8 Steps to Go from Insurance to Cash Practice

[00:00:00] [SPEAKER_00]: Hey, what's up? Welcome back to the Aaron LeBauer Show. Today we're going to talk about transitioning

[00:00:05] [SPEAKER_00]: out of network, adding cash-based services. So this is a great show for you if somehow you're

[00:00:12] [SPEAKER_00]: listening and you own a practice and you're not doing cash-based services or you're still in

[00:00:16] [SPEAKER_00]: network or hybrid. It's also for those of you who are thinking about it, you're going to learn

[00:00:24] [SPEAKER_00]: a couple things today as well. And if you've already started cash practice and

[00:00:28] [SPEAKER_00]: you're looking to grow, I know there's a nugget in here that's going to help you. I was just actually

[00:00:33] [SPEAKER_00]: discussing nuggets last night with a new friend of mine who's not even PT, Bobby. And we were chatting

[00:00:40] [SPEAKER_00]: and just talking about things. And he's, I mean, I think he does like sales and stuff like that.

[00:00:45] [SPEAKER_00]: He's like, all I need is one nugget when I go to an event or meet with a group of people.

[00:00:50] [SPEAKER_00]: I just need that one thing that I know is going to add $100,000 in the next year. Like

[00:00:54] [SPEAKER_00]: just one nugget. It's one action, one thing. And I just want everyone to know before I even

[00:00:59] [SPEAKER_00]: get into the details and meat of the show that that's all that matters is that you pull

[00:01:05] [SPEAKER_00]: one nugget from every interaction, from every investment, and you take action on it and you

[00:01:10] [SPEAKER_00]: utilize it to continue to grow. So with that said, let's talk about the eight things you

[00:01:18] [SPEAKER_00]: need to know to transition your practice out of network to full cash or hybrid so that

[00:01:23] [SPEAKER_00]: you can do it. Because look, when I started coaching and consulting back in, I don't know,

[00:01:30] [SPEAKER_00]: it was probably 2011 or 2012. I think 2012, but I can't remember exactly. I'd have to go back

[00:01:36] [SPEAKER_00]: and look. And it was back when someone first asked me, hey, how much do I owe you? Well,

[00:01:43] [SPEAKER_00]: back then before I launched my course, The Cash PT Blueprint, and I launched it in 2014.

[00:01:49] [SPEAKER_00]: In 2012, 2013, most of the private coaching I was doing were people who already had

[00:01:53] [SPEAKER_00]: existing practices and were feeling the pressure of insurance companies declining reimbursement.

[00:02:00] [SPEAKER_00]: And we're looking to switch to cash base. I never switched to cash base. I started straight up

[00:02:05] [SPEAKER_00]: 100% cash right out of PT school. If that's you, you can do it too. But I've helped

[00:02:10] [SPEAKER_00]: hundreds of people, maybe thousands of practices move from in network to cash in some way.

[00:02:17] [SPEAKER_00]: I've had people like Mike and Christy Blefford come through our Cash PT Platinum

[00:02:22] [SPEAKER_00]: Mastermind program. And over the course of two years, transitioned almost 80% out of network.

[00:02:29] [SPEAKER_00]: I've had other people come in and do it as well. I think one of the coolest things about

[00:02:33] [SPEAKER_00]: them is what they did was generate a lot more time. And like their biggest ROI,

[00:02:41] [SPEAKER_00]: their biggest wins were generating more time and less headaches and hassles.

[00:02:44] [SPEAKER_00]: As they continue to grow their business, they've been in business for 20 or 25 years.

[00:02:48] [SPEAKER_00]: And I think Christy got to spend like eight weeks on the road with her daughters watching her play

[00:02:54] [SPEAKER_00]: travel soccer because I think her youngest daughter is heading to in her senior year this year.

[00:03:01] [SPEAKER_00]: And then after that, she's already been scouted for college and she got to travel a ton

[00:03:05] [SPEAKER_00]: this year with her family and spend time. And that's one of the biggest wins versus sitting

[00:03:09] [SPEAKER_00]: at home doing extra documentation and chasing payments and reimbursement. I think we can all

[00:03:18] [SPEAKER_00]: agree that over the last five, 10, 15, even 20 years, reimbursement from insurance has been

[00:03:24] [SPEAKER_00]: decreasing and it's harder and harder now to make a profit running a traditional practice.

[00:03:31] [SPEAKER_00]: I mean there is a way to do it and it still works. I mean, Pivot physical therapy just

[00:03:38] [SPEAKER_00]: opened up a mile and a half away from my clinic on one of the busiest streets in Greensboro.

[00:03:44] [SPEAKER_00]: I'm pretty sure it's Pivot. I mean if there wasn't money in it, they wouldn't have opened,

[00:03:50] [SPEAKER_00]: right? I'm not exactly sure who owns it but it's a pretty big corporate owned clinic.

[00:03:55] [SPEAKER_00]: You know, there's not a lot of corporate owned clinics there. I mean the majority of

[00:04:01] [SPEAKER_00]: clinic owners, cash and Innetwork are you know like small mom and pop businesses or you know

[00:04:08] [SPEAKER_00]: mom and dad, you know father and son. I don't know like small one person maybe two person

[00:04:13] [SPEAKER_00]: owned businesses. That's really the fabric of America is built on small businesses.

