EPISODE 382: Business Updates Show

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] Welcome to another episode of modern chiropractic mastery. This is your host, Dr. Kevin Christie. And today I'm bringing a solo episode. We're going to talk a little bit about business. I've got five things to chat about on some business related updates and topics that we've kind of come across, whether it's through our coaching program, our mastermind, or even some of the Facebook groups that I hang out in and trying to give you some insights on that.

And today we're going to talk about five things. We're talking about cashflow. We're about compliance. We're going to talk about outsourcing or in house billing. We're going to talk about having a future bigger than your past. And then we're also going to talk about knowing your numbers. So let's dive right into cashflow.

I had an interesting conversation with one of our mastermind members this past weekend in Chicago. And we were kind of talking about, he's been practicing for quite a long time. And he just really talked about where, um, cashflow. And we know [00:01:00] this is just so important, you know, whether it's your investments and your net worth and things of that nature.

But as long as your cashflow in your personal life and in your business is confident, um, you will feel really good about yourself and what you're doing. And when you have cashflow issues, it can be the other way around, right? You can have person A and person B or say chiropractor A and chiropractor B.

And let's say all things are equal. And let's say they're really pushing the envelope. They're really working hard. They're working 60 hours a week, 50 hours a week, whatever you want to say. They're like working hard. If chiropractor A Has cashflow confidence in their personal life and in their business.

And they're feeling good about that. They're going to prevent burnout and feel really good about their progress. They're making compared to chiropractor B who is having cashflow issues. And so you got to protect your cashflow. You have to make decisions based on your cashflow. And some of you run into cashflow issues.

And I know I've [00:02:00] run into cashflow issues in the past, but some of you run into cashflow issues because, you know, Frankly, there's not enough money coming in. You need to get more patients. You need more new patients. You need more, you need more act, uh, reactivations, you need more office visits. You need better patient adherence to your treatment plans.

You frankly need more revenue coming in. And in some of you, it's not a revenue problem. It's an overhead problem. And you might've made some decisions that have chipped away into that overhead and setting you up To be cashflow crunched. And that's not a fun feeling. And here's the reality of is you, you know, you're going to run into some cashflow stuff here and there's a lot of things that happen if you practice for long enough, 30, 40 years, maybe times where cashflow got tight.

And cause even, even like the big CFOs, a big companies mess it up, right? Like they, uh, you know, it could be a. A billion dollar company and they mess up the cashflow. And that's when you see, you [00:03:00] know, hundreds of people laid off. And so you have to give yourself some grace if it happens, but you want to make it kind of a blip in the radar versus a chronic cashflow problem.

Right? So the. There's a big difference between, yeah, one month or two months out of the year, or, uh, one year out of 10 or, you know, whatever I had some cashflow stuff here versus a chronic cashflow crunch where it's, it's like death by a thousand cuts that can happen. It just eats at you and it gnaws at you for a long time.

And there are a lot of strategies. That we work with chiropractors to help out with their cashflow. And again, it's not always just, you know, not enough money coming in. Sometimes it's too much money going out. And sometimes it's a little bit of both, right. And we can kind of, uh, pull some levers here and there to try to figure that out or give you some insights.

And sometimes it's, uh, it's hard to. Know how to get out of it without a second set of eyes. That's a little more [00:04:00] objective and taking the emotion out of it. Right. And so you, you got to really protect that cashflow. And another strategy I really want you to consider, and this is something that's been instrumental for me is that, um, you know, you should have an emergency savings fund, but that emergency savings fund should be for true emergencies, not payroll emergencies.

Right. Um, It should be where a hurricane hits and you have to close down for a week or Somehow billing got messed up for a month. You noticed and there's no money coming in There was a flood right you got injured and you're the only doctor and you couldn't practice for a month Those are true emergencies.

The other account you should have is a sinking fund account, which is money you take out of the operating account into another account and it sits there, but you utilize that for say non emergencies. Maybe you put money in there and you pay off your malpractice insurance for 4, 000 when it comes in.

You're putting money in there to hire someone and you want some cushion. [00:05:00] Uh, you put money in there to get into the summer months cause it's slower in the summer months. You put money in there because you're going to take a two way vacay. Two week vacation, you're the only doctor and you got money in there.

