Marketing my new cash practice that opens in a few weeks

[PatBateman]

My new cash practice opens in a few weeks. Still trying to finalize the rates likely $250/60 min initial and $120/30 or $100/20 min follow up.

Marketing steps I’ve done so far
- Psychology today profile
- Paid someone do to some SEO
- article written about the business in a local publication that reaches about 25,000 households, done for free
- bought 100 of these nice Belgian chocolate cookie tins from Costco and I am dropping them off in person along with promotional materials to counseling offices, primary care, pediatricians, and other psychiatry offices who I know are full and not taking patients
- have like 20 lunches scheduled with therapists, cannabis physician, and other potential referral sources
- meeting with reps from 3 different workers comp insurance companies

Any other ideas?

I really enjoy the business and marketing side of things. My wife is going to review all the intakes in the portal and do the scheduling.

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[heyjack70]

You have np rates.

 

[PatBateman]

You have np rates.

I can raise prices later

 

[clozareal]

I think these are overwhelmingly excessive first steps (but good ones!) as I have done MUCH less than you have, but still getting a steady stream of referrals/intake with higher rates. You're really going to 100 different offices in person to drop off those tins? and 20 lunches scheduled??

Why not just get on one insurance panel, which will do the marketing for you, save your time and money, and get paid about the same if not more (in my area, much more than your cash rates).

 

[medium rare]

My new cash practice opens in a few weeks. Still trying to finalize the rates likely $250/60 min initial and $120/30 or $100/20 min follow up.

Marketing steps I’ve done so far
- Psychology today profile
- Paid someone do to some SEO
- article written about the business in a local publication that reaches about 25,000 households, done for free
- bought 100 of these nice Belgian chocolate cookie tins from Costco and I am dropping them off in person along with promotional materials to counseling offices, primary care, pediatricians, and other psychiatry offices who I know are full and not taking patients
- have like 20 lunches scheduled with therapists, cannabis physician, and other potential referral sources
- meeting with reps from 3 different workers comp insurance companies

Any other ideas?

I really enjoy the business and marketing side of things. My wife is going to review all the intakes in the portal and do the scheduling.

Dealing with Workers Comp can be a pain. I only have 2 WC patients in my practice and that’s 2 more than I want. The WC company for both have been so frustrating to work with that I told my office manager no more WC patients. It’s basically like dealing with commercial insurance - or worse.

 

[PatBateman]

I think these are overwhelmingly excessive first steps (but good ones!) as I have done MUCH less than you have, but still getting a steady stream of referrals/intake with higher rates. You're really going to 100 different offices in person to drop off those tins? and 20 lunches scheduled??

Yeah I drew out a map the other day planning the routes. I really enjoy meeting people and getting out there so it’s not work for me.

I don’t think $120 follow up is too cheap.

16 follow ups a day = $1920 x5 days =$9600 x 44 weeks = $422,400 drop 4% credit card fees(little lower actually) =$405,000

Drop $2000month overhead I’m at $381,000

Ok not accounting for no shows, declined credit card payments, etc whatever but I’ll schedule 18 a day and do a no show fee. This is giving me 8 weeks off too which is a ton of vacation I’m not used to that

 

[PatBateman]

Dealing with Workers Comp can be a pain. I only have 2 WC patients in my practice and that’s 2 more than I want. The WC company for both have been so frustrating to work with that I told my office manager no more WC patients. It’s basically like dealing with commercial insurance - or worse.

My mentor loves workers comp and that is pretty much the only patients he sees besides overseeing 2 PA, TMS, and ketamine treatments.

 

[medium rare]

My mentor loves workers comp and that is pretty much the only patients he sees besides overseeing 2 PA, TMS, and ketamine treatments.

Some people enjoy it…

 

[Bartelby]

1- looking forward to updates about how it goes!

2- I agree with others that the rate is quite low. I also suspect you could do significantly better with insurance. I think it will be hard to make as much as you would in an employed position with similar effort taking those rates. I presume, though, that you know your market.

3- do you actually want referrals from "the cannabis doctor?" That sounds like someone to avoid.

Overall it looks like you are off to a good start. You might consider giving some public talks, for example to local colleges, patient advocacy organizations, professional societies, etc. if things get off to a slow start.

 

[calvnandhobbs68]

Yeah for your 30min followups I get about that much for a straight 99214 from my two biggest insurers. 99214+90833 way more and actually make even more than $120 for a 99213+90833. Granted that's before the cut from the overall practice in my case but if you took even one insurance panel (so relatively easy to do the billing yourself) + cash you'd probably fill way quicker for close to the same income.

