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Location: Bozeman Montana
Date of graduation: 1997
Years in practice: 14
Years of non-insurance dependency: I have always offered a care plan, but it wasn't until I started free form in the fall of 2014 that I actually trusted the process more. So I am actually newer in fully committing, honing and developing my NID practice habits.
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City/State/Province of Practice:
Bozeman Montana
Date of graduation from chiropractic school:
1997
Years in practice?
14
What percentage of your collections are cash?
75%
How many years have you been a non-insurance dependent practice?
I have always offered a care plan, but it wasn't until I started free form in the fall of 2014 that I actually trusted the process more. So I am actually newer in fully committing, honing and developing my NID practice habits.
If you converted from insurance dependence to non-insurance dependence (NID), what percentage was insurance before?
50%
Why type of practice do you have, i.e. family, wellness, sports, etc.?
Family, prenatal and pediatric
Why do you not take insurance?
When I was with PM' s that were new or routine, in the back of mind I was trying to determine if my notes would be sufficient enough to meet the insurance standard of determining if the care I was providing was reasonable and necessary. Talk about distraction from intention! We are not a heavily managed care state, but for 1 family, I was sending in "notes for review" and the consumption of time, energy and emotions was distressing and the idea of doing more than this one family convinced me that I did not want to go down this path far, as writing persuasive narratives is not why I wanted to be a chiropractor.
In addition, the "in network write offs" for many companies was like 30%. Between the write off and the added work load, frustrations were mounting!
My CA has thanks me multiple times as she does not have to spend time on the phone chasing down insurance payments. Her goal was to have a 1 page aged report.
Please share with us your number 1 best practice for being NID?
Basing care recommendations on core score, x-ray and dimensions of stress regardless of coverage.
What advice do you have for chiropractors out there that are insurance dependent?
There is a huge amount of freedom and reward in looking in a PM's eyes and making the best recommendations for them. The recommendations that transform their life, their heart and their existence. When your vision and passion is to change the world, it takes honesty, integrity, authenticity and commitment. It all starts with being an honest doctor, one that is willing to tell the truth about the real condition of a practice member's health. It is what builds trust and transformation. The rest of your practice success and reputation is built on the basis of communicating a truth and nurturing a sense of trust.
Briefly, how did you switch over?
One step at a time...and we still have a lot more to implement, but are reaping the benefits exponentially already: in volume, retention, percentage of collection and more importantly in PM's that are getting the Big Idea. There is much more ease, flow and simplicity in the practice.
We started with identifying the insurance companies that had the largest in network write offs or who had ever requested a review of records. We are weaned down to billing for 3 companies, when we were billing and accepting assignment for over 20. . We aren't even using the cash plan calculator yet, so once we do, it will even be that more smooth and easy.
What were the largest hurdles?
Making up our minds.

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