EPISODE 378: Staying Compliant With Your Billing with Kristi Hudson

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.

Dr. Kevin Christie: [00:00:00] Hey docs, welcome to another episode of modern chiropractic mastery. This is your host, Dr. Kevin Christie. And today I am excited to bring on Kristi Hudson of Chiro Health USA. Uh, I should have had her on many years ago. It's a topic that we just haven't discussed on the, on the podcast and we need to, and we're kind of having a little bit of a run here on compliance, certain things like that, how to, how to optimize your practice in certain ways that may not be.

Marketing and all the stuff that you see out there that you're, that you're attracted to maybe, uh, but we're going to dive in today, which is something very important. This is your, uh, you know, honestly, it's your billing compliance. It's like avoiding the dual fee schedule, how to have prompt payment, um, discounts and certain things you can do.

And you gotta, you gotta watch out for. And my goal for. every, uh, chiropractic practices to do well [00:01:00] for itself and do it the right way. And sometimes it's, you know, maybe not understanding what you can and cannot do. Sometimes it's maybe just being a little bit on the lazy side. Sometimes it's hard. It's frustrating.

It's like, it should be easier, but there's a lot of things we have to be compliant as a healthcare provider and, and what you're billing your patients and charging your patients is a big aspect of that. And so we dive into today. We, we give you some really good solutions. I should say, Christie gives you some really good, uh, solutions and, you know, ChiroHealth USA has just been doing this for many years and doing it with, uh, I was very surprised to hear the number that she shares, how many, uh, clinics that they do work with and, and their, uh, service does help avoid.

Many of the traps that we fall into as healthcare providers from a billing standpoint, like the fee schedules and, and that stuff. So we, we dive into that, uh, today, [00:02:00] uh, before we get into that, I just want to remind you, we do have openings for the West mastermind in 2025. It's going to be Uh, really good.

I'm excited about the lineup we have, uh, for the West. Um, the, the very vast majority of our current members in 2024 are coming back for 2025, and we're gonna be adding some people to that. And we will have Dr. Mark King speaking to us in weekend one. We've got dollar, Dr. Sorry, let me redo that. Becky. Uh, we got Dr.

Holly Tucker speaking in weekend two. We've got Dr. Brett Winchester speaking on the it factor in practice, not necessarily the clinical side, but all the other things that he's doing in his practice to have such a big and successful practice. And then weekend four will be a meeting of both the East and West mastermind groups.

In New Orleans, and we're bringing in the great game of business. You can look that up. The great game of business. It's a phenomenal business structure, and we just want to spit out phenomenal chiropractors, [00:03:00] not only clinically, but also understanding business and doing it in a way that inspires your team and helps everybody grow.

And the great game of business is a big Part of that. And we have also Jay Greenstein speaking there on all things, technology and AI, uh, that will be up to date as of that late 2025, because it's ever changing. And then I'll be speaking that weekend as well on marketing. And so check that out. Just go to modern chiropractic marketing.

com. You will see a tab. For mastermind, and you'll see a couple of different years. We have an East and West, but check out that West group there and feel free to reach out to us if you are interested in joining us in 2025, it is an investment, it is a high level mastermind, but you will get a return on your investment and a return on the relationships you form in that mastermind.

Without further ado, here's my interview with Christie Hudson.

All right, [00:04:00] excited to have Chrissy Hudson on the line here on the podcast. It's someone that, uh, I've gotten to know over the last year because we spoke at Jay Greensign's event and, uh, that was fun and we had a good time and it's, uh, kind of a shame that I haven't had you on the podcast before. We've been at this for seven years and this is a topic that a lot of chiropractors should know about and they should hear it from you.

And so before we do dive into it, tell us a little bit about yourself.

Kristi Hudson: Hi, everybody. Um, my name is Christie Hudson, and I'm the vice president of business relations at Car Health USA. And outside of our founder, Ray Foxworth, I'm the longest employee we've ever had. They're very first employee. I'm about to be there 15 years, which is mind blowing to me.

Dr. Kevin Christie: That's awesome. How long has the company been around?

Kristi Hudson: 16 years.

Dr. Kevin Christie: Oh, there you go. Perfect. Sounds about right. Sounds about right. Cause I've been, I've been out 19 years and I kind of remember when I first started hearing it, which, um, that, that makes sense for sure. And then, [00:05:00] uh, for the sake of brevity, we can call it Chusa now moving forward, right?