[00:04:18] [SPEAKER_00]: Technically I think a small in quotes business according to like the government IRS is

[00:04:23] [SPEAKER_00]: anything under like a thousand employees but there's like these micro businesses and

[00:04:28] [SPEAKER_00]: majority of PT practices are small businesses with one, two, maybe three to five therapists

[00:04:34] [SPEAKER_00]: but one location. The minority of practices are these multi-location practices yet

[00:04:42] [SPEAKER_00]: when you have multi-locations and lots of volume, you can make small changes to increase

[00:04:49] [SPEAKER_00]: your revenue rapidly but you also have a little bit better, maybe not great,

[00:04:53] [SPEAKER_00]: but a little bit better negotiating power with insurance contracts and panels.

[00:04:59] [SPEAKER_00]: And ironically for the same treatment, same treatment codes

[00:05:04] [SPEAKER_00]: when a patient is seen in a hospital-based outpatient clinic, the hospital-based outpatient

[00:05:09] [SPEAKER_00]: clinic gets reimbursed higher rate at a higher rate than a private practice and that should make

[00:05:16] [SPEAKER_00]: you mad if it doesn't already and it probably made you mad a long time ago and you're just like

[00:05:21] [SPEAKER_00]: it's not going to change. APTA private practice section isn't going to do anything to change

[00:05:25] [SPEAKER_00]: that so let me just figure this thing out. I don't know about you but I never felt like

[00:05:32] [SPEAKER_00]: I was really supported well by the APTA and PPS. Yes, you know my practice act here in

[00:05:37] [SPEAKER_00]: North Carolina is supported by them. We can now do manipulation, we can do dry needling,

[00:05:43] [SPEAKER_00]: we've been if you had direct access for a long time so great like supporting my the practice

[00:05:47] [SPEAKER_00]: act but as a business owner I never really felt supported even though there were resources

[00:05:55] [SPEAKER_00]: available they weren't resources that were relative to me and my practice during COVID.

[00:06:01] [SPEAKER_00]: PPS was kind of holding behind their like paywall to use a better term information on how best

[00:06:11] [SPEAKER_00]: practices to reopening COVID whereas the dental association spa association made all that stuff

[00:06:16] [SPEAKER_00]: free. You know I even told the president at the time PPS has said hey just you know they're

[00:06:21] [SPEAKER_00]: like oh this for our paying numbers. I'm like cool you want more members? Give something of

[00:06:26] [SPEAKER_00]: value first like just say hey we'll give you this you know reopening guidelines just

[00:06:31] [SPEAKER_00]: give us your name email and best contact details. Give value first and then come back in a few

[00:06:35] [SPEAKER_00]: months and say hey wasn't that great value we provided? We do a whole lot more of that

[00:06:39] [SPEAKER_00]: why don't you come join our section? I don't know that would be too easy. You know I've

[00:06:44] [SPEAKER_00]: had so when I first started in 2011, 2012, 2013 I think it was really like 2012, 2013

[00:06:51] [SPEAKER_00]: a lot of the people coming were trying to add cash base or transition they had started

[00:06:56] [SPEAKER_00]: they've been doing it for five ten years and they were like fed up and then like 2016 through

[00:07:01] [SPEAKER_00]: you know 2022, 2021 it was mostly people coming to me to like start a cash practice

[00:07:09] [SPEAKER_00]: you know brand new. They'd never been business owners before or maybe they had been a

[00:07:14] [SPEAKER_00]: business owner for a while then went back to work and were like I can't do this they'd

[00:07:17] [SPEAKER_00]: earned it and came back to start a cash practice and in the last two and a half to

[00:07:21] [SPEAKER_00]: three years more people have been coming to me and joining our programs and groups

[00:07:27] [SPEAKER_00]: who already have existing businesses. There's a couple things that if you already have an

[00:07:32] [SPEAKER_00]: existing business you've been doing it for 20 years the hardest thing is the technology

[00:07:37] [SPEAKER_00]: to market. You have to be willing to learn something new, you have to be willing to do

[00:07:41] [SPEAKER_00]: new things get uncomfortable and the other second hardest thing is charging higher prices

[00:07:45] [SPEAKER_00]: and so I want to talk to you today about the things you need to know to transition out of

[00:07:51] [SPEAKER_00]: the business. Number one your revenue per visit must be above your cost per visit if you have

[00:07:58] [SPEAKER_00]: like a if you have an in-network or out of network or cash based practice your revenue per

[00:08:02] [SPEAKER_00]: visit must be above your cost per visit so how do we figure that out? You know you do

[00:08:07] [SPEAKER_00]: a thousand visits in a year you made a hundred thousand dollars in revenue let me just do the

[00:08:11] [SPEAKER_00]: math with you let's say we did a hundred thousand dollars in revenue divided by a thousand

[00:08:16] [SPEAKER_00]: and that's a hundred dollars per visit okay your expenses and costs and what you pay yourself are

[00:08:24] [SPEAKER_00]: seventy five thousand dollars so I buy a thousand visits and your cost per visit is 75 so you have

[00:08:30] [SPEAKER_00]: a 25 dollar margin and the problem is is every insurance contract is going to be different

[00:08:36] [SPEAKER_00]: and everyone there's some of them are going to be easy and others are going to be a pain in

[00:08:40] [SPEAKER_00]: the ass. I've had some clients say well Aaron so-and-so is paying me 180 dollars a visit

[00:08:45] [SPEAKER_00]: I'm like well don't get rid of that you know and other people have come to me and said they've

[00:08:50] [SPEAKER_00]: calculated this number after we work together we hop on our game plan call and we work together

[00:08:54] [SPEAKER_00]: and they're like hey this one you know this insurance company is you know the average revenue

[00:08:59] [SPEAKER_00]: per visit is 70 dollars but my cost is 75 or the average revenue is 55 dollars and the cost

