EPISODE 373: Optimizing Merchant Processing with Holly Jensen

Hey, chiropractors. We're ready for another Modern Chiropractic Marketing Show with Dr. Kevin Christie, where we discuss the latest in marketing strategies, contact marketing, direct response marketing, and business development with some of the leading experts in the industry.

Hey docs, welcome to another episode of Modern Chiropractic Mastery. This is your host, Dr. Kevin Christie. And today I'm going to bring you a really good interview with Holly Jensen of Cash Practice Systems. She is the COO and been there for quite a long time, as you will hear in our interview. And we, we talk about merchant processing, but we talk about it in a way that is not boring.

And it is actually very important for you to understand. I recently actually had the

Um, at our West mastermind group. And he was our guest presenter talking on the patient experience and dove into a lot of different aspects of that. But one is how to have a frictionless patient [00:01:00] experience. And one of those friction points is the money side of things. And they developed. The software cash practice systems that really does a great job of allowing you to track the finances.

It's merchant processing. There's a lot of different things you need to know about that. And we dive into that in this episode with Holly, she does a great job of giving you the ins and outs of what to look for on merchant process. But then also. What if you sell cash packages, uh, what if you sell payment plan, how do you track that appropriately?

What if you're in network with insurances and you, uh, you know, that patient has co pays, but then you have add on services and you sell it as a, as a package, how do you track that appropriately? What's, uh, you know, are you storing the credit card on file? Uh, are you getting appropriate signing from the patient on that and, and certain aspects of, uh, recurring revenue that your merchant processing could or may not [00:02:00] do.

And just some other aspects of something that we will all have to deal with as a chiropractic practice. And that is the money side of things and the transactions of it. And so Holly does a wonderful job. of going through that, making it interesting and giving you some things you need to look at and consider, uh, with your practice and how to maybe save some money on merchant processing, how to optimize, uh, the patient experience and remove some of those friction points from the merchant aspect of it.

And then some things you should be aware of without further ado. Here is my interview with Holly Jensen.

Dr. Kevin Christie: All right. Welcome to the show, Holly. I really appreciate your time today. Excited to have you on and discuss, uh, all things merchant processing, but before our audience gets too concerned, there's a lot of awesome things about merchant processing. We're going to dive into more than just the nuts and bolts of it.

And I think it's a topic, you know, I know it's a topic we haven't had on our show before. And I think it's a topic that a lot of chiropractors have to get a grasp of and then [00:03:00] understand some of the capabilities that are out there for that. And so we'll dive into that today, but. Uh, before we do introduce yourself and tell us a little bit about yourself personally and professionally.

Holly Jensen: All right. Well, thank you, Kevin. So I am Holly Jensen. My current title is chief operations officer for cash practice systems. And, uh, I've been doing this going on 22 years. Um, I started out as a chiropractic assistant for Dr. Miles. And, you know, witnessing the miracles in chiropractic with our patients and my family and myself, I was hooked.

I had this fire in my belly and I remember telling, uh, miles, like, I want to serve right alongside you. I want to make chiropractic my career. And at that time, I thought I was going to be a career CA. But then he, he founded cashpractice. com and needed my help. And so now here I am running, running the show.

Dr. Kevin Christie: So it's [00:04:00] cool. We've

Holly Jensen: had the pleasure of working together for two decades now.

Dr. Kevin Christie: Yeah. It's cool to see you in chiropractors, um, you know, Grow out of their practice and then build something, uh, for the profession. And then you'll see sometimes folks that were like yourself with in the practice, uh, transfer over into the, the new business and really, uh, flourish in that.

So that's pretty cool to see you to really grow in that thing to, to the level that it has.

Holly Jensen: Yeah. And it's been, you know, more than just being the COO of cash practice, you know, him and I are out speaking on a national level, um, speaking in regards to patient retention. And I know one of the topics we're focusing on today is, is merchant processing.

And the reason why we're picked that topic is because when you're doing it right and you create a frictionless payment experience in your practice, it's going to help not only increase your revenue, but it's going to increase retention as well.

Dr. Kevin Christie: Yeah. And, you know, we had miles on the podcast a couple of years ago talking about that.