Kristi Hudson: We can

Dr. Kevin Christie: do you choose. The other thing I wanted to say is, uh, you guys have like the best booth at events. Like when I was at the, in the FCA Orlando last year, I mean, I don't know who comes up with the ideas and how that works, but that's, it's awesome.

Kristi Hudson: so much. Um, believe it or not, like we just randomly talk about it, like what will be our next theme and then trying to top each other.

And last year's booth, which was sports related was from our accounting manager. She had a dream. Um, and that's where it came from. And then this year's is a motorcycle theme and it came actually out of a joke. Um, but I was like, oh, wait, and, you know, we're gonna be the daughters of anarchy.

Dr. Kevin Christie: Oh, that's great.

That's great. [00:06:00] I love it. Yeah. Creativity is, is awesome. It stands out. I mean, I even brought it up a year later on a podcast, right?

Kristi Hudson: I love it. We feel so good because we do put a lot of heart and soul into those themes and how do you tie sports? Well, sports is easy. How do you tie motorcycles back to chiropractic?

Yeah, yeah,

Dr. Kevin Christie: no, it's, it's great. It's awesome. And then, um, You kind of said it before, um, we hit record and I wanted to kind of reiterate a little bit before we dive into it. How many clinics are you guys working with now?

Kristi Hudson: Over 7, 000.

Dr. Kevin Christie: That, that kind of blew my mind when you said it. I was like, did she say 700 or 7, 000?

That's, uh, that's incredible.

Kristi Hudson: Um, I want to say, well, I don't know how many clinics that is. It's over 7, 000 providers are multi D, uh, clinic. So I think we have right around a thousand non chiropractors who work in chiropractic offices, whether they're like nurse practitioner, things like that.

Dr. Kevin Christie: That's cool.

[00:07:00] Awesome. Good stuff. And then, uh, what is CHUSA?

Kristi Hudson: Oh, I love this question. It is an effective way for you to implement a profitable discount strategy in your practice. Um, as you know, chiropractors, sometimes that DC stands for doctor of creativity, and it really shows when we're trying to attract new patients into the practice or make care affordable and chiropractic.

Um, unlike everything else in healthcare, we see our patients. More frequently than any other health care provider, um, you know, a dentist, the twice a year, your eye doctor once a year, you have a, you know, an issue. You might see a general practitioner three to four times a year. I'm going to see my chiropractor three times in a week.

If I'm having an issue 12 times in a month. Um, and so we get really creative in the way that, uh, we offer discounts and practice. Uh, I've really been talking a lot around the country about social media advertising. [00:08:00] Lately, and, uh, the pitfalls that we make with new patient specials, and unfortunately, you know, we work in the 2nd, most regulated industry in this country.

And you can't just say, you know, my 500 dollar new patient visit is 99 dollars without violating a host of rules and regulations, but cover health USA is a discount medical plan organization, which originally were started by insurance companies were not owned by an insurance company were owned by a chiropractor.

And. It allows you to legally offer discounts outside of what we're legally allowed to do, because it's now part of the contract. So it's very similar to like an insurance contract, but a lot without those restrictions and the negativities, because we're not going to dictate what you're going to get paid.

Dr. Kevin Christie: Yeah, and I want to, um, chat about something before we dive into that a little bit is, um, a chiropractor can offer a time of service discount, but isn't that about 15 percent give or take is that

Kristi Hudson: it is? I [00:09:00] mean, it can be somewhere between 5 and 15%. Um, one of the caveat to that is that it needs to accurately reflect your bookkeeping savings by not having to collect interiors and build the patient afterward.

Yeah. Um, and most chiropractic consultants will tell you that the average bookkeeping savings in a chiropractic office is 7%. And it just, just thinking of an adjustment, forget about any other service that a chiropractor offers, but a 7 percent discount, even a 10 percent discount on an adjustment that is not saving anybody any money that's not making that care affordable.

Dr. Kevin Christie: Yeah, exactly. That makes a lot of sense. And I just wanted to get kind of get that. Out of the way there as far as the time of service discount. And again, just for clarity sake, this is a little bit of a selfish episode to learn in myself. I got a good beat on it, but I want to make sure that everybody's clear because some people ask how that works.

And you mentioned, you know, let's just say, I'm just going to make up numbers [00:10:00] for sake of ease. Something is 100. You bill that blue cross blue shield plan a hundred dollars. You have a contract with that blue cross blue shield. They pay you 42. Um, that's a contract you have with blue cross. Obviously that's a highly discounted, um, amount they're paying you based on what your, your fee is.

