Q: Hi Doc, I am getting ready to set up my own Chiropractic practice. I was just wondering how you can set up different systems of payment so that when a pt's insurance runs out they don't have to worry about discontinuing their care. And how about family plans? I don't understand because they say that you can't legally set dual fee schedules. If you could please give me some info. on this I would very much appreciate it. Thanks a lot, A: Thanks for your e-mail. I recommend you consider purchasing my Smart Start Book which is a gem for many DC's nationwide. As far as dual fees .. this concept has been tossed around for many years. There is no question that the more fee arrangements you have cause an administrative headache if nothing else. But .. business is business and within reason you try to stay in business .. which includes some arrangements about maintenance or family fees. To assist my patients .. I joined PCD (Preferred Chiropractic Doctor) .. there is no fee to join but it allows a patient to join for a token fee of $35 a year a supplemental insurance program allowing you (if you are nervous about dual fees) to lower your fees for the patients that join. This group is in some states but not all .. call them at 1-800-239-3552 to see if they are in yours. Below is the form I give after a discussion to my patients after their 4-5th adjustment. I hope it helps. Also .. be sure to look through my webpage: http://www.mindspring.com/~chirosmart under Cyberconsulting and Practice Tips .. the cyberconsulting area are answers like yours .. check there for answers to questions you may have. As far as a Family Plan .. if the entire family comes in the same day .. yo could give a global fee of possibly twice the office fee or 1 1/2 fee for two .. or take the insurance without co-payment for the second person or $10 fee children or just insurance .. don't worry about the dual fee concept .. in all my 22 years of practice I never heard to the dual fee police auditing anyone¼s practice as even those that caution you about it .. do it. Use proper judgment. If you wish to purchase my Smart Start Book ($60) or my PI Workbook ($25) or Workshop Workbook ($25) or the PR and Marketing Book ($25) or a document disk for the Smart Start Book with the forms and letters and a complete narrative with ratings for Windows and Mac (please request which) ($15) .. you can do it on-line at http://www.chirostore.com/catalog/cat8.htm .. or call my office at 770- 491-3639 and order it directly. Relief or Corrective Care Patient¼s Name ___________________________________________ Date ___________________ In order to assist you with the care necessary to provide relief as well as attempt to correct your spinal condition the following will help in your decision. If money and time is a factor we recommend you choose the relief schedule, but if you wish to benefit from the potential of chiropractic care and be pro-active in preventive health care then corrective care would be your best choice. The choice of care is yours. First the difference between relief and corrective care. __Relief Care: As long as it takes to provide pain or symptom relief. Time necessary depends on many factors .. structural instability .. history of injuries or repetitive joint aggravation .. patient¼s age .. family history .. recent factors that brought you to our office. On average .. a schedule of between 4-8 visits over a period of 3-4 weeks may achieve the results as well as begin to stabilize the area(s) of concern. __Corrective Care: A process of further stabilization and rehabilitation of the specific area(s) as well as maintaining the supporting structural regions. On average this care extends beyond your relief schedule over a period of 6 months with less care rendered after the initial relief schedule ends. Correction is dependent on many factors including age, weight, level of exercise, nutritional balance, lifestyle habits, work routine, sport activity, accident history, structural weakness and instability and more. Therefore, the word correction would best be served as management. On average .. a corrective care schedule is between 30-40 visits within six- twelve months. Your insurance carrier provides for Relief or Acute Care only. This is for a short time frame. Chronic conditions warrant further care and will be your responsibility. We estimate your carrier to cover only _________ visits for the acute period of care Your corrective care schedule with an estimate of fees and times is as follows: o Relief Schedule: _______ visits over a period of _____ weeks o Corrective Schedule: _______ visits total over a period of _________ months o Total of visits between relief and corrective schedule is: ________ Corrective Care Fee Balance without therapy @ $35 $ ____________ Corrective Care Fee Balance with therapy @ $60 $ ____________ PCD* Corrective Care Fee Balance without therapy @ $25 $ ____________ PCD* Corrective Care Fee Balance with therapy @ $35 $ ____________ PCD savings of with therapy $ ________________ without therapy $ ________ The most important facet of care is repetition and momentum. Whatever schedule you choose it is imperative that you follow this schedule. Therefore, your decision concerning corrective care and our schedule of specific dates and programs should be decided shortly. Payment Schedule Payment Options over a period of eight (32 weeks) months (Paid the beginning of each week or month) Weekly payments with therapy of $ _________ Weekly payments without therapy of $ _________ You can also save 10% of the balance by making one payment for the above schedule. During the accepted period of treatment you are responsible for your co- payments only. Requested care beyond this period will be your responsibility with a credit card imprint on file. We can either bill your credit card weekly or monthly. If you have no credit card your personal check will suffice. We rather not bill you for these visits. Often payments will be for services already rendered. Please be current on your account. If we need to bill you and a collection service is necessary all collection fees and interest will be your responsibility Name on Credit Card: _____________________________________________________________ Type: ____MC _____Visa ____AMX Credit Card # ____________________________________________________ exp: _____________ * Preferred Chiropractic Doctor program costs $35 a year per individual to join. Our normal fees are $35 an adjustment and $15 for therapy. PCD allows you a substantial savings at $25 per adjustment and $10 per therapy. I have read the above and agree to the provisions outlined. I understand there is no guarantee of health care results. If for any reason, I wish to discontinue care and have pre-paid for services, I will be reimbursed for all services not provided at the rate the appropriate fees above. Necessary care beyond the above schedule will be discussed and similar financial arrangements can be made Signed: ___________________________________________ Date: ________________ Witness: ___________________________________________ Date: _______________