And one of the [00:05:00] things he dove a lot in was the friction points in the patient experience, which was really eyeopening to the point where, uh, actually, uh, probably before this episode releases, he is our guest presenter at our mastermind in the West group talking about the patient experience. And I think too many chiropractors, um, don't grasp the friction part Of the patient experience, and there's too many friction points or, or obstacles.

And yeah, merchant processing, uh, can be one of those. And, and I know that, um, , merchant processing, isn't that sexy, but cash practice is. And, uh, that's why I wanted to have you on to, to talk about some of the different things that consider with merchant processing and what that looks like.

Holly Jensen: Yeah, you know, and, and I'll dive right in because especially when it comes to just good business practices, especially in a chiropractic office, when, when you're picking. your merchant [00:06:00] processor. There's a couple of things. I like to separate them into buckets. So imagine we have three buckets. Your first bucket is a traditional payment processing.

That's like your, your Costco, your bank, like they'll set you up with a merchant account. And those are more for one time payments. That means you have every single patient in your practice stopping at the front desk and making a payment over the counter. And those are great. There, there's a lot of pros that go along with those merchant accounts.

Um, you, if you have a bank account, you know, with that bank where you're providing the merchant accounts, it's typically an easier approval process. Uh, the rates are fairly competitive. Um, they maybe have you buy or lease a terminal, but it's traditionally for one time payments. The next bucket, the second bucket we have is your Aggregated merchant accounts.

These are more of like your stripe, your squares. Those aren't really designed [00:07:00] for businesses that want high volume, high retention, high revenue. They're more for like the farmer's markets, the craft shows, the, the hairstylist, you know, it's more for like those mom and pop shops. It's not designed really for a business.

Growing the business and it'll have you do some invoice like PayPal has some cool features on their stuff, but that's not typically what you would want to be using in an environment where you're trying to increase revenue and retention. Our third bucket. Is a business growth suite, and that's where cash practices categorize we give you the benefits of like these traditional and aggregated accounts because we're very competitive.

It's it's easy to set up, but we go above and beyond, which is why I like to refer to our merchant processing or what we do here at cash practice as a business growth suite. Because it actually helps your business grow, [00:08:00] adding more cash into your bank account and, um, and there's a lot of tools that can be used besides just the one time payment processing, um, that will really help the business grow.

And part of what we're doing with that is we're creating a frictionless payment experience in the practice. And what that means is we want to remove situations where patients have to think about the money or touch the money. So if we think about it from the patient's journey in the office, right? If you're having them pay per visit, they're stopping at the front desk.

They're pulling out their wallet. They're handing over their credit card. The CA is running a transaction. All of this also takes time. Versus like, we also have offices that come to us and they're like, well, I've never done, um, a business growth suite. I've only just done these one time payments. How can we make that [00:09:00] better?

And how we make that better is we have, we teach them how to keep the patient's card on file securely, and then automate the way that one time payments being collected. So that way you're, when the patient comes in, maybe they're just paying their copay or they're paying for the time of service. Cause they're not on a care plan.

You're like, Hey, John, today it's 80. We'll charge your card on file and email the receipt to you. See you next week. And it's just as simple as that versus you get stuck at the front desk with grandma Sally talking about all of her grandkids and pulling out her cell phone. And then there's a line of people waiting to check out behind you.

Dr. Kevin Christie: Yeah, it makes a big, you know, a big deal. And I know, um, you know, care plan cash packages are great for that. Uh, One of the things within that, you know, I think there's a couple of different things, you know, you guys traditional treatment packages for, for patients, but then recently I've been talking a lot about add on services, uh, [00:10:00] certain things like dry needling, we're seeing in laser and shockwave where, uh, the practice may be insurance based, but then they're selling packages of, of those add on services.

Uh, this could be a great option for them to be able to track that. Correct.

Holly Jensen: Yeah, absolutely. Uh, are we in our business gross weight? We give the ability to not only create these compliant care plans that can automate the way their monthly payment is being collected, but also if their service is happening outside of that, you can charge that using the card on file.

The biggest thing is having the patients not only their card on file, but their signature on file because you don't want them. Having to stop, even though you have their card on file, you don't want them stopping to sign anything. So we, we have the ability for our doctors to create a payment authorization form that the patient [00:11:00] signs.