Now you might bill that same 100 to auto insurance in the state of Florida and get paid 98 of that. It's the same fee. It's a different, um, rate you're getting paid because again, it's a contract. Uh, now you go and you offer that same 100 fee service to a cash patient, but you charge them 60 cash at your cash rate.

Um, that doing good math is a lot more than a 10 to 15 percent time of service discount. And unfortunately, it probably puts you into that dual fee schedule, correct? [00:11:00]

Kristi Hudson: It absolutely does. Um, we always joke that, you know, in the South four letter words are bad words and cash is a four letter word. Um, especially when it comes to offering discounts, I'll add that free is also a four letter word.

Um, we never want to do that. And it's interesting because I have that question asked a lot. They're like, well, why is it okay for Blue Cross Blue Shield? Um, Or another insurance company to pay me less than my actual fee. And it's because you have a contractual discount. You signed a contract and you agreed to that lesser fee.

The cool thing about the DNPO, uh, or CHUSA is that we use that same contractual model to be able to do the same thing to help you to have a lower fee. But I think the most important aspect of all of that is we do want to make care affordable for our patients. Absolutely. We want to expand access to chiropractic care around the country.

But at the same time, we want all of our chiropractic offices around the country to be successful and profitable because if you're not profitable, you're [00:12:00] not going to stay open. You can't treat your patient. Um, and so helping chiropractors understand the difference between offering a discount, but still maintaining profitability to keep their doors open and for them to be successful in practice.

This is our number 1 goal.

Dr. Kevin Christie: Yeah, absolutely. And this is a great way of doing it. And so I just, I want the audience thinking of it. This is essentially like signing, um, an insurance agreement with a patient. It's not insurance, but it's a similar type of legality that now allows you to, um, charge that 60. to that patient, even though you charge a hundred dollars to the personal injury insurance, correct?

Kristi Hudson: Oh, absolutely. Cause it doesn't change what your actual fee is. You know, your fees, your fees, your fees. So it's still a hundred dollars. And the great thing, and I love that you brought that up with personal injury, which is big in a lot of parts of the country. I know it's big in Florida. Here's the thing is that when you have those cash fees and you are [00:13:00] building personal injury, This is the number one hiccup that gets chiropractors on the stand or in a deposition is because they will ask you, what is your cash fee?

And they'll want to know why you're charging cash 60, but you're charging Geico 100 and it will actually have them. They will legally reduce your fees right there on the stand. And you can get in so much trouble in those situations. Um, there was a consultant that I used to work with years ago, and 1 of the ways that he used Just to part of his training consulting was he would have people go through that practice depositions or practice being on theían, and having to defend their fees.

And that was the part that strips them up every time. Um, but the great thing is when you says oh well n no, our fee is 100. Do you ever charge less only by contractual. Discount mandated fee, schedule those kinds of thing they can't arbitrarily reduce your fees right there. Because why would you want to get paid 98.

dollars.

Dr. Kevin Christie: Yeah. And then the other thing on the flip side, I, I've talked to [00:14:00] chiropractors where, um, they end up since they're, let's just make up numbers again, their cash service is 75. And then they, they have auto insurance come in and they only bill out. Um, a certain amount and, and they're not getting a lot of money, they're not getting paid well from the auto insurance because they're, they're trying to abide by what their, their fee is.

So they actually, um, are selling themselves short on what they could get paid from auto insurance because the reality of it is, is like, uh, for some States, auto insurance is the only thing left that actually pays us what we're worth.

Kristi Hudson: You know, that's such a great point. It's really interesting. It's one of the things that I talk about when I'm talking about valuing your services and being aware of what is the market value because you're right in a lot of states that PIP schedule is absolutely one of the highest and in many states workers comp is also pretty high.

And it's really interesting that so many chiropractors don't pull those fee schedules. They're like, well, I don't build enough PR. I don't build enough workers comp. [00:15:00] It doesn't matter if you don't build enough. If you build it once, why would you not look at that? Um, one of the working with state national associations, it's very interesting how much time is spent, especially on the state association level.

Where they're battling workers comp to not reduce those fee schedules. They're battling to make sure the fee schedules aren't reduced because 80 percent of the chiropractors in the state don't even charge what is allowed. So, why would they want to continue to pay you 100 for an adjustment when you're willing to always build them 60?

They should just lower the fee schedule.

Dr. Kevin Christie: And I'm glad you brought that up too, because they do learn from what people are billing. And if, and if you're not billing enough on your fee schedule, because you're trying to mitigate this, this or navigate this whole thing with the cash, then they, they just continue to re reduce the fee schedule.

