Chiropractic Financial Care Plan - Billing Precision Perspective

A typical financial care plan helps the patient to afford the care while establishing a guaranteed cash flow to the provider. The concept of financial care plan is based on a relative cost difference for the same service during the plan period and outside of it. The patient guarantees lower fee for each service encounter by committing to higher number of service encounters.

A financial care plan improves the perception of service cost-benefit, because without the plan, the cost for the same service would be higher. Therefore, it is important to track the plan for each patient and, upon reaching the end of the plan, immediately charge the regular (higher) fee.

But tracking multiple patient care plans becomes difficult upon reaching large numbers of patient visits, impeding the continued development of the clinic. Worse, the complexity of individual plan management is exacerbated by varying sources of payments required for different kinds of visits. For instance, the fee for care during a specific period of time is paid either by the insurance company or by the patient. Finally, the number of visits in each plan is variable too, depending on patient health condition and specific plan. For example, the number of visits during the care plan period is indefinite but the number of recommended adjustments is typically finite.

Therefore, chiropractic office billing technology must be able to handle both kinds of complexities. First, it must be able to handle multiple care plans. Second, it must be able to allocate different charges separately to care plan while managing the combined payment status for the same visit.

Care Plan Definition

A powerful care plan management system maintains three kinds of edits, namely, addition of a service encounter without adding charge, addition of plan payment without adding a service encounter, and addition of both a service and a payment. Also, if the current plan is pre-paid in full at the beginning of the plan, the service charges during the care period must be discounted.

A care plan is defined by three components, namely, time period, total amount of charges and payments, and total number of services provided to the patient. Services include adjustments but often exclude X-rays and exams, and always exclude supplies, such as pillows or vitamins. To define a care plan:

• Select patient
• Select care plan start and end
• Update maximum plan visits
• Update maximum care plan amount
• Update expected insurance payment
• Update deductible
• Select one of the following billing options:
  • Bill patient only (no insurance charge)
  • Bill insurance upon exceeding patient's maximum care plan amount
  • Bill patient upon exceeding maximum care plan amount and write off patient's portion

Care Plan Status

Chiropractic office management system must be able to show status of both combined and care plan, which include:

• Visits
• Charges
• Payments
• Write-offs
• Balance

Note that Care Plan Status must be available to both the provider and the Front Desk person, who will be able to discuss any outstanding balance with the patient upon arrival to the office. Colored display of relevant information helps the Front Desk person to react quickly and effectively to situations that require correction, e.g., bad plan definition dates, missing visit data, or unpaid balance.

Care Plan Tracking

To begin charging the patients regular fees or define a new care plan upon care plan expiration, the office must track care plan end dates. Such care plan expiration tracking function is accomplished in two ways:

• Today's appointment list shows patients with expired care plans
• Separate report lists patients with expired care plans within a given date range.

A financial care plan is an important component of practice building strategy as it helps the patient to afford the care while establishing a guaranteed cash flow to the provider. But tracking multiple patient care plans becomes difficult upon reaching large numbers of patient visits impeding the continued development of the clinic. Outsourced computer technology combined with effective billing service helps chiropractic clinic overcome care plan management complexity and continue building high-volume practice.