Answer these questions as a group and the 2nd person in each group will post the answers on the blog. Can you have a “cash only practice”? Explain how and why you can or cannot.
This assignment is due September 26th.
Please remember to discuss (and show evidence of that discussion) to receive credit for the blog. Also, if I ask for an explanation in the comment, it would be wise to define what you are attempting to explain.Thank You,
Dr. Frost
Please remember to discuss (and show evidence of that discussion) to receive credit for the blog. Also, if I ask for an explanation in the comment, it would be wise to define what you are attempting to explain.Thank You,
Dr. Frost
Group 24:
ReplyDeleteYes you can have a cash only practice. Your patients can pay up front or in installments over a payment plan. The exception is you must bill medicare if you care for a medicare patient.
group 17:
ReplyDeleteA cash practice is an option if you do not see any Medicare patients.
Group 21:
ReplyDelete(discussed via email):
"Yes,you have the patients pay and they can be reimbursed by sending their bill into their insurance comapany if they want."
"I think you can if you do not except anyinsurance and do not except any Medicare patients."
"You can have a cash only practice. With insurance claims you can have the patient pay you and file the claim for the paymenttobe reimbursed. Medicare you can be non-par but stil arerequired to file."
"You can opt not to take patient's insurance,give patients a form so they can be reimbursed, but if you have patients with Medicare, you have to bill Medicare."
"Any practice that renders a medically necessary service collects cash from the patient, but sends a bill or provides the information from which a bill is sent, not only has post-payment liability for the representations made regarding the service performed and the necessity of that service, but is, in essence, an insurance practice.
Since DCs cannot opt out of Medicare, even nonpar providers retain the obligation to bill Medicare for covered services. A 100 percent cash practice means patients pay at the time of service 100 percent of the time. I think this is unrealistic."
Group 1:
ReplyDeleteWe as chiropractors can have successful cash practice. The patients would pay for all services they received at the time of service. If they are a medicare/medicaid or a patient with insurance you can bill the insurance for the patient then have the insurance pay the patient. Another way is to fill out the information and have the patient send the information into the insurance and have the insurance pay the patient. The downfall for a cash only practice is patients may not want to work with there insurance company/medicare. They want you to do all the work with them so there is a possibility you would lose patients.
A Cash-only practice is very limiting!
ReplyDeleteIt is possible to have a cash only practice but it does limit you in many ways. In order to serve your community it would not be beneficial to solely have a cash only practice. If Chiropractic is about helping all then this will not benefit you. Alot of the times you get a service somewhere only because it is cheap or your insurance pays for it, not because of who served you and how good the service was so in this regard it is limiting.
Group 4
ReplyDelete4.1 I think chiropractors can have a cash practice. The patient can receive a superbill with the codes from the chiropractor and work with their insurance company. Also, the office can take care of the necessary submitting, and make sure to mark on the form that the check goes to the patient. Either way with a cash practice, the chiropractor needs to make sure all payment is given upfront to assure payment. The patient can say he/she never got the check to pay their bills and instead they are pocketing the bill, so making sure that payment for each visit is paid in full when services are performed.
4.2 Yes a cash practic is possible keeping in mind that you will still have to work with Medicare and provide an itemized recipt or superbill to those patients who want to submit to their insurance. Also good record keeping is a must. Keep in mind that some states have laws about discounts.
4.3 Yes, you can have a cash only practice but there are a few things that need to be kept in mind. For instance, no matter how you are billing, if you treat anyone on Medicare, you HAVE to bill them regardless of how the patient is paying. Also, your cash prices CANNOT be less than Medicare prices. You can create payment plans, give payment at time of service discounts, and hardship discounts but you must have some sort of written protocol for these price adjustments to provide a record and keep things fair. To give hardship discounts, patients must qualify financially based on your state requirements. Finally, even in you are a cash practice, you still have to bill patients and keep accurate records of patient encounters, treatments, and billed procedures.
4.4 You can have a mostly cash only practice, but chiropractors don't have the ability to not see medicare patients. So if they do see them, they still need to bill medicare. Everything else can be done cash, and can be done successfully. So can you have a cash only practice? Kind of.
4.5 Yes you can however you need to follow all laws. Also if you check into the major insurance carriers in the area, it may be to your benefit to accept some of the main ones.
Overall answer: Yes you can,there are some important aspects to keep in mind, like doing things the right way so that your patients have an easy time submiting to their insurance that they pay a lot of money for and Medicare.