Kristi Hudson: They do, and that's interesting is because, as you know, we're in a lot of the same, you know, social groups where one of the topics of conversation that comes up all the time is that insurance [00:16:00] reimbursement is continuing to diminish, um, and people want to blame insurance companies. Why don't they pay as much as other health care providers?

Well, have you ever looked at an EOB from another health care provider? They're using the same exam codes that you're using just comparing exam codes where they have the same documentation requirements. Um, they have to do, everything is the same. What they're required for, um, to get paid is you, even if it is a different healthcare provider.

Yeah, they get paid two to three times as much as a chiropractor. Well, their actual fee is market value. Yours is a third. So why would they pay you more? They're not going to pay you more when you're always willing to accept less. And I think that a big point is like, we'll never change the reimbursement model for chiropractic if we don't start charging market value.

Okay.

Dr. Kevin Christie: And then this is a way where you can do that. And then obviously not worry about your patient having to pay 150 a visit for it. For that.

Kristi Hudson: [00:17:00] Oh, absolutely. Because again, you don't want to, the point of charging market value is again, it's establishing value, not just for chiropractic services, but, um, but it's to the insurance company as well, um, is to show that we are in line with the rest of the healthcare model instead of making ourselves cheaper.

But we do want to keep care affordable for our patients who don't have the benefit of insurance and they can use. If they have a high deductible or one of those crazy high copay plans that like, I remember when I started 15 years ago, we had a patient with a 5, 000 deductible and I thought, wow, they have really crummy insurance.

That's great insurance today. So, and then having them be able to use cover health USA, instead of their insurance in those situations. Um, I think the other aspect that I, that I began to appreciate now that I'm a mother and I didn't know this, but, um, there are insurance. Plans that don't allow for [00:18:00] chiropractic care or PT care for children under the age of 12.

So this was mind blowing to me as long as I had worked here. But when my son was 10 years old, five minutes before my best friend walked down the aisle, he decided to jump from a tire swing and break his leg. And I don't mean like just break his leg. He broke it to the point he was in a cast for 13 weeks, a wheelchair, five of those weeks.

And at the end of that, We're at one of the best pediatric orthopedic specialists in our state. And I asked him if he was going to recommend PT for my son, who clearly needed physical therapy. And he said, well, Ms. Hudson, your insurance doesn't cover physical therapy for children under the age of 12.

That's not what I asked and it was very disheartening to me because one care for me or my child should never be dictated by what my insurance will cover and number two, there is no amount of money. I would not pay for my son to get the care. He needs. Luckily. I work for a chiropractor and a multidisciplinary spine center with a full PT department and my chiropractors [00:19:00] that my child to PT.

Dr. Kevin Christie: Yeah,

Kristi Hudson: um, but, um. But, you know, so in those situations, care should not be limited by what insurance will cover. Everybody has the right to affordable chiropractic care, and ChiroHealth USA helps to make that happen.

Dr. Kevin Christie: I love that. And I just want to make sure I get something right on here. Now, if a patient has out of network or in network insurance, um, and it's got a high deductible either way, and they, and they want to go to the choose a route.

Then at that point, you do not build the insurance. Correct. If they opt for the choose a discount, then you can't build the insurance. Correct.

Kristi Hudson: That's correct. So they just form that says I'm telling you not to build my insurance. It's like an insurance opt out form that we provide now, because a lot of times again, short of having an appendix removed or giving birth to a baby, you're not going to need that deductible.

But let's just say you do have your appendix removed, or you do give birth to a baby, then they can find another form that says, now we're going to opt into my insurance because I'm at my deductible. But [00:20:00] thanks to HIPAA HITECH, a patient gets to determine, do I want to use my insurance or do I want to use something else?

Dr. Kevin Christie: They can make that decision, which I like, um, tell me like, walk me through, you know, patient comes in this particular chiropractic practice uses choose. Uh, they come in as a new patient or reactivated patient. Whatever. Uh, what does that look like?

Kristi Hudson: It's super easy. Um, you know, you. Patient, let's just say it's a new patient or let's do a shopper call.

These are my favorites.

Dr. Kevin Christie: Okay.

Kristi Hudson: How many times a day does somebody ask your front desk? How much does it cost to see the doctor all day? Um, and so the great thing is, or the bad thing is, is we treat.