 

[TexasPhysician]

Rate is too low. If you are ok with these rates or slightly higher, insurance would pay better than this.

Insurance rates have gone up lately. My cash prices are higher than yours and even I’m contemplating an insurance clinic.

I’d either spend a lot on marketing and jack up those prices or go insurance. You are going to spend tons of hours on lunches, promotions, developing strategies, etc that are all unpaid. Add those hours to your hours worked. You are doing all of that for $100-120 per follow-up. That’s an insurance rate pre-psychotherapy code. Don’t bust your tail for easy numbers.

Things like psychology today, print ads, and short-term SEO is worth almost nothing. SEO is a long-term game. In-person meetings is where to spend your efforts or just take insurance (you’ll earn more for the same time).

 

[brosa]

Question about insurance. I am a PGY-1 and from what I hear, it seems that working with insurance is horrible. Even if I have a panel of a good-paying insurance, working full panel 40h, wouldn't that mean I have to spend another 10h calling the insurance to get paid or check if they are paying me? I've read people complaining about that here. If that's the case and the gains are similar, it would be easier and cheaper to charge cash even if getting the same amount without the hustle, wouldn't it?

 

[TexasPhysician]

Question about insurance. I am a PGY-1 and from what I hear, it seems that working with insurance is horrible. Even if I have a panel of a good-paying insurance, working full panel 40h, wouldn't that mean I have to spend another 10h calling the insurance to get paid or check if they are paying me? I've read people complaining about that here. If that's the case and the gains are similar, it would be easier and cheaper to charge cash even if getting the same amount without the hustle, wouldn't it?

You hire staff for that or utilize a billing company. Develop a good system.

 

[romanticscience]

Question about insurance. I am a PGY-1 and from what I hear, it seems that working with insurance is horrible. Even if I have a panel of a good-paying insurance, working full panel 40h, wouldn't that mean I have to spend another 10h calling the insurance to get paid or check if they are paying me? I've read people complaining about that here. If that's the case and the gains are similar, it would be easier and cheaper to charge cash even if getting the same amount without the hustle, wouldn't it?

If you only take 1-3 insurances, it can be relatively painless. I take insurance. Here are workflow steps to reduce headache:

1. Know people’s coverage beforehand. Whether they are active under the plan, have a copay, or a deductible. This can be done my utilizing the insurers’ database (BCBS uses Navinet).
3. Utilize an EMR with integrated claim submission, ERA receipt, and credit card payments.
2. Enroll in the ability to electronically submit claims through your EMR and to receive ERA reports. Enroll in the insurer’s direct deposit system.
3. Yes, I do have to look into unpaid claims sometimes. However, more often then not, it’s my error and it takes re-submitting the claim with correct info or just filing a secondary claim.

If it helps, I have not called an insurance company in 2-years. Granted, I’m not contacted with any of the known bullies.

Just thought you may appreciate a perspective from an insurance practice!

 

[calvnandhobbs68]

Question about insurance. I am a PGY-1 and from what I hear, it seems that working with insurance is horrible. Even if I have a panel of a good-paying insurance, working full panel 40h, wouldn't that mean I have to spend another 10h calling the insurance to get paid or check if they are paying me? I've read people complaining about that here. If that's the case and the gains are similar, it would be easier and cheaper to charge cash even if getting the same amount without the hustle, wouldn't it?

Yeah so you've got a couple of good responses above as a couple good approaches to this. If you only take a couple insurance panels, you can pretty much do the billing yourself if you use an EMR that does integrated billing/claims tracking. If you want to take more insurance panels or don't want to get an EMR that does that, most people just end up using a 3rd party billing service that takes a relatively small % fee.

The main issue OP is going to run into is that at those rates, it's not clear what kind of market he/she is going to capture. The kind of people that typically end up paying cash OOP for medical services aren't the kind of people who want bargain cost services. Honestly, part of the problem with the rates being that low is that many people might perceive this as not being costly ENOUGH. Cash only healthcare is a kind of personalized, concierge service that people end up having the feeling of getting what you pay for. Kind of if they saw a BMW at Toyota prices...you're kinda wondering what's wrong with that BMW. Or getting a "discount" facelift. This is the slice of population you're trying to market to in a cash only practice.