[00:09:05] [SPEAKER_00]: is 75 like you're losing money on that contract even if the average the average cost

[00:09:12] [SPEAKER_00]: per visit was 75 and the revenue was 100 if you've got one insurance contract that makes up

[00:09:18] [SPEAKER_00]: 10 percent of your business and the revenue per visit is lower than the than the cost per visit

[00:09:25] [SPEAKER_00]: you're losing money and what you also need to factor in is what's the what's like the

[00:09:31] [SPEAKER_00]: opportunity cost and what's also the time cost because you may be paying your staff

[00:09:38] [SPEAKER_00]: you know your staff like one company I don't know United Health Care you might have to go on the

[00:09:42] [SPEAKER_00]: phone with them three times to get reimbursed whereas other maybe like there's a workers

[00:09:48] [SPEAKER_00]: comp in your area that's really easy and you don't ever have to go on the phone with them

[00:09:51] [SPEAKER_00]: to get 180 a visit like a couple of my clients you know some work comp is great others

[00:09:55] [SPEAKER_00]: is shit so you have to factor that into who's the biggest pain in the ass who's the easiest

[00:10:02] [SPEAKER_00]: what's the so the the least revenue and the biggest pain in the ass those things got to go

[00:10:07] [SPEAKER_00]: otherwise you're you're losing money and you might think oh my ethics get in the way

[00:10:13] [SPEAKER_00]: and then I have to treat these patients like they deserve to be treated okay great

[00:10:19] [SPEAKER_00]: I'm gonna say if you think that and this is somewhere else in my notes but

[00:10:24] [SPEAKER_00]: you know if you think that asking for cash is unethical but yet you're willing to allow

[00:10:31] [SPEAKER_00]: United Health Care rake you over the coals and not pay you what you're doing

[00:10:37] [SPEAKER_00]: just because the patient deserves deserves to be treated and shouldn't have to pay for physical

[00:10:43] [SPEAKER_00]: therapy like you really shouldn't be in business you know that you've got to separate your

[00:10:48] [SPEAKER_00]: caring for people with your I need to care for myself and my family and operate this

[00:10:54] [SPEAKER_00]: business business needs to operate at a profit it should you can't operate at a loss forever

[00:10:59] [SPEAKER_00]: it'll drag you down and there's a lot of other a lot of other things are wrong with that but

[00:11:08] [SPEAKER_00]: if there's a significant population of people like we can treat them for free

[00:11:12] [SPEAKER_00]: we can do pro bono work but you shouldn't be doing pro bono work for united health care

[00:11:16] [SPEAKER_00]: etna cigna etc like do not do pro bono work for them because they're worth billions of

[00:11:23] [SPEAKER_00]: dollars they're on the stock market you and I aren't listed on the stock market your revenue

[00:11:28] [SPEAKER_00]: visit must be above your cost per visit if you're losing money on any patients even if

[00:11:32] [SPEAKER_00]: your average is above breakeven you are still operating at a loss we have to drop those

[00:11:38] [SPEAKER_00]: contracts you're operating at a loss okay insurance is reimbursing more not less I mean

[00:11:43] [SPEAKER_00]: we all know that right is it gonna get better or are you just going to treat more people per

[00:11:49] [SPEAKER_00]: hour I don't know I'm not going to treat more people per hour all the time and there

[00:11:56] [SPEAKER_00]: are models where we can still do one to many but I'm not doing one to many because I'm not

[00:12:02] [SPEAKER_00]: getting reimbursed by an insurance company and I have to pack people in I'm doing one to many

[00:12:06] [SPEAKER_00]: because it's what's best for the people people say oh Aaron my patients can't afford to pay more

[00:12:12] [SPEAKER_00]: than a copay I guarantee you they can if someone complains about a copay and yet they're

[00:12:18] [SPEAKER_00]: walking around with an android or apple device guess what they're paying more for Verizon

[00:12:24] [SPEAKER_00]: every month than they are for your physical therapy they're paying more for their plumber

[00:12:31] [SPEAKER_00]: to come to their house and unclog their toilet than they are for physical therapy okay get your

[00:12:37] [SPEAKER_00]: toilet unclogged right now cost like a hundred bucks and the guys come in they spend about a

[00:12:43] [SPEAKER_00]: half hour they get crap water all over the walls ask me how I know and they walk out and

[00:12:49] [SPEAKER_00]: you a bill for 100 125 bucks okay I just paid 80 bucks this morning for a massage for for 60 minutes

[00:13:00] [SPEAKER_00]: okay copay is 75 bucks they come see you for physical therapy don't tell me that patients aren't

[00:13:05] [SPEAKER_00]: going to pay more than a copay for PT they're not they will it's just they don't value it

[00:13:12] [SPEAKER_00]: we've done our profession's done a bad job at explaining what we do there's a lot of we

[00:13:16] [SPEAKER_00]: do a lot of different things so it's your job as a business owner to convey the value of your

[00:13:21] [SPEAKER_00]: sessions to your patients and prospects and they will pay what else do people pay more for that's

[00:13:27] [SPEAKER_00]: kind of dumb five dollars a day at at starbucks you can make your own coffee for 50 cents

[00:13:35] [SPEAKER_00]: um I don't know uh Taylor Swift concert tickets 900 bucks like people will empty their bank

[00:13:40] [SPEAKER_00]: accounts to go see Taylor Swift but yet they won't they can't afford a 35 dollar copay

[00:13:45] [SPEAKER_00]: come see you okay they can pay it doesn't matter where you live what city state how rural it is

