Low Payers

Hi, this is Dave Kats from Therapist Consultants and I have a tip for you.

As insurance weakens, some insurance companies pay less and less and less, and there comes a point in time where you have to kick the low payers to the curb.

Where you have to look at the insurance companies that you have and see what they’re paying and if they’re not paying enough, I think you have to get off that panel and then charge the patient cash.

I think in the Mid-West, in Florida, in Texas, probably most areas in the United States; probably $68 is about the breakpoint. If they’re not paying you at least $68, you probably just need to get off that panel, be an out-of-network provider, and then have the patients pay cash because, here’s what we’ve found out, it actually cost between five to ten dollars to have you file insurance especially if you have some outside company doing your billing.

Instead of the insurance company paying you $58, really they’re in essence paying you -- instead of insurance company paying you $68, really they’re in essence paying you $58 because it costs you about $10 of time and labor, money to file that insurance.  In most cases if a patient comes in and you say they’re only going to pay this much, and I’ll accept you for that price, the patient will come to you, and you won’t have to use your insurance companies.

You won’t have to rely on the insurance companies.

I think you should look at your insurance companies. If you have a fairly full practice and there are some insurance companies that are paying less and less, let’s say, $65 to $68, maybe you want to kick those low payers to the curb, get off their panel, and move more towards a cash practice.

This is Dave Kats. Thanks for listening