Authorizing that card to be used up to a certain dollar amount so they can say like, Oh, you could charge my card on file up to 300 for services outside of my regular care plan without needing my permission or signature. So that makes it really easy. And our, and our software will actually tell whoever's processing the payment.

If the signature is on file, which cards are on file, because you can have multiple cards. Somebody might say, Oh, use my HSA card for XYZ service. Um, but it makes it really easy because when people aren't thinking about the money, study show, they'll actually spend more because they're not touching the money.

Dr. Kevin Christie: You know, that makes sense. And I think another thing that I've, uh, had experience with is that, you know, you might, um, you have a patient that has a treatment plan of a certain amount in length. And let's just say you're, you know, that patient's cash, uh, or your practices completely. And, uh, you know, they may not.

You know, let's just say I'm just [00:12:00] gonna make up a number. Let's say the, it's going to cost a thousand dollars for the treatment plan that you've rendered for them. And, um, you know, instead of having them pay each visit, uh, you, you could obviously sell a cash package, but they may not have a thousand dollars on them right now.

So it's not necessarily. Uh, it's, it's a cash flow problem, right? In their personal life. They don't have a thousand dollars now, but they, they would have a thousand dollars over three months. You could do like a payment plan for there. And I, and your system would, would track that for them as well. Correct?

It would

Holly Jensen: absolutely do the payment plan. You know, one, one thing that drives me nuts when I go into offices, um, and I go in there and training, or maybe I'm utilizing services. Um, you know, You know, I'm like the spy, the mole coming in, and I see they've got this big sign at the front desk that's advertising care credit.

Now there's care credit is great for when you need to use it. Um, however, if you can do in house financing, so like you just said, Kevin, if they can spread [00:13:00] that payment out, you know, maybe. 300 a month for the next three months, then that's going to be easier for your merchant processing rates versus paying care credit, the 10 to 13 percent chunk that they're going to take out of it.

So it's about creating a affordable payment options for patients. So they pay you in house and you're making it easy for them to utilize the services and also to create that frictionless payment experience. And our system will allow you to do. Monthly payments, weekly payments by monthly, like whatever weird stuff you could think of, literally you, you can do that within our software.

Dr. Kevin Christie: Yeah. I've, I've had the pleasure of doing a tour through it and really learning it. And it's just really simple to do any of those things you want to do again, whether it's payment plans or just cash packages and then the other one. And this was something that miles and I had talked about a decent amount, but it'd be good to kind of rehash it was memberships because a lot of chiropractors are fascinated by the membership model.

[00:14:00] And if I'm correct, you guys are able to also implement something like that.

Holly Jensen: Oh yeah, absolutely. Whether it's using our care plan calculator, which creates the compliance service agreement between doctor and patient and outlines the patient's financial responsibilities. And then it breaks it down into affordable payment options.

And those can be customized, um, per patient or. Through the financial policy and the practice, but yeah, it's, it's really easy to do and just set it up and you literally, we have, we were just in Chicago speaking a few weeks ago and we had doctors telling us like, oh man, I love in the middle of the night, you know, my phone will ping because money's been processed from these.

Membership payments coming through and they wake up and there's an email saying you've had, you know, 6, 000 deposited into your bank account because this is just recurring revenue coming in. You're not dependent upon somebody at your front desk sitting there collecting it. And, you know, I'll, I'll add on [00:15:00] that.

And Miles may have brought this up when, when you interviewed him, but during the pandemic, during the shutdown, we, you know, we have thousands and thousands of clients and so we're able to see the amount of money coming through that these doctors are collecting from their patients. And when the shutdown happened instantly overnight.

Doctors who were collecting primarily one time payments, the revenue went down 50 percent just like that overnight versus the doctors who had patients on some sort of membership, a monthly payment plan, we saw less than a 3 percent drop in revenue. So, I mean, if you want to like pandemic proof your practice or future proof your practice, you need to be putting people on payment plans or memberships in order to have a consistent cash revenue coming in throughout the month of money you can depend on versus waiting for people to show up.