[00:13:51] [SPEAKER_00]: how far how much it is to the next city how much competition you have if you differentiate yourself

[00:13:59] [SPEAKER_00]: people will pay because insurance is reimbursing less not more and it's a sinking ship and uh

[00:14:07] [SPEAKER_00]: don't go down with the captain please um number three this is something I learned recently

[00:14:12] [SPEAKER_00]: united healthcare like I don't have the proof I'd love if you hear this and you send me some

[00:14:17] [SPEAKER_00]: proof that'd be dope I had a friend tell me that one of her friends told her this was one

[00:14:21] [SPEAKER_00]: of her friends trying to get her a job with united healthcare and she said her friend gets

[00:14:26] [SPEAKER_00]: a bonus of 75 dollars for every contract over five thousand dollars that she denies the claim

[00:14:33] [SPEAKER_00]: right so let me just say that again this uh a friend of mine has a friend that works at

[00:14:38] [SPEAKER_00]: healthcare and her friend told her that she gets a 75 bonus 75 dollar bonus for every claim

[00:14:45] [SPEAKER_00]: that's over the amount of five thousand dollars that she denies right so she is

[00:14:51] [SPEAKER_00]: incentivized to deny claims I guarantee you there's other um policies like that I know some

[00:14:57] [SPEAKER_00]: insurance companies policies just deny everything the first time and then you run it through the

[00:15:01] [SPEAKER_00]: second time and it gets approved I've had physical therapists tell me that so what's more

[00:15:07] [SPEAKER_00]: unethical charging cash for pt or bonusing your employees 75 dollars for every um

[00:15:15] [SPEAKER_00]: every claim that you deny I mean okay because people tell me all the time especially on our

[00:15:21] [SPEAKER_00]: ads that uh charging high prices and cash for pt is unethical okay yes the insurance company

[00:15:28] [SPEAKER_00]: is not making decisions and policies to actually help your patients they're not

[00:15:33] [SPEAKER_00]: um they're doing it because it helps their stock price it helps their investors it helps their

[00:15:40] [SPEAKER_00]: bottom line they are a business they are not a health care charity and neither should you be

[00:15:44] [SPEAKER_00]: a health care charity okay patients are willing to pay cash for high value services patients

[00:15:50] [SPEAKER_00]: are willing to pay cash for problems if you can solve a problem that someone else can't they

[00:15:56] [SPEAKER_00]: okay so when you one of the biggest mistakes people make is thinking the um insurance

[00:16:05] [SPEAKER_00]: is like uh insurance uh payments are um you know they're they're earned or or they're right

[00:16:13] [SPEAKER_00]: like it's my right to use my insurance I mean it technically is but insurance is um

[00:16:21] [SPEAKER_00]: logical they don't think it's your right thing it's their right to deny your claims hey what's

[00:16:26] [SPEAKER_00]: up at darin real quick if you already own a cash practice you're already seeing patients

[00:16:30] [SPEAKER_00]: but you've struggled to really hit 5k months or maybe now you finally quit your job or you got

[00:16:36] [SPEAKER_00]: let go and you're ready to go all in and you'd like some help hitting six figures or

[00:16:40] [SPEAKER_00]: more in the fastest time possible you might be a great fit for our cash pt academy coaching

[00:16:44] [SPEAKER_00]: program in our cash pt academy you'll get access to our extensive training vault private

[00:16:50] [SPEAKER_00]: facebook community bi-monthly coaching calls to get all your questions answered and a personalized

[00:16:54] [SPEAKER_00]: game plan every 90 days so you know exactly what to work on and when if that's you let's hop on

[00:17:00] [SPEAKER_00]: a call we'll brainstorm some ideas and make a plan just go to call with aron.com and book

[00:17:05] [SPEAKER_00]: in the time or shoot me a message on instagram with the word academy and we'll go from there

[00:17:09] [SPEAKER_00]: now back to the show peace I had a health insurance uh wasn't denied claim denied what

[00:17:16] [SPEAKER_00]: I was back in 2001 I was trying to get health insurance I was in living in san francisco

[00:17:22] [SPEAKER_00]: racing bikes I didn't have health insurance and I was like well let me try get some health

[00:17:24] [SPEAKER_00]: insurance and at the time um I got denied health insurance why did they deny me health

[00:17:31] [SPEAKER_00]: insurance said well you're not following the orders of your physician well we all know I

[00:17:35] [SPEAKER_00]: have adhd and I had uh riddle in prescribed to me and the psychiatrist who prescribed at

[00:17:41] [SPEAKER_00]: time said hey you know I'm going to write you a prescription for three times a day for 10

[00:17:45] [SPEAKER_00]: milligrams so you've got you know a bunch of them take them whenever you need I was like

[00:17:50] [SPEAKER_00]: okay great well when the survey comes to get insurance it says what medication you prescribed

[00:17:55] [SPEAKER_00]: and I said you know riddle in 10 milligrams um and it says how often do you take it and

[00:18:01] [SPEAKER_00]: I said whenever I need well the prescription said three times a day for 30 every 30 days

[00:18:06] [SPEAKER_00]: and so they denied my new health insurance because I wasn't following physician's orders

[00:18:11] [SPEAKER_00]: well I was it's just I wouldn't I didn't write down what he prescribed I wrote down what he

[00:18:17] [SPEAKER_00]: told me to do okay what's another goal here you know denying the claim to someone healthy

[00:18:25] [SPEAKER_00]: or nitpicking the whole thing I mean people are willing to pay cash for high value service