I don't have a crystal ball. That says, well, Dr Kevin is going to do this. So this is what it's going to be. Um, so you happen to say, well, it really depends on what the doctor finds necessary. What your insurance will cover. And they say well, This is why I'm asking. I don't have insurance. I deductible, blah, blah, blah.[00:21:00]

No problem. Well, the great news is, uh, is that we have this great program in our office called ChiroHealthUSA that you can join today for 49 and it covers you and all of your legal dependents. Now, our typical new patient visit is. It's somewhere between 3 to 500, depending on what Dr. Kevin does on that visit with Cairo health USA.

The most you would pay for today's visit is in my fake example, 150, but every and accepts that fee like a morning or an afternoon appointment because typically when we say 3 to 500. The patient heard 500, they can't afford it. They hang up, they call somebody else. Now I just gave them an option that was less than that three to 500.

So even with the 49 fee, they're going to pay 199 today to see a doctor. And now we've given them an affordable option. You know, and like, I, we spend so much money on marketing and advertising to attract new patients. And a lot of times, bless their hearts, they do it the wrong way. Because if [00:22:00] you tell people it's 39, 29, 69 for that initial visit, You're setting a precedence for inexpensive care.

We never tell them the value of our services. Number one. Number two, is it attracting the right kind of patient to your practice? Uh, but this way we're saying it's a valued at 500, but we can give it to you today for 199. Um, and when they come in, they're more committed to that care. And I will say, when we track those numbers, when Ray owned a practice, 95 percent of those patients scheduled and showed up to those appointments.

Dr. Kevin Christie: No, it makes a lot of sense. And so you're, you're letting them know essentially what the fee would be. And then, um, with this discount, uh, obviously planned, they're going to, they're going to understand that, okay, this, this is a lot more digestible. And so you're, you're talking to them about that. And then let's say that now they come in, they agree to it, love it.

They come in that first visit, um, there's got to be paperwork. We've, you know, we, we talked about contracts earlier. [00:23:00] What, what does that look like? Um, how, how easy is it to seamlessly implement this for the front desk to have that new patient, uh, or reactivated patient fill out this information, make the payment of 49, like talk, talk to me about that a little bit.

Kristi Hudson: Oh, it's so easy. Uh, a lot of practices use the QR code at the front desk or that patient literally scans it. They fill in their name, their address list out all of their dependents, put in their credit card information and hit submit and show them their card on their phone. If you have patients who don't want to do that, depending on your software, we're integrated in there.

Lots of software. Um, but a lot of practices use the iPad and they just hand them the iPad and it's part of the paperwork. They fill it out, sign it and pay for it right there on the iPad. It takes like a minute and a half to do the paperwork because all we're asking for is their first name, their last name, their address, their date of birth and list their dependents.

That is it.

Dr. Kevin Christie: And then you mentioned earlier, um, the, the, the clinic, the doctor gets to set the [00:24:00] terms in there. What are some examples? I remember, um, hearing that you can set like a max amount per that day of that visit. Um, how does the fee schedule look on that, um, when they're signing up?

Kristi Hudson: So, the cool thing is, is that there, we do allow for a lot of flexibility.

So you can set, like, a max new patient visit fee and you can limit what services are included in that, but you can do a max new patient visit. So, like, in my example, I said, 150, you can do a routine office visit fee and do a cap for that. A lot of clinics will choose to do. They see a lot of Medicare or federally insured patients.

So they'll do like a cap fee for like therapy modality only and you can set like a set fee per service. There's lots of ways to do it. The other really cool thing is for those practices out there that are seeing a lot of families that are wanting to expand into more families and see more children, pediatrics, um, you can set [00:25:00] family plan.

This is my favorite part about going through and helping chiropractic offices is reviewing their fees and it'll say like 98940 BABY. And I'm like, oh, no, no, no. And it has a different fee. I'm like, please don't tell your mouth insurance carrier. You do that, um, you know, it's like a 9940 is a 1 to 2 region and adjustment.

It doesn't have a size. It doesn't say if under 4 feet tall, you know, so if it's 100 for the adjustment, it doesn't matter if they're a newborn. Or if they're 100 years old, it's still 100, but we can let you set it up so that you can set up a family plan for children and you can do it by age, or you can just do it like.

Child one is this price child to child three child for the great thing is this when you work with as many practices as we have Heather and ginger can say, what are your goals? What is your demographic look like? What are we trying to accomplish? And they can help you to set that up so that it [00:26:00] fits your practice model.

Dr. Kevin Christie: That's great. I like that. And then, um, it's 49 for the family. It's per year, correct? And it auto renews at that year?

Kristi Hudson: So it doesn't auto renew about 60 days before it would expire. The email, the patient gets an email that says, would you like to go ahead and renew? And they can do it online and it sends you a notification to let you know the patient renewed or they can, uh, renew in your office.