Dr. Kevin Christie: [00:16:00] Yeah, that's great. And it's a, it makes for a really well rounded practice. And I think one of the things we, we should touch on a little bit is that, um, you know, compliance as far as, uh, you know, dual fee schedules and things like that. And I, and I do believe you utilize a third party to help with that as well.

Is that correct?

Holly Jensen: Yeah. When it comes to, you know, compliance, that's one area that we've had to become experts on because. We're, we're creating memberships or programs of care, right? So there has to be a compliant service agreement between doctor and patient, especially in the last couple of years in 2022, um, the federal government outlined the patient no surprises act.

And so now we have to have the good faith estimate, um, even if it's for a PI patient, not just cash patients or not just insurance paid is for everybody. And so there's a lot of misunderstandings. All doctors will come to us being like, well, I'm 100 percent cash. So the rules don't apply to me. [00:17:00] Actually, that's not true.

We all have to follow the same rules. And part of that is your documentation and your service agreements with patients. And so we, um, have a board of compliance advisors, Dr. Ray Foxworth of ChiroHealth USA and Kathy Mills Chang of KMC University, who regularly connect with us, review our, our plans for compliance and give us feedback on any upcoming changes.

So ensure that our doctors utilizing our care plans, um, are following the rules and they're compliant and they're not going to get in trouble with those dual fee schedules.

Dr. Kevin Christie: Yeah. I strategically, uh, Within a few week period of time, I have your episode releasing. And I also have an interview with Christy Hudson for, for, um, two.

So there, and so ChiroHealth USA. And so I'm kind of, I'm going to save some of the details of that for her. Uh, but people can really feel confident that you could implement certain things like packages and memberships and, uh, payment plans and [00:18:00] the like, and feel compliant or not feel be compliant with it.

Holly Jensen: Yeah, and utilizing a DMPO, a discount medical organization, which is what ChiroHealth USA is, and our, um, our care plans integrate the ChiroHealth USA fee schedule in there. So it makes it really, really easy for doctors to be compliant on their fees in regards also being compliant in the care plans.

Dr. Kevin Christie: Perfect. I love it. Um, question I have is, uh, I know that there's a, probably a laundry list of them, but some of the key EHRs that your software is compatible with?

Holly Jensen: Yes. So, um, pretty much all, all the big players out there, Cairo HD, Cairo Touch, Platinum, Pay D C, um, some Hertford, if anybody's using that still, um, maybe take

Dr. Kevin Christie: that out.

You can take that out. Uh, how about Genesis?

Holly Jensen: Yes, and Genesis, of course. Um, we have a great integration with [00:19:00] Genesis. In fact, with the Genesis integration, it's a little bit more unique than the other integrations we have. You can actually open the cash practice platform. All of it, care plans, wellness scores, emails, payments, all of it within Genesis versus the other integrations are payment processing only.

Dr. Kevin Christie: Okay. And then I, you know, obviously there's probably some chiropractors that have EHRs that aren't yet compatible. Uh, what are, uh, some of the scenarios there? Do you have some that, um, you're able to get KPIs with? Is that what it is? Cape? No, not KPI.

Holly Jensen: It would be an integration is what we call it. Yeah, we do have a lot of doctors come to us saying like, Oh, I wish you guys integrated with this software.

And you know, there's some that just flat out, I hate to say it, but they have, they offer their own merchant processing. So they want, they want to keep all the money. They're in there and they don't want to offer other options, so they're not [00:20:00] interested in having an integrated partner. There's others that, um, are want to work with us.

And we have some things behind the scenes. Our newest integration is also eye patient care. This is great for these, uh. multidisciplinary types of practices. Um, so they'll, they'll be integrating with us. It actually hasn't been launched the first time I'm saying it publicly right now, but, um, so it, that all comes from doctors saying, you've got to work with cash practice.

So the more noise you make, you know, from with that EHR. Um, and we have a really easy integration, but we'd love to integrate with everybody. It's just some of the business strategies for EHRs. They, they want to have their own in house payment processing. So we have a lot of doctors who use our services who don't have an integrated EHR.

And guess what? It's just as easy because you're still automating payments, whether it's recurring payments or one time payments. Um, [00:21:00] we, we also have a mobile app, like all of these things you're still collecting. You're just manually posting it in the EHR as you would if you just had a traditional merchant account.