[00:18:30] [SPEAKER_00]: like if you can solve a problem if you can solve their neck pain or their knee pain when

[00:18:34] [SPEAKER_00]: else can't or you can position your services in a way that solves a problem not and you guess

[00:18:42] [SPEAKER_00]: what range of motion money is not a problem patient cares about they want to be able to

[00:18:46] [SPEAKER_00]: get on the floor they want to be able to climb the steps they want to be able to sit in

[00:18:48] [SPEAKER_00]: their car comfortably um five out of five strength is not a problem patients care about

[00:18:54] [SPEAKER_00]: they want to go back to CrossFit you know they they want their arm pain to stop uh stop

[00:19:00] [SPEAKER_00]: so they can focus at work so when you drop contracts just remember people will pay more

[00:19:06] [SPEAKER_00]: than their copay my copay right now is 175 a visit for a specialist physician or physical

[00:19:12] [SPEAKER_00]: therapist or even a chiropractor I mean you know like maybe I don't have great insurance

[00:19:17] [SPEAKER_00]: but I've got it through my business and that's what I can get and you know like

[00:19:23] [SPEAKER_00]: there's other people with that um and people will happily pay because you know

[00:19:28] [SPEAKER_00]: what that's less than what they're going to pay for um out of network if they

[00:19:32] [SPEAKER_00]: go to the hospital the hospital bill is like three hundred dollars an hour

[00:19:35] [SPEAKER_00]: or three hundred dollars every 30 minutes and um my copays 175 and in our clinic we're charging

[00:19:41] [SPEAKER_00]: 250 for a visit but we're not charging per visit we're charging two thousand dollars for

[00:19:45] [SPEAKER_00]: a eight visit 12 week plan of care which can be eaten up in about four visits

[00:19:54] [SPEAKER_00]: two visits uh uh a week for two weeks um somewhere out of network at like a

[00:20:00] [SPEAKER_00]: hospital-based system so think about that and don't do the math the math is not going to solve

[00:20:06] [SPEAKER_00]: your problems um on that just know that when you drop these money losing contracts and you

[00:20:10] [SPEAKER_00]: start charging cash even if you're charging a hundred dollars a visit 125 a visit at volume

[00:20:16] [SPEAKER_00]: you can add um a lot of revenue and solve a lot of problems you don't need to charge high

[00:20:24] [SPEAKER_00]: that needs to be the next thing you don't need to charge high prices to add ten thousand

[00:20:27] [SPEAKER_00]: a month um or more in cash to your revenue so if you have a like a high volume clinic

[00:20:34] [SPEAKER_00]: i mean you're doing 100 visits a week or more you don't need to charge a whole lot if you're

[00:20:39] [SPEAKER_00]: doing 20 25 visits a week if you're in network you're probably doing more than 25 visits a

[00:20:43] [SPEAKER_00]: week you're probably doing 50 visits a week just imagine if we added 25 a visit per

[00:20:51] [SPEAKER_00]: week in cash so 25 times 50 that's 1250 a week times four that's five thousand dollars a month

[00:20:58] [SPEAKER_00]: we just need to increase your um average revenue by 25 to add five thousand dollars

[00:21:03] [SPEAKER_00]: a month if you're only doing 50 visits a week that maybe it's at 50 visits at 30 minutes

[00:21:08] [SPEAKER_00]: great we just need to add 25 and guess what that's 60,000 extra dollars per year

[00:21:15] [SPEAKER_00]: that's more that's about 3x what it cost to join our mastermind program just imagine you joined

[00:21:22] [SPEAKER_00]: our program we set you up with a system to do that and then your whole year is paid for

[00:21:27] [SPEAKER_00]: plus more and really our most of our members um our average members have an average plan

[00:21:33] [SPEAKER_00]: of care um for each patient worth about two thousand dollars or more because we get them

[00:21:39] [SPEAKER_00]: to a plan of care and then most of the people move on to an ongoing program

[00:21:44] [SPEAKER_00]: and so 15 new patients a month um at two thousand dollars each is about thirty

[00:21:49] [SPEAKER_00]: thousand dollars a month that's about an extra three hundred thousand dollars plus a year

[00:21:55] [SPEAKER_00]: for not very many people um and with some small changes you know for instance uh Alan

[00:22:01] [SPEAKER_00]: Ling is one of my private clients out in El Cerrito I was a student of Alan's in PT

[00:22:06] [SPEAKER_00]: school I did my final clinical rotation there we've been friends Alan spoke at PT BizCon and in

[00:22:12] [SPEAKER_00]: the preparation for uh and I did some private coaching with him about eight years ago on

[00:22:16] [SPEAKER_00]: some different things on like massage adding massage therapy and stuff and at PT BizCon we

[00:22:21] [SPEAKER_00]: were talking about it in early 2023 I think when he spoke and I was telling what one of

[00:22:27] [SPEAKER_00]: he's like oh yeah here in the Bay Area we can't do xy and z I was like yeah but

[00:22:30] [SPEAKER_00]: you know one of my clients is in Oakland he's doing multiple six figures in Oakland cash and

[00:22:35] [SPEAKER_00]: he's got a million dollar business and he's like really like right down the street I'm like yeah

[00:22:40] [SPEAKER_00]: and so what Alan called me back a few days later is like Aaron I think I'm finally ready to you

[00:22:45] [SPEAKER_00]: know get your help on this and listen to you and he's I think they see like he's got like

[00:22:50] [SPEAKER_00]: seven therapists so you know 500 600 visits a week or something like that what we did is we

[00:22:56] [SPEAKER_00]: just started charging a hundred dollars for every visit for 30 minutes and Alan added

