Q:

Hello Doc. 



I have an unusual situation. I think I have an old patient who may be 
upset that she owes me a large amount of money. She has insurance 
and it did not pay. What can you do if this happens to you? 



Also can you please explain the laws behind cash patients and 
insurance patients? How can you legally handle  your fees if they are 
paying cash?



I bill out $40.00 and many times $65.00 when I am doing 10-15 
minute adjustments with activator technique. (feet, knees, 
shoulders, spine, wrist)



Any way I do not want to do anything illegal. I have read your  
smart start and I am stuck on the  insurance with pre payment co-
pays  and deductible compared to your non insurance, with discounts 
to pay up front. what makes the two okay when their out of pocket 
are charges are different? 

Q2:

I received this today on the internet and I believe it is the above 
patient.




I wrote you an e-mail yesterday so if you have already answered, 
then just 

disregard this one. I want to inquire about yur rates if someone 
does not 

have insurance. I understand that you have some packages where a 
person can 

pay cash up front and get some treatments. 



My husband does not have insurance but needs some help for his 
back. He could 

pay you cash up front. What kind of rates could he get if he did this. 
He 

would be interested in probably 10 to 15 treatments. Also, what is 
the best 

time to call for an appointment? We are asking several 
chiropractors but live 

close to you so you would be easier for us to visit. Please answer 
as soon as 

posssible. Thank you.




How would you handle this?


A:

Thanks for the e-mail. This is always a sticky problem dealing with fees. Once you have an 
established fee you stick to it and if a person cannot afford them or they cannot pay their 
bill you decide if you wish to place them on a payment plan over a period of months or 
write it off .. in other words forget about it.. I would recommend you offer patients like 
this a payment plan of your regular fees over a period of 6 months .. just estimate how 
much the care would be for a series of visits and then have them decide how to pay. If they 
owe you money rather than losing it all ask if they can begin payments over an extended 
period of time .. lets say at $50 or more a month. You get paid just slower. I also 
recommend you begin asking for credit card numbers on your case history form so you 
have something to fall back on.

As far as the dual fee thing and the question the person posed to you. Call 1-800-239-3552 
and see if PCD (Preferred Chiropractic Doctor) is in your area. It doesnžt cost you anything 
to join and the patient just pays PCD $30 a year to be a member which allows you to lower 
your fee by 25% without the dual fee concern.

As mentioned before .. have some payment plan options for those that want care but cannot 
pay all at once. My webpage under Practice Tips has my Financial Options or Worksheet .. 
scroll down and look for it

Have a Great Day

Dr. M