““I want to use my insurance. Why don’t you accept insurance?“
It’s a good question, so let me boil it down. Almost all my patients have insurance, but they come here knowing they’ll end up spending less. How is that possible? Well….
1. Insurance companies pay the provider less for the privilege of doing business with them. The assumption is the doctor will get more patients who are “in-network.”
2. Because insurance pays less, the provider needs to see more patients in the same amount of time.
3. With more patients to see you spend less and less time with the doctor.
4. This results in patients waiting to see the doctor because 3 or 4 other people were scheduled the same time as you. So you wait in the big room, then wait in the little room, then get treated when they have finished with the 3 or more other patients.
5. Many chiropractors have this model and will have a huge room with multiple treatment tables, with no privacy, where they go from table to table doing quick adjustments.
6. Insurance companies incentivize chiropractors to see patients as much as possible. The FIRST thing your chiropractor will do if you use insurance is call the insurance company to see how many visits you’re “allowed” that year. I can almost guarantee your treatment plan will include all of them!
7. Because of the need to work fast they rely on “therapies,” which are generally done by assistants and the interaction with the chiropractor is brief. Additionally, these therapies, like e-stim and massage tables, can be charged to insurance companies at about $7 or so for each therapy. If they do that on EVERY patient that’s a couple hundred dollars a day…times 5 days…etc. It’s an easy thing to do, makes money, but honestly does very little for the patient. It just means they’ll have to spend another 15-30 minutes.
8. This model requires a larger staff who have to be paid….and therefore require a lot of patients….and the cycle continues.
By NOT taking insurance, here is my model.
I see my patients ON TIME because I don’t have to overload my schedule to make up for lower payments from the insurance companies.
I spend more time with them, in private treatment rooms, and they get better, faster than in offices that require 3-5 visits per week. My prices are about what most co-pays are for insurance (sometimes even less).
I am not prohibited from doing a variety of treatment types to fix the problem. Essentially, insurance companies will not pay for me to do more than one kind of treatment per region. For example, I do not get paid for doing ART (Active Release Techniques) on the low back in addition to an adjustment.
I get great outcomes because I can take my time. Because I am not rushed with my patients, and I’m allowed to do whatever it takes to improve their condition, I get great outcomes. Most new patients will only see me 1-3 times to get them out of their acute condition, which is usually neck and low back pain.
Insurance companies routinely demand money back even if it is years later. If I take insurance, there is always the possibility that the insurance company will come back in 5 years and say, “Yea, we don’t think the patient needed all those things you did, so we’ll need that money back now.” It happens all the time, and I’m not setting myself up to deal with that!
The vast majority of my patients have insurance they could use elsewhere, but those who have tried that realized they actually ended up spending more money because those offices wanted to see them significantly more.
I’m a smaller office but I get results. See an ad for discounted services? Ask yourself why they’re doing that…
For a more comprehensive explanation of why I don’t accept insurance, click here.