Or if you run into a cashflow crunch and you have a little bit of protection there. So that sinking fund will give you a little peace of mind. when you do happen to get into cashflow, uh, issues there. And so consider the sinking fund. So there's a lot, I could probably do a whole show on cashflow. I'm not the full expert on it.

I do feel with our team of experts, um, we've helped a lot of chiropractors out of, uh, chronic or, or acute cashflow issues.

Second is compliance. Uh, our clinic is going through full compliance training. Um, I have a, uh, saying after going through it is, uh, compliance is a thief of joy and, uh, but it's, it's necessary evil and I'm learning a lot and, and there's definitely a lot of things that we had to clean up with as far as HIPAA, as far as Medicare notes, as far as, um, I mean, [00:06:00] just to give you an idea, uh, one of the, there's a few things I want to touch on here that, that I've learned, uh, as of July 1st, if you have a, uh, Salaried employees, right?

Not your hourly, but your salary, there's now a salary minimum wage, right? So if you have a salaried employee, non doctor, non attorney, and there's a couple of other, I think non teacher, but if it's just like, let's say it's your office manager, your front desk, your CA, um, if they are a salaried employee, the minimum, the minimum wage.

Um, yearly salary salary now is I think 48, 000 and change per year. And it's going to actually go up January 1st at like 58, 000 and change. And so some of you may have salary employees are making less than that and you have to get compliant with that. And you have two options typically is either increase their pay, their salary paid to that, or you're going to have to convert them to hourly.

I'll let you look up [00:07:00] the details of that, but that is something I learned. recently. Uh, and that is a real thing, believe it or not. So, um, compliance is important. There's no doubt about that. There's also certain compliance training, things you need to have a compliance manual. I'm working through that right now.

Um, you should have a employee handout manual as well. Um, there's a lot of different types of trainings you need within HIPAA. Diversity now, uh, pass the law, there's a whole diversity training you have to do in the clinic. Um, there's a lot of things and it's, it's, it's wise to get compliant in your practice.

Okay. Um, so just, uh, check that out. I'm going through that. There's, there's different company options from there. Uh, I'm not gonna necessarily, if you want to reach out to me personally, um, with a recommendation, you can Kevin at modern jockey. com and give you some, I'll give you a few options. Okay. Um, number three is, I saw a question about, [00:08:00] should I in house or outsource my billing?

And I don't think there's any necessarily right or wrong. I think there's a lot of variables. But what a few things you want to consider the benefits of outsourcing your billing is that, um, that person's going to work on a percentage, which is good and it should be a fair percentage. And, but that's going to make them fight the insurance companies when they're getting denied and things of that nature, because that's how they get paid.

You know, if there's coding wrong, they're going to come to you and make sure you get it right. They're going to fight for the dollars because that's how they get compensated, which I really like. The second is, is you typically don't have to worry about turnover and that's, that's a good thing. Um, you don't have to worry about turnover typically.

Obviously find a reputable outsourced company. Um, that, that's a given. Uh, and then the third thing is, is it's typically a lot cheaper than a billing person. If you're at a certain level of collections. Now I'm not going to go through what level, you know, collections you should have, but if you're [00:09:00] like a 15, 000.

Uh, a month revenue, 20, 000, 25, probably even more, you know, outsourcing that probably makes sense because to hire a full time billing person is going to cost you considerably. Now, if you have a full time like say a front desk person that's doing that. You need to make sure that they have some, you have some way of cross check.

I have too many nightmare stories of chiropractors reaching out to us saying that they had entrusted one of their team members to do the billing, but it was just part of their hourly or whatever. And they just didn't care enough or they weren't trained well enough. And there was massive issues in the billing.

https: otter. ai billing specialist that's really good at that. Or you got to make sure you have checks and balances. If it's just like your front desk person or a part time person doing it, that [00:10:00] isn't compensated based on the collections coming in from that insurance. You got to get, make sure you're on point with that.

Now, if you're a big clinic, you know, you're collecting 50, 75, a hundred thousand a month, then it may be wise and you're in network with insurances. It may be wise to, to have a in house billing specialist and going that route. And that's kind of my opinion. You got to do the math and say, okay, if I give up 7 percent of my insurance collections to outsourced, how much does that cost?

If that cost is X amount and that X amount is way is more, uh, than having an in person. Then it's something to, um, to consider, but know your, know what your costs are, uh, for the outsource versus the in house. And the concern with the in house, you got to always take care, Tara, is make sure you have backup plans.