[00:23:02] [SPEAKER_00]: $30,000 a month in cash revenue to his business which is dope on top of what he's already doing

[00:23:09] [SPEAKER_00]: right and it's so expensive there that they can't they already couldn't afford to keep some of the

[00:23:15] [SPEAKER_00]: contracts and I dropped some but we all we did was update uh the script for the front desk

[00:23:20] [SPEAKER_00]: and do a little training for his his team and he messaged me again a couple months later

[00:23:25] [SPEAKER_00]: said Aaron the new therapist I brought in is you know less than a year out of school and

[00:23:29] [SPEAKER_00]: seeing 18 cash patients a day which is which is dope but what it what does it take it take

[00:23:38] [SPEAKER_00]: took Alan the decision to do something different than he was already doing even though he'd

[00:23:42] [SPEAKER_00]: been in business for 30 years and taught and taught me a lot about PT business he took one

[00:23:48] [SPEAKER_00]: of the strategies that we are using and add to his business and brought in 300 extra 300

[00:23:53] [SPEAKER_00]: thousand dollars and more so you can still take insurance this is point number six you can still

[00:24:00] [SPEAKER_00]: take insurance in quotes when you move in network to network you're still when someone says Aaron do

[00:24:06] [SPEAKER_00]: you take insurance well yeah you know I don't say no there's a different way to answer that

[00:24:10] [SPEAKER_00]: question but if someone says hey hey doc Jen you know Chris do you take insurance you say

[00:24:15] [SPEAKER_00]: yeah we we take insurance that does they didn't ask are you in network and you can say yes we

[00:24:21] [SPEAKER_00]: take all insurances you can still answer that question with the yes and you can then work on

[00:24:27] [SPEAKER_00]: the value-based conversation explain the details because if you already have a clearinghouse and

[00:24:33] [SPEAKER_00]: you're already processing claims and you move out of network you can still utilize your existing

[00:24:38] [SPEAKER_00]: infrastructure of your business to file claims on behalf of your patients and do courtesy

[00:24:43] [SPEAKER_00]: billing in quotes air quotes courtesy billing you can do courtesy billing where it just takes

[00:24:48] [SPEAKER_00]: burden off the patients to file their own claim it's not it doesn't take away all the friction

[00:24:53] [SPEAKER_00]: but it takes away a good chunk of it where we've had patients say okay that's cool

[00:24:57] [SPEAKER_00]: but then they're like oh I don't want to go through the effort of filing the claim on myself

[00:25:01] [SPEAKER_00]: I'm not going to come in or I'm not going to come back but if it was already set up

[00:25:05] [SPEAKER_00]: in my business to do that um like it probably is for you if you have an in network business

[00:25:11] [SPEAKER_00]: you're just not in network you're out of network but you still have the team you know

[00:25:17] [SPEAKER_00]: the admin support or you have the clearinghouse already set up to file claims on your patient's

[00:25:22] [SPEAKER_00]: behalf and do courtesy billing it reduces a good chunk of the friction and makes it easy it's

[00:25:28] [SPEAKER_00]: kind of like the dentist most dental practices are out of network and even if you have dental

[00:25:33] [SPEAKER_00]: insurance which I don't you know they always offer to hey we'll file the claim for you

[00:25:38] [SPEAKER_00]: you know I'm like I don't have dental insurance but they'll still do it um you know so that

[00:25:45] [SPEAKER_00]: makes it easy and PT is going to turn more and more like that I think a lot of uh people

[00:25:50] [SPEAKER_00]: don't have dental insurance by default it's an add-on um just like you just like a lot of um

[00:25:57] [SPEAKER_00]: psychotherapists and and mental health counselors they are out of network or even if they're

[00:26:03] [SPEAKER_00]: out of network maybe they file on behalf a lot of people don't want to tell their insurance

[00:26:06] [SPEAKER_00]: are getting um psychotherapy um other times it's just not covered etc I think things have

[00:26:11] [SPEAKER_00]: changed in the last few years with some of the new laws around insurance but in general um big

[00:26:17] [SPEAKER_00]: chunks of those professions are not in network and PT is going to be um the same soon if it's

[00:26:23] [SPEAKER_00]: not already getting there but I don't think the um I don't think the shit hits has hit the fan yet

[00:26:29] [SPEAKER_00]: there's not this massive cascade but it's coming people are either going to sell or go out of

[00:26:34] [SPEAKER_00]: business or close because they're going to be you're going to be unable to afford to stay

[00:26:38] [SPEAKER_00]: in business because of these um contracts are paying so little they're costing you

[00:26:43] [SPEAKER_00]: so much uh enjoyment in being a like a physical therapist and a business owner

[00:26:48] [SPEAKER_00]: that is burning people out and it's burning out your staff they're having to document for

[00:26:53] [SPEAKER_00]: insurance companies like our documentation takes two minutes and if your staff is complaining

[00:26:58] [SPEAKER_00]: about having to document over the weekend it's because they're having to document so detailed

[00:27:02] [SPEAKER_00]: and manipulate the documentation to get visits approved you know this is burning them out

[00:27:08] [SPEAKER_00]: there's two more things um number seven is you need a proven patient enrollment system

[00:27:13] [SPEAKER_00]: you need a proven system and pathway scripts and offers to get your patients to enroll

[00:27:20] [SPEAKER_00]: in a plan of care and be willing to pay cash for it and you can even get some of them to

[00:27:26] [SPEAKER_00]: pay in full for their plan of care to discount because you're not in network