But you'll also get a notification that they didn't renew online. But I would say probably close to 40%. Go ahead and renew from the email.

Dr. Kevin Christie: Perfect. And then, um, could you choose as the clinic to pay the 49 and build it into your fee?

Kristi Hudson: Unfortunately, no. Um, you know, again, we're regulated by the department of insurance.

So just like insurance companies, your patient, um, you know, there's those crazy HSA rules and insurance rules and DMPOs have those same rules. So the patient actually has to [00:27:00] pay the membership. However, if they do have, um, yeah, so they have to pay the membership and sign up for the program to get the discount.

Doctors ask us this all the time, but the bottom line is why would you pay the 49. It's not a good business decision.

Dr. Kevin Christie: That makes sense. Just had to ask that one. Um, now the, now the hard one, um, you know, the, the practice has been out of compliance, let's say for example, and they've been, you know, doing things, uh, like a lot of practices probably have been doing it and they say, you know what, we're going to, we're going to clean this up and we're going to implement Shusa and we're going to make sure we, uh, are, are doing this the right way.

Um, how do you. Retroactively get patients that were getting the discount before without paying anything, uh, to now pay something for the same, um, discount and, uh, navigating the fact that you're admitting that you were out of compliance for a period of [00:28:00] time there. What does that look like?

Kristi Hudson: Oh, it's super easy.

So you're the patient coming in. You've been getting my 50 percent discount all this time. I would say, Kevin, we've recently been made aware of state and federal rules and regulations that prohibit us from giving you the discounts you're used to receiving. I'm not sure, you know, since you've been a patient for so long.

It's been such a long time that the actual fee for the services that you're receiving are 100. Now, I know you've been paying 50 a visit for the last decade. The great news is, is to ensure that you continue to get the same affordable care in our office, we've joined a program called Cairo Health USA. So we're limited on what kind of a discount we are able to offer to only 10 to 15 percent.

We know that's not beneficial to you, but with Career Health USA, you can still get that same 100 service at 50. It is going to cost you 49 a year to join, but the great news is, Kevin, it's now going to cover you, your wife, and your beautiful [00:29:00] children. So you'll all continue to get a discount in our office.

Dr. Kevin Christie: Can you come to my office and do that for me? I would love

Kristi Hudson: to. You've done

Dr. Kevin Christie: that before. You've done that before. Um, I love it. No, it's good. And then just, you know, good clear communication with them and and just being honest with it, right?

Kristi Hudson: Yeah, when technically you're not admitting any fault, what you're saying is, we've recently been made aware of rules and regulations that prohibit us from doing that.

And effective immediately, you have to change it. And I think the great thing about that is, is because a lot of times when people join us, they literally just became aware of it because they heard me or Jay or somebody Evan speaking at a conference and they're like, what do you mean we can't offer a 40 percent discount to our cash patients?

Dr. Kevin Christie: Now, do you, you know, like, let's say the clinic implements this, they're doing it the right way now. Um, does that really kind of cover you pretty well for maybe the years prior you weren't really doing it so right, but now you're compliant, you've, Dodged your eyes and [00:30:00] crossed your T's. I know you're not a potentially a legal expert on that, but is it giving you a little bit of grace?

Kristi Hudson: So no, not a legal expert, but I am a certified professional compliance officer. So here's what I will say is if you ever noticed, or if you ever sit in one of my classes and you hear me talk about fees, it's never like it's a hundred thousand dollar fine, it's between 50 and a hundred thousand dollars.

Or 000. And the reason why there's the gap is because they're going to hit you with the maximum. If it's clear, you knew you were breaking the rules. If you have made adjustments, because you became aware on this date and you implemented on this date to clean this mess up, they tend to be more lenient.

I'm not saying they always will be. Now, most chiropractic offices are always concerned when we have this conversation. Like, what happens now? So, the great news is, is, um, NCMIC actually has an audit insurance policy. They've partnered with us to create CHUSA defense. Um, it's [00:31:00] cheaper than malpractice, and I will, you can get up to a million dollars in coverage, and that will cover your legal fees in an audit situation and fines and penalties.

What it doesn't cover is if you actually have to pay back money that was paid to you. But I will tell you, for example, like, 1 of the. Examples that I use in one of my presentations is a doctor was paid like 30, 000, um, in insurance billing. He violated rules and regulations by the time they added on fines and penalties and everything like that, that he owed that 30, 000 plus like another 200, 000 If you have audit insurance, the only thing you're paying back is 30, 000.