Cause if for some reason that brilliant person is, you know, MIA quits or whatever, um, Then you might go a period of time without billing. If you don't have someone [00:11:00] that knows it as a backup plan for, so those are my thoughts on the in house billing.

Um, next is a quote from Dan Sullivan. And that is you always make your future bigger than your past. I think a lot of chiropractors struggle with seeing a future that is bigger than their past. Past or their current and they get frustrated and it gets burned out and they feel like quitting the profession because they are not seeing a future bigger than their past.

When you can see envision a future bigger than your past. That is when you can work hard. That's when you can sustain it. That's when you can see. The fruits of your labor and you can prevent burnout. Um, I think that's a big thing. Now I know it's just kind of a contextual saying, make your future bigger than your past, but you know, what does that look like?

You know, with all our clients, we do a three year vision planning session. I was like, what, I want to know exactly what you're thinking. [00:12:00] Three years looks like in your mind's eye, like what's your bigger future. And then we got to reverse engineer that with you to make sure that we put you on a path to that bigger future so that you're not just dreaming, right?

The difference between dreaming and a vision is that you actually have a plan to achieve that vision. Are you kind of in a malaise? Are you waffling in your career and you don't know why? you, you start to get concerned that your, your future is not bigger than your past. Number five, know your numbers. Um, I, I think too many chiropractors don't know key statistics of their practice.

If I asked them what their office visit average was like dollar amount, they should be able to tell me. Right. Is it 81 per visit on average, right? That's, um, take all of your office visits for the year, divided by all your collections or vice versa. [00:13:00] Uh, and that's going to be a dollar amount, right? So if you had a thousand dollars and you had 10, you got the, you get the idea, right?

So your office visit average is going to be a number that you want to know. And from there, We can kind of ballpark it where I shouldn't say ballpark, we really hone in on, you know, depending on certain variables, right? If you're in network versus out of network, if you're in network with insurances and you're in a great state that pays well, like say Oregon or North Carolina or Illinois, or you're in network with insurances and you're in a state that pays shitty like Missouri or Florida and some others, most others.

Um, those are things that are going to be realities. But we can get clear on that and we can have strategies to increase that. Cause what's cool is I've had so many clients that have increased their OVA by like five bucks, even more than that. But let's just say you see 400 people in a month and I give you five extra dollars a visit, that's 2, 000 for doing nothing.

That's awesome. Right. And it can be even more than that. And [00:14:00] so know your OVA, know what your new patient value is. How much is a new patient worth in your practice? Is it a thousand bucks? Is it 1500? Someone like the scheduling Institute would recommend that your new patient value should be as a chiropractor, at least 1, 500 dentists more than that.

They work with mostly dentists, but I got a lot of chiropractors where it's 700 bucks. It's 500 bucks. It's 800. Where's that? Why is that happening? Right. And so we can dissect into that. So know what your new patients are worth. That way we do marketing. And you say, I spent 1, 000 on this campaign and I got two new patients and my new patients are worth 1, 500.

That's 3, 000. That's a three to one return on your investment. That's worthwhile. So you want to know that. I need you to know what your, uh, you know, how many new patients you average in a month. I'm sorry. Yeah. Per month over a year. Uh, how many office visits are you averaging in a month? What's all that looking like?

What are your bad months? Typically? What are your good months? So you got to know your numbers in our CSA digital dashboard we have, which is a whole [00:15:00] dashboard. You can go to csacircle. com. Um, for, if you want to check out the CSA membership within that and within the MCM coaching, we have a whole dashboard that helps you plan out your marketing events, calendar, um, networking tool.

But also we have a. Uh, an in depth practice analytics that you can, that you can look at that. And we'll give you those numbers as well. And so check that out. Right. All right. So those are our five cashflow compliance out, you know, billing, uh, future bigger than your past and know your numbers. Always make sure that you are, um, honing in on your business skills.

And if you feel like you need to be better at business, but ethically reach out to us, go to modern chiropractic marketing. com. We have plenty. We have a coaching tab there. We have a mastermind tab. We have, uh, uh, an academy tab there for CSA. We have many options for you to just get really good at business, but in an ethical way to where you're still [00:16:00] patient centered.