So it's, it's really not a big deal.

Dr. Kevin Christie: I mean, that's the thing. It's like, you could just easily do that way. So, so not, not a problem there. Uh, what's a typical range of a healthy, um, merchant processing fee per transaction, like what's just a range percentage wise,

Holly Jensen: I would say if you're. 4 percent or under of your overall effective rate, um, then, then that's pretty good because, and here's the, the reality of it, which is why I can't just give like a number because there's over 450 different rates out there.

And it could be like, if your patient has the cash back capital one visa card, You as the business, you're paying a higher rate to accept that card versus if they use their debit card that has a Visa logo on it, you're paying a lower rate [00:22:00] for that. Um, also if you submit the address with the transactions versus not submitting an address, there's different rates for that.

So basically you take your overall volume against what you're paying and you'll come up with an overall effective rate. And that's one thing that we offer here. Cause A lot of us don't like looking at numbers, right? We just want to like take care of our patients. So we offer at cash practice what we call a competitive rate analysis.

It's no charge. And we ask you to send us your current merchant statement. And we'll tell you like this office we just worked on last week. They were paying 80 a month in terminal rental fees for a terminal that they threw in the trash a couple of years ago, but they didn't know that because they don't know what they're looking for.

And then also their rates were really high. And so we're able to tell them like, look, even if you don't use us, Here's what you're looking at. This is what you're dealing with. But usually people are impressed with what we're able to do [00:23:00] because we do beat 99 percent of our competitors, whether it's a traditional or aggregated merchant account.

Um, so we're able to see some savings, which people are like, Hey, that's a draft.

Dr. Kevin Christie: Yeah, that's nice. And, you know, we kind of, before we recorded, we were talking about a trend, uh, you know, talk about. Talk to us about that. You know, there's a lot of clinics out there trying to figure out ways to, to save money.

And you mentioned them passing it on to the patient. What's going on with that? And what are your thoughts on that?

Holly Jensen: Yeah. So one of the big trends out there is you might be at a seminar and you'll see a vendor who's advertising zero percent, you know, in processing fees. But here's the trick to that is you have to purchase their credit card terminal.

You can't just use any one. Um, that terminal will not accept HSA, FSA cards or insurance payments. And then you can, It also is passing the fees onto your [00:24:00] patients and that's going to piss people off right there. No, I mean, even just going to the gas station and paying an extra 10 cents a gallon, because you're using your credit card like that.

So if you're doing that for a healthcare service, people do not like it. And then

 so if you're falling for these 0 percent marketing gimmicks, these programs are designed to pass the fees onto your patients.

And so if you're charging extra fees to them for using their credit card, not only can it lead to patient dissatisfaction, but patients might feel like you have like this hidden charge or unfair pricing, and it can damage your relationship with the patient. Um, and then when it comes to patients who want to turn in their receipts to be reimbursed through HSA, FSA, or their insurance, they're not getting reimbursed those fees.

So, if they're spending some good money in your practice, and they're unable to get reimbursed for that, um, that that's going to [00:25:00] be a problem. I'm going to have a lot of negative perception about that, um, and a negative impact on your patient base. Yeah, and

Dr. Kevin Christie: I can, I can relate to that because there's a lot of times where.

I want to pay my credit card for a service and they'll say, Oh, well, it's going to be a 4%. You know, I put a whole fence around the printer perimeter of our house and I wanted to pay credit card to get the points. But the guy was like, Oh, it's going to be a 4 percent charge extra on that. And I get it. I get it.

Um, but he, and he told me, but I was frustrated by it, you know, and there's been other times where, um, I just had a plumber at, uh, at our office to fix the same thing. So, um, you know, it's definitely something where people are not expecting to have to pay the merchant processing.

Holly Jensen: Mm hmm. Yeah. And it's also a bookkeeping nightmare because, you know, if you're running a payment for 82.

53, but you really only intended to You still have to post the full amount of money that you collected because, um, when you get your [00:26:00] 10 99 and you have to do your taxes, they're going to show you paid X amount of money. It's just a bookkeeping nightmare. So, we usually recommend instead of passing your merchant fees onto your patients, just raise your fees by 3 to 5 percent to offset those processing fees.