Everything else is being paid by that policy.

Dr. Kevin Christie: That's great. So just for the audience, NCMIC has an audit insurance policy looked that up. Awesome. Great. That's a, that's a phenomenal resource. I want to switch gears a little bit. A lot of pack, uh, [00:32:00] Practices sell cash packages or, uh, payment plans and that type of stuff with Chusa.

Can you have it in there to where if I'm just going to make up an example, patient comes in, pays per visit and your Chusa allows him to pay 60 for that visit. Um, could you also offer a package of. 10 visits that comes out to be 50 a visit instead of the 60 by paying up front at the beginning of like a cash package.

Kristi Hudson: So a lot of it's funny. I know that you recently interviewed, uh, you recently had Dr Bogdan at one of your masterminds. So a lot of our mutual clients will do stuff like that. So the way they do is they have it set up in their cash practice software. Essentially, you're using the choose to be and you can do a time of service discount on top of that because they're prepaying.[00:33:00]

You could do instead of it. It came out to 60 and you wanted to do an additional discount. You could do 10 to 15 percent off of this 600 visit.

Dr. Kevin Christie: So it's like a prepayment discount. Correct?

Kristi Hudson: It's like a prepayment discount.

Dr. Kevin Christie: Yep. Awesome. Perfect. Yeah. I just want to do that. Um, is there any allowances within Chuso or anything as far, cause I get a lot of this question now, cause everybody loves recurring revenue, but like a membership model, are you working with that?

Is that, that's a tricky one. I didn't know what the regulations are around that.

Kristi Hudson: So some states allow for a membership model, but here's what I will say. Membership models were created with other healthcare practitioners in mind. If you look at where the practices like in healthcare practices that are most successful with membership models, those patients typically don't come in more than four to six times a year.

If you look at a chiropractic office, It just doesn't fit because of how [00:34:00] many times we see a patient. If you look at your average You know your PVA for your office and you broke it down you'd be like wait a minute I don't want to get paid ten dollars a visit because that's how it's going to roll When you do it, it's really hard to make that membership model profitable for practice um, I get the I I get why people would want to do that I do because yeah recurring revenue is fantastic, but this is health care and so if you have a patient that basically is paying for this membership model of two visits a month that A hundred dollars a month, but they don't come in for six months.

You still owe them all those visits or you're paying them back. So it are refunding their money. So there's a lot more legalities. It's not like a gym membership. It's completely different in health care. And again, it's just we've done the math in a couple of different ways. It just doesn't financially make sense for me, like, 95 percent of practices.

Dr. Kevin Christie: Perfect. And, um, I guess the last question, a lot of [00:35:00] people are doing add on services that may not be covered services by insurance. Um, does that follow the same legalities of dual fee schedule and things of that nature where you still need to, you can't, um, you know, you can't bill, it can't be a hundred dollar, uh, fee.

And then you, you collect 50 for that, even if it's not covered by insurance.

Kristi Hudson: Yes, it's still the same. Um, absolutely. Because whether or not you can build it into to insurances, that's not even important, right? That's not how you set the value of the service. You still can't offer more than a 10 to 15 percent discount and there's a lot of reasons for that.

Um, there's the, the time to the rules and regulations. I have a group of practices that I work with under 1 consulting group. And they have an addiction. I don't know how other words that to to chiropractic like they love every kind of new machine and reality therapy [00:36:00] technology. It was funny when I first started working with them, a lot of the stuff that they were utilizing in their practices, I had never heard of.

I'm like, y'all got to send me a brochure. I don't even have to code this.

Dr. Kevin Christie: Um,

Kristi Hudson: you'll have to code it correctly. Right. Even if. This isn't going to bill for it. Um, but we do have special pricing set up for that under CHUSA. Um, if they want to do it that way, you know, if they want to use CHUSA as an option for those add ons.

And in some cases, um, especially my neuropathy clinics, like they have a device and they're like, I don't want to offer a discount on, I'm like, great. CHUSA fees, but we can offer it on your adjustments and new, every new patient exams. So there's a lot of flexibility there. And here's what I'm going to say is like.

The joining to set is super easy, but the very first thing we do is we're like, we're not jumping into your discounts other than to say, what are you doing? Now? This is a confessional. Tell me every discount you're offering. And then I'm going to ask you a bunch of questions to dig a little deeper and then we're going to figure out what is your cost of doing business?