[00:27:30] [SPEAKER_00]: so they can pay in full for their plan of care and get a discount now that discount

[00:27:34] [SPEAKER_00]: you know shouldn't um equal out to be lower than what you're already getting an average per visit

[00:27:40] [SPEAKER_00]: it should be higher but you anchor the price higher and you offer them a discount to pay in

[00:27:46] [SPEAKER_00]: full and commit to the plan of care and it's not just about the offer it's about the

[00:27:50] [SPEAKER_00]: questions you ask and the eval need to be different the questions you ask on the phone

[00:27:53] [SPEAKER_00]: and even installing one of our application funnels or automated new patient follow-up

[00:28:01] [SPEAKER_00]: sequences to get people to painful for their plan of care whether it's on the first visit or

[00:28:06] [SPEAKER_00]: the third there's a proven system to be able to do that and that's how many of our members are

[00:28:11] [SPEAKER_00]: doing 20 30 and even 40k months cash with one physical therapist and if you have a network

[00:28:17] [SPEAKER_00]: network business you don't need to jump from a 75 to a 200 per visit fee we can ramp up

[00:28:24] [SPEAKER_00]: but it should be more than a 25 increase and if you're doing shorter visits we can do like

[00:28:32] [SPEAKER_00]: you know this is what i would recommend for alan to do is do 125 a visit

[00:28:36] [SPEAKER_00]: or one fit maybe he's doing one fit he might be doing 150 for a half hour

[00:28:40] [SPEAKER_00]: but i think he might even only done 100 but like i said it doesn't matter because

[00:28:46] [SPEAKER_00]: if you can increase your revenue per visit by 25 and you're seeing 700 people a week like

[00:28:52] [SPEAKER_00]: a client in florida seeing 700 visits a week and if we just do 25 times 700 visits in a week

[00:29:00] [SPEAKER_00]: that's an extra 17 000 in a week it doesn't need to be a lot so that cash pay rate could be

[00:29:05] [SPEAKER_00]: 99 instead of 75 okay everyone knew it was coming in at a higher rate it could be 125

[00:29:13] [SPEAKER_00]: dollars guess what they're still getting a 50 discount over aaron labauer coming into your

[00:29:18] [SPEAKER_00]: for treatment because my copay is 175 so it's you can even say it's 175 and when you pay in full

[00:29:26] [SPEAKER_00]: it's you know for 10 visits it's just 1250 which makes 125 visit they get a massive discount

[00:29:31] [SPEAKER_00]: for paying in cash they get a cash discount it's super easy your your fees that you're

[00:29:38] [SPEAKER_00]: billing out per hour are probably already elevated and if they're not you're not capturing

[00:29:43] [SPEAKER_00]: all of your possible revenue but let's say it's you're charging already 75 a unit three units in a

[00:29:50] [SPEAKER_00]: visit or two units in a 30 minute visit that's 150 an hour hey it's 150 an hour when you pay

[00:29:56] [SPEAKER_00]: in cash in full you can get a 10 discount and you know you just have to do the math and know

[00:30:03] [SPEAKER_00]: your own numbers if you'd like some help with it i'm happy to set you up with a strategy call

[00:30:08] [SPEAKER_00]: to do that but you know your own numbers and now this discount for paying cash and paying

[00:30:12] [SPEAKER_00]: full makes it so you're getting more money for less effort and the patients feel like they're

[00:30:18] [SPEAKER_00]: saving and it's a win-win okay number eight you need a predictable lead generation system so now

[00:30:25] [SPEAKER_00]: that we're dropping some insurance contracts and don't forget you've got to drop them you

[00:30:29] [SPEAKER_00]: can't just decide to drop them you have to look at your contract you have to send in

[00:30:32] [SPEAKER_00]: letters you have to notify the right patients not all the patients and there's a list of

[00:30:40] [SPEAKER_00]: I do have all the documents contracts sample documents etc on how to move out of network

[00:30:48] [SPEAKER_00]: and once we drop someone you're going to have some extra time but guess what patients are

[00:30:53] [SPEAKER_00]: still going to come and at minimum you're going to be seeing that higher value insurance

[00:30:59] [SPEAKER_00]: contracts and dropping the lower value ones you might have some extra time and now you can work

[00:31:03] [SPEAKER_00]: on the marketing strategies to bring people in and educate your staff and your team so they

[00:31:09] [SPEAKER_00]: what to say when people come in and ask do you take my insurance and people aren't like no

[00:31:13] [SPEAKER_00]: as soon as someone tells a prospective patient no you're going to lose that patient do not

[00:31:18] [SPEAKER_00]: tell them no there's a different set of questions we need to ask we need to do the training

[00:31:23] [SPEAKER_00]: and you're going to have a little bit extra time to do that your time is going to be

[00:31:26] [SPEAKER_00]: valued higher so that we can start ramping up your cash per visit your cost per your

[00:31:33] [SPEAKER_00]: your revenue per visit and cash in your bank so we need to be able to set up a

[00:31:38] [SPEAKER_00]: lead generation system because patients aren't going to be coming from physicians as much anymore

[00:31:44] [SPEAKER_00]: because the physicians are going to say hey that practice isn't a network go here so we need to

[00:31:48] [SPEAKER_00]: reach out to prior people existing people and new people through our marketing and the marketing

[00:31:55] [SPEAKER_00]: has to be different it's not hard it just has to be different we've set up some of those

[00:32:00] [SPEAKER_00]: systems and now we've got a predictable system to add 10 15 even 30 cash paying patients a

