Q:

Dr. M

My wife and I have been have tried many "cash plans". We have been 
doing one with our patients that is a tiered plan. Starts at $360 for 
a family and drops to $120 by the end of the year. I think it works 
well, but we have a few patients that tend to abuse it and come it 3-
5 times in a week. If they need the care great, but they say I pay for 
chiropractic  and I want to get my good out of it (similar to a 
smorgasbord diner). I don't mind charging a set rate per visit,
non-negotiable, but I really want to promote wellness care and do it
affordable but at a rate that I can live (and pay on student loans). I
really value the financial plans and want to make it a win-win 
situation. Do you have any suggestions or places to look for ideas? 

A:

Thanks for the e-mail. Financial plans have been the burden of DC's 
from the get go. In one breath we believe that everyone deserves 
care and some DC's actually give care away since placing a fee upon 
an adjustment is unthinkable. But as you wrote .. you have to pay 
your bills and live as a professional with all the years of study 
deserves. 

This is what I do. I am heavily in insurance managed care programs. 
There are pros and cons of this. The positive .. we always have new 
patients with nothing to do about it but answer the phone. The 
downsize .. people pay a co-payment and we must accept the small 
insurance payment as payment in full. Some pay better than the 
other but in general patients get used to the co-payment fees and 
stop care after their insurance benefits run out. This makes it a 
difficult in terms of patient education concerning wellness and/or 
maintenance care.

To make it clean .. this is what we do .. to have patients continue 
care .. I charge them a regular adjustment fee .. $35 .. for their first 
visit of the month and then they pay only $15 for each visit for the 
remaining days of the month. This would keep people from abusing 
the system and keep a monthly maintenance visit  at least 
affordable. For the family .. charge just $10 or $15 per family 
member per visit with a $50 strat of the month fee as a global 
family one time fee. Play with this