christian_ReichardtChristian has been a practicing doctor of chiropractics since 1983. A former disability evaluator for the State of California, he turned his attention from work-related injuries to sports injuries due to his own involvement in sports. He became one of the first certified chiropractic sports physicians in the U.S. in 1986, as well as a Diplomat of the American Academy of Pain Management. His practice in Santa Monica, Ca., draws a large clientele of Hollywood celebrities, as well as professional and amateur athletes. He has worked with a number of U.S. Olympic Team members and golf professionals. Christian has been using vibration technology for the last 15 years.