Group 9 met and discussed:
ReplyDeleteYes, it is possible to own and operate a successful "cash" practice. We as chiropractors need to be able to educate our patients and potential future patients on the importance of chiropractic as true "health care". This is whether you own a insurance practice or a cash practice. The difference, however, is that if you fail to educate (or sell) patients in a cash practice you will not be successful. We as patients (consumers) need to believe in what we are purchasing since we are spending our hard earned money. We might have the security as a insurance patient that even if our care is sub par we are not losing as much as shelling out our money for the full price. Patient care is the main goal of any practice. Even if a cash practice is owned, all the same rules of the business still apply (i.e. patient notes, documentation, HIPPA etc.) So again, yes, it is possible to own a successful cash practice, but remember you get out of your business what you put into it; hard work, patient education and low overhead are just some things to keep in mind in order to achieve this goal.
As chiropractors, we can have a cash only practice. This does, however, limit your practice to patients who are willing to submit their own insurance claims or who have the money available to cover their appointments without insurance. You would also not be able to see any medicare patients because you must submit claims to medicare. In addition to this, it would be difficult for a cash only chiropractor to treat personal injury and workmans comp cases because of the complicated insurance process that is required.
ReplyDeleteYou can have a cash practice with some limitations. If you have a medicare patient you must bill medicare. If a patient's insurance covers chiropractic care you can accept cash up front and provide the patient with the correct paperwork to bill the insurance.
ReplyDeleteYes, chiropractors can utilize a cash only practice. Although a chiropractor may not accept any private insurance they must still bill Medicare if the patient has it and prices cannot be lower than Medicare prices. The patient will pay at the time of service; the patient may also file their claims on their own if they are insured. A chiropractor must check with their state and local laws.
ReplyDeleteClass 121 group 10:
ReplyDeleteOur group discussed cash practices though email, over football games, and through one-on-one conversations.
Some members believe that cash is the only way to go, since insurance companies basically decide our income if we play by their rules. I was asked why we should even have a fee schedule, if they make the call anyway. Good point.
Other said insurance could boost income because they cover more than just adjustments. The exam, films, rehab, and possibly braces and other orthotic-type devices could be covered depending on the patients plan.
One member posed a hybrid idea, which seems to be the standard. Patients will be billed via their insurance until their insurance runs out, then transferred to a cash-type plan.
I personally noticed patients in the northeast want to pay their copay, and then maybe a bit more if necessary. Not $80-$100 per visit. I understand this because insurance premiums cost anywhere from $2000-$4000 a year depending on the plan selected. They really shouldn't have to pay much more! But, I also believe they should investigate their policy before they choose it. My personal plan covered 20 adjustments, and re-evaluations monthly for 3 months. With a plan like that, why not accept insurance?
Yes you can have a cash only practice. The only exception is when you have a medicare patient you have to bill the medicare insurance. You can have the patient pay you when the service is provided or do a payment plan. So the end result is that you can have a cash only practice.
ReplyDeleteGroup 14:
ReplyDeleteYes, someone in theory can have a cash only practice but you would have to be very careful in who you would take on as patients because anyone who is medicare or requires insurance to be billed would be off limits to you. You would be limited to only those patients that only want to pay on their own and are not under an insurance plan that requires the insurance company to be billed.
Group 2
ReplyDeleteGroup
It is possible to have a cash only practice. Depending on the type of practice, it could be ill advised though. If someone would like to work with acute care patients, and be constantly seeking new patients, then insurance is a very lucrative option. Patient's come in with a condition, and insurance usually pays well for that problem to be resolved. But when patient's are used to having insurance pay the bill, few are likely to pay out of pocket for wellness care after they feel beter.Someone who wants to have a wellness, patient retention clinic, it may be better to have a cash practice. I've spoke to a couple of docs that simply advise the patient to send in their own superbill to the insurance company for reimbursement, but still pay cash. Also, chiropractic is now listed as a specialty service in some states, so the co copay can be up to $100, which is more than most regular office visit. Seeing that medicare doesn't pay for wellness care anyway, billing them for something they won't pay for isn't much extra work, and still means you are a cash practice.
Group 11
ReplyDeleteIt is possible to have a cash only practice. The problem with it is that it drastically narrows the range of people that can be seen. You cannot see medicare patients in your practice as well as people who want insurance to pay for it. This covers most of the population of the US unless you can find your own niche where cash would suit you better.
Our group communicated via e-mail. We came to the conclusion that you can have a cash only practice. This would require payment at the time of service. You could print off anything the patient would need to send the bill to their insurance company themselves, but whether or not their insurance would cover the visit would not affect the care you give. Being a cash only practice eliminates a lot of work for you and your staff.
ReplyDeleteA downside to an all-cash practice is that you may miss out on some patients. All Medicare patients would have to be turned away and you wouldn’t be able to take any WC or PI cases. Some patients may choose not to come to you because you don’t accept their insurance.