[00:32:05] [SPEAKER_00]: month to your business which means tens of thousands of dollars in the bank and as you

[00:32:11] [SPEAKER_00]: drop the contracts that cost you time and money like I said you'll have more time to

[00:32:15] [SPEAKER_00]: set up a predictable marketing system that brings in dozens if not hundreds of patients

[00:32:19] [SPEAKER_00]: willing to pay cash for pt does that make sense that's a lot hope that's not too much

[00:32:25] [SPEAKER_00]: that's just the tip of the iceberg those are just like the top eight things that you

[00:32:29] [SPEAKER_00]: need to know about transitioning out of network and it may not be the right time

[00:32:32] [SPEAKER_00]: everyone to do it but I'm going to venture to say it's probably past the right time for you

[00:32:38] [SPEAKER_00]: to do it especially if you're listening to this episode so if you have a pt business

[00:32:43] [SPEAKER_00]: and you want to transition it to a hybrid model or even 100 cash like hybrid meaning

[00:32:48] [SPEAKER_00]: medicare plus cash or medicare blue cross plus cash or some variation or even go 100

[00:32:55] [SPEAKER_00]: cash over time and you want some help building out a personalized game plan getting the

[00:33:02] [SPEAKER_00]: transition easy and the support along the way to install the systems and build out a brand

[00:33:07] [SPEAKER_00]: new marketing strategy I'd love to work with you all you got to do is DM me the word strategy

[00:33:12] [SPEAKER_00]: over on Instagram tell me a little bit about your situation and I'd be happy to set you up

[00:33:16] [SPEAKER_00]: with a free new patient strategy call or just go to call with Aaron.com that's call with

[00:33:22] [SPEAKER_00]: Aaron.com a a Ron two a's and book in a time to chat and let's chat and talk about your

[00:33:29] [SPEAKER_00]: situation we can brainstorm some ideas and make a plan for you to go out of network or partially

[00:33:35] [SPEAKER_00]: out of network and add tens of thousands of dollars of cash paying patients to your business so over

[00:33:41] [SPEAKER_00]: time you continue to grow and thrive and you're spending less time on the headaches

[00:33:45] [SPEAKER_00]: and more time enjoying what you do that's it for today I appreciate the time you spend with

[00:33:50] [SPEAKER_00]: me every week on this show so if there's anything else you'd like to learn about or

[00:33:56] [SPEAKER_00]: I can do for you to support you and your business just shoot me a random message over on

[00:34:01] [SPEAKER_00]: Instagram and say hey Aaron listen to your show I'd love you to talk about X or hey I need some

[00:34:06] [SPEAKER_00]: help with Y X Y and Z whatever it is do that and if you're on my email list you'll get

[00:34:13] [SPEAKER_00]: notifications about our upcoming live webinars and trainings where there's always time at the

[00:34:17] [SPEAKER_00]: end to ask questions and hopefully on those trainings you get more value than you expect

[00:34:23] [SPEAKER_00]: you've got the ideas and strategy and you know what to do moving forward so that our profession

[00:34:28] [SPEAKER_00]: could continue to grow and serve people and we don't we stop losing really good physical

[00:34:33] [SPEAKER_00]: therapists to burn out because insurance companies are working for themselves in

[00:34:38] [SPEAKER_00]: their bottom line and not for the patients so I work for patients not insurance companies

[00:34:41] [SPEAKER_00]: I'm Aaron LaBauer and I'll see you on the next show peace out hey what's up it's Aaron

[00:34:45] [SPEAKER_00]: thanks for listening to the show whenever you're ready here's three ways I can help you grow

[00:34:49] [SPEAKER_00]: physical therapy business number one grab a free copy of my book it's the roadmap to launch grow

[00:34:54] [SPEAKER_00]: and scale your physical therapy business go to cash pt blueprint book.com or dm me the word

[00:35:00] [SPEAKER_00]: book over on instagram and I'll send you a link to get it shipped to you for free number

[00:35:05] [SPEAKER_00]: two join our cash pt blueprint case study program I'm putting together a new case study group

[00:35:10] [SPEAKER_00]: this month if you'd like to work with me to launch a six-figure cash practice and start

[00:35:14] [SPEAKER_00]: seeing patients in just 90 days send me a message over on instagram with the words case

[00:35:18] [SPEAKER_00]: study and I'll apply back to you with all the details number three you can join our cash pt

[00:35:24] [SPEAKER_00]: academy coaching group I meet with dozens of successful cash practice owners weekly on zoom

[00:35:28] [SPEAKER_00]: to solve business headaches brainstorm ideas and teach the latest marketing and business

[00:35:33] [SPEAKER_00]: building strategies and tactics this is our coaching program that takes existing pt businesses

[00:35:38] [SPEAKER_00]: and helps them scale to six and multiple six figures in just 12 to 24 months if you've got

[00:35:43] [SPEAKER_00]: a pt practice and you rate add 10k a month or more to your revenue you may qualify to join us

[00:35:48] [SPEAKER_00]: just dm me the word academy over on instagram and I'll set up a time to chat and four for some

[00:35:54] [SPEAKER_00]: reason if you're not one of those and you own a business brand you want to work with me directly

[00:35:58] [SPEAKER_00]: to help you add seven figures to your business or another 250k this year and you're looking

[00:36:03] [SPEAKER_00]: for private one-on-one coaching vip days etc and you'd like to maybe partner together in

[00:36:08] [SPEAKER_00]: your existing business send me a message with the word private tell me about your situation

[00:36:12] [SPEAKER_00]: work on together and we'll set up a time to talk to you I'll see you next time peace