Reimbursements: Selling is Helping

Based on surveys and group panels, a trend has occurred where practice owners continue to sign on with insurance companies offering lousy reimbursements, based on the rationalization, “If I don’t do it somebody else will”. That’s putting a nail in the coffin of your budget every time you tie yourself into a contract that makes you treat patients for peanuts.

It’s probable that you got into your profession to deliver the highest quality care and to handle the underlying CAUSES of the problems your patients present. Can you consistently handle a patient’s pain issues, let alone get to the underlying causes, when you’re being “permitted” a limited amount of visits for a limited amount of money?

So, what CAN you do? You can kick the trend and follow the plan below.

Practice owners along with their patients are, to varying extents, addicted to insurance—particularly professions such as PT, OT, CHT. For many years we have had such an abundance of insurance and government programs available, that we’re caught in an entitlement, “co-dependency”.

Another interesting trend was in Canada over the last 20 years, as the reimbursement shriveled, many practice owners went straight cash-pay instead of relying on reimbursements to provide the cash flow.

Here’s the bottom line: The only real contract that matters is between you and your patient. Your part of the contract is to handle the patient’s pain issues, get to the underlying causes and fix those and ultimately to educate the patient so that they can maintain the improvements. That’s your real product – not doing the best you can with the time allotted.

When a healthcare professional compromises the quantity and quality of his care based on reimbursements, the ethical problems start. One day you walk into your clinic and it’s just not as much fun as it used to be.

It’s when the patient “just wants what his insurance will cover” that he or she really hasn’t been SOLD on the indispensability of your service.

Don’t like the word “selling”? Then let’s substitute the word “helping”. It means the same thing. You simply will not be able to continue through the years to offer quality care to your patients as a viable practice if you don’t:

  1. Offer the best care you can “and then some” and
  2. Get an abundant exchange for it.

Interestingly, the ONLY practices that I interviewed, and the ONLY practices I’ve ever personally consulted in Canada that survived and flourished, had one thing in common—they could SELL their services when they needed to.

I know you don’t want to hear the four letter “S” word. But it’s a fact that many of our healthcare colleagues—dentists, dental specialists, audiologists and others have had to “S – – -” to survive.

“Mary, you need two crowns. That’s going to be $500. How do you want to pay for that?” And any dentist worth his weight in gold or porcelain will just look Mary in the eye and wait for her to figure it out, or he’ll simply give her the truth about the prognosis of those black stubs she calls teeth and send her to a patient care coordinator who will “close” the deal and get payment.

Having worked with more than 4,000 private practice therapists around the country, I know how scary it is to deal with patients regarding payment for services, let alone getting them to dip into their pocket for services insurance won’t cover.

It isn’t simple, but it is do-able and an indispensable ingredient to your success. “SELL” full, corrective care and deliver it.