What's my break [00:37:00] even point? Every time I walk through the door, almost every practice we talked to has no idea what that price is. So how do you set a discounted rate if you don't even know what you have to make to pay your bills and your overhead? And then we're going to do an evaluation of your fees like we're going to help you See, what is the market value based on your zip code in comparison to every other health care provider in your area?

And see how far off you are the average practice we work with hasn't adjusted their fees in seven years

Dr. Kevin Christie: I mean,

Kristi Hudson: we don't have to tell people that the price of everything has gone up so much Significantly in the last, since the pandemic alone, right? So, which means you're seeing the same amount of patients.

You're collecting the same revenue. Your expenses have gone up. Your profitability is down. So we're going to write that ship. And now we're going to talk about discounting your fees to make care affordable for your patients. Um, which is probably why our, most of our practices, like the average increase in revenue.

When they, um, implement, she said the average is [00:38:00] 20%. There are some that are significantly more than that.

Dr. Kevin Christie: That's awesome. This is great. Um, anything I didn't ask you or anything that you feel like the, they really need to know the, the chiropractor listening to this.

Kristi Hudson: Here's what I'm going to say. Most chiropractors think, oh, this is something new that I have to implement at my practice.

Let's just all admit change. It changes uncomfortable, do anything different. But the bottom line is that if you keep doing things the same, you're going to get the same result. If you're not sure if you need chirohealth USA, then just set a consult call. Like, we're not hard sales. We'll tell you exactly how to fix it without using us.

It means charge your actual fee. We'll still help you even figure out what that fee should be. Number two, um, if you want to use this, this will be the easiest thing you ever implemented in your practice. And I'm not saying that like from me, I am saying that because that is the feedback that we get from all of the clinics.

And I [00:39:00] mean, the office managers, the doctors, the CA, this is the easiest thing we ever implemented into our practice. So what do And it's free. It's free to the practice.

Dr. Kevin Christie: That's great. And I, and I want to go back just real quick. And then, um, I want you to tell us where they can find more information on it.

But I forgot to ask if, let's say you're, you're out of compliance, you get CHUSA, you're, you're in compliance. Should you document that? Like the day, like we've implemented this, where like, should you just document it? Would that help you out? Um, as far as.

Kristi Hudson: You should document it in your compliance, um, manual.

Dr. Kevin Christie: Manual.

Kristi Hudson: Yeah, if you have one, if it's still in the plastic on your shelf, just ask us about that. We'll help you fix that too. Um.

Dr. Kevin Christie: You have compliance manuals for us?

Kristi Hudson: Oh my gosh. Well, we, you know, we own multiple companies and one of them is a company that will actually do your compliance program for you and they'll document all of that.

What's

Dr. Kevin Christie: the name of that company?

Kristi Hudson: Cairo armor.

Dr. Kevin Christie: Oh, perfect. [00:40:00] Okay. Another good resource. We're going to make compliance easy.

Kristi Hudson: You know, that's so funny because that's kind of like our tagline.

Dr. Kevin Christie: That's why I said it's,

Kristi Hudson: you know, because the bottom line is that any time that a doctor spends doing anything other than treating patients, It's costing them money, right?

And a lot of times, what is a chiropractor do? We make our most dependable team member responsible for compliance, not giving them any resources or training on what that entails. Um, and that's not necessarily the right path either. So why would you not? Then a little bit of money to ensure that everything is taken care of and you don't have to be responsible for it.

Dr. Kevin Christie: So let our audience know where they can find more information to make that happen.

Kristi Hudson: So you can go to, uh, Cairo armor. com and we do a free consult on that one too, in an evaluation to see where you are. Um, or you can go to Cairo health USA. [00:41:00] com and you can find information under Perfectly protected practice on the.

Audit insurance that we have NCMIC, Cairo Armor, and Cairo Health USA.

Dr. Kevin Christie: Perfect. And then they can reach out and get that ball rolling and get into compliance. So, hey, this was, this was great. I hope I, uh, see you out there on the road. I know you are one of the handful of people that travels even more than I do.

Um, so I'm sure I'll see you out there this year.

Kristi Hudson: You will. I mean, at the very least, I'll see you next month in DC for the That's right. assessment summit.

Dr. Kevin Christie: Um, I was hoping you could be there. So I'll see you in DC. And if anybody has listened to this, I highly recommend you go to Jay's event, not because I'm speaking, but because of all the other people that are speaking and just the, uh, information and collaborations you get out of it.

So hopefully we'll see you there. I think that's June 22nd and, uh, hopefully see you there and looking forward to it, Christy, have a great rest of your day.

Kristi Hudson: You too.