Um, ensure your rates are competitive. So do some research, get some quotes, contact cash practice for competitive rate analysis. Um, you can also increase your patient visit average. So keep more of your patients because if you're not so dependent upon new patients, you're not going to be so worried about.

Constantly marketing and spending money on looking for new patients. Um, and then, you know, reduce patient dropout, look at things that you can do to identify and remove situations that cause an exit door to the practice.

Dr. Kevin Christie: Yeah, no, absolutely. And I think ultimately it's kind of a cost of doing business now, you know, if you didn't accept credit [00:27:00] cards and you only accepted checks and cash, uh, you probably would lose out on a ton of patience and money.

And so it's just a reality that you got to face. And there's a lot of options out there that it, you know, makes it beneficial. Just like you talked about with the business growth suite, you can change the mindset on it. It's like, okay, emergent processing is a. Potential growth opportunity for our practice and not an expense.

It's more of an investment. And I think that will help people to really start to make proper business decisions around it.

Holly Jensen: Yeah. And, you know, it's one other thing I'll add is, you know, we're talking a lot about merchant fees and we're mainly focused on credit cards, but with our cash practice software, you can actually get the patient's routing number and account number.

And the way I did that as a I would let the patient know like, Hey, Kevin, our financial policy is to automate the way you're paying us, whether it's for the membership or one time payments or outside services. So, um, we prefer to debit directly from your [00:28:00] bank account on your phone. Just open up your banking app and you can read off your routing number and account number to me.

Dr. Kevin Christie: Yep.

Holly Jensen: If some people are like, oh, I really wanted to get the points like you did, Kevin. I really wanted to get the points and use my Capital One Visa. I'd say, no problem. I'll, you know, we can go ahead and get your credit card. Um, but if they ever ask, well, why, why do you want my My bank account versus my credit card.

I'm up front. I'm like, it helps keep our costs down so we can continue to provide a core affordable care and quality service. So.

Dr. Kevin Christie: No, it makes sense. That makes sense. Um, is there anything I didn't ask you that is kind of important around this topic?

Holly Jensen: Yeah, I, I, one thing I want to add in regards to our business growth rate, really what sets us apart from the other processors out there, of course, you do one time payments, you can do recurring payments.

We have a mobile app. So if your, maybe your power goes out in the office, um, or you're doing a screening event, we have a mobile app that [00:29:00] allows you to be able to collect money right there on the spot. We also have, uh, uh, Online payment form link, which you can send to your patient. If you have your texting platform, it'll generate a link so you can either email them the link or use your own text platform to text the patient the link, but they can pay their own bill online, or you can send them the payment link so that they can.

Join a monthly membership. So it's not just for one time payments. And then we also have a gift card platform. You just buy the gift cards and then you're able to sell the gift cards. We've had practices tell us during the holidays, um, or even like this time where it's like father's day graduation and mother's day right now is a really popular time for these gift card sales.

And they're generating just 10, 000 in income, just selling gift cards. Um, So it, you know, it does a lot of different stuff and it has some really nerdy, cool [00:30:00] reports so you can forecast the money that's coming in. If a payment's declined, the patient receives an email with a button for them to, um, update their own billing information.

So you're not chasing down money. There's like a lot of stuff you can nerd out on in cash practice. If you love looking at stats and who doesn't love seeing the money coming in and it's cash. None of it's insurance money, right? It's all cash.

Dr. Kevin Christie: Yeah. Which is

Holly Jensen: exactly

Dr. Kevin Christie: so. Well, this is great. How can they find out more?

Holly Jensen: All right. Well, they can go to cash practice. com and there's a button right on that page for you to book a call. And when you book a call, it's a 10 minute call and you can speak to our patient retention experts. And they'll be happy to get a competitive rate analysis up and running for you, which takes us.

Typically a day or less, and then you're able to make an informed decision on, you know, what, what it is you're dealing with. And if [00:31:00] you want to utilize cash practice services.

Dr. Kevin Christie: Perfect. I love it. Thank you so much for your time today.

Holly Jensen: Yeah. Thank you so much for having me.