On the other hand, most middle class and upper middle class people don't really want to pay cash when they have insurance (and with insurance panels that are increasingly limiting OON coverage benefits or having higher OON deductibles to the point where you might as well be paying cash). Even if they have high deductible plans, they'd rather pay towards their in network deductible than not at all. Also you're seeing a lot more independent psych NPs or 1 psychiatrist/4 NP practices that are in network with insurance plans...who people then end up going to see.

This leads to most cash practices (even high demand specialities like C+A) to build up pretty slowly over time as you try to capture that slice of the population that's willing to pay high cash rates. OP is extrapolating income for completely full panels of 16 patients per day. OP is highly unlikely to get anywhere near a full panel of cash paying patients even a year (or two or three depending on the market) into practice. This is why most people who have cash only private practices have a main job initially while they build up a more concierge type cash practice on the side. On the other hand, taking even a couple insurance panels in most markets almost guarantees you'll be close to full within that first year, especially if local therapy groups or PCPs know you have openings and are taking X insurance panel.

 

[PatBateman]

1- looking forward to updates about how it goes!

2- I agree with others that the rate is quite low. I also suspect you could do significantly better with insurance. I think it will be hard to make as much as you would in an employed position with similar effort taking those rates. I presume, though, that you know your market.

3- do you actually want referrals from "the cannabis doctor?" That sounds like someone to avoid.

Overall it looks like you are off to a good start. You might consider giving some public talks, for example to local colleges, patient advocacy organizations, professional societies, etc. if things get off to a slow start.

Thanks maybe I’ll look into a couple insurance panels and public talks.

The Cannabis doctor is an old friend and doesn’t seem shady.

Yeah so you've got a couple of good responses above as a couple good approaches to this. If you only take a couple insurance panels, you can pretty much do the billing yourself if you use an EMR that does integrated billing/claims tracking. If you want to take more insurance panels or don't want to get an EMR that does that, most people just end up using a 3rd party billing service that takes a relatively small % fee.

The main issue OP is going to run into is that at those rates, it's not clear what kind of market he/she is going to capture. The kind of people that typically end up paying cash OOP for medical services aren't the kind of people who want bargain cost services. Honestly, part of the problem with the rates being that low is that many people might perceive this as not being costly ENOUGH. Cash only healthcare is a kind of personalized, concierge service that people end up having the feeling of getting what you pay for. Kind of if they saw a BMW at Toyota prices...you're kinda wondering what's wrong with that BMW. Or getting a "discount" facelift. This is the slice of population you're trying to market to in a cash only practice.

On the other hand, most middle class and upper middle class people don't really want to pay cash when they have insurance (and with insurance panels that are increasingly limiting OON coverage benefits or having higher OON deductibles to the point where you might as well be paying cash). Even if they have high deductible plans, they'd rather pay towards their in network deductible than not at all. Also you're seeing a lot more independent psych NPs or 1 psychiatrist/4 NP practices that are in network with insurance plans...who people then end up going to see.

This leads to most cash practices (even high demand specialities like C+A) to build up pretty slowly over time as you try to capture that slice of the population that's willing to pay high cash rates. OP is extrapolating income for completely full panels of 16 patients per day. OP is highly unlikely to get anywhere near a full panel of cash paying patients even a year (or two or three depending on the market) into practice. This is why most people who have cash only private practices have a main job initially while they build up a more concierge type cash practice on the side. On the other hand, taking even a couple insurance panels in most markets almost guarantees you'll be close to full within that first year, especially if local therapy groups or PCPs know you have openings and are taking X insurance panel.

The county I am I’m in doesn’t have a single Psychiatry practice taking new patients and the population is 500k++ -and growing. I’ve been told I will fill up as fast as I want. I’ll see if that’s true pretty soon.

 

[Candidate2017]

You have np rates.

If it quacks like a duck... OP, are you not an NP?

I can't imagine many psychiatrists would think referrals from a marijuana doctor is a good idea. Or would charge such hilariously low rates, especially any psychiatrist who is seeking referrals from pediatricians (i.e., a child psychiatrist).

 

[clozareal]

If it quacks like a duck... OP, are you not an NP?

I can't imagine many psychiatrists would think referrals from a marijuana doctor is a good idea. Or would charge such hilariously low rates, especially any psychiatrist who is seeking referrals from pediatricians (i.e., a child psychiatrist).

Ah you're probably right. This explains why OP is doing so much to try to get patients and asked about NPs who have independent practices in another post.

 

[jbomba]

I can raise prices later

But why start at np rates to begin with?

 

[PatBateman]

A so

Ah you're probably right. This explains why OP is doing so much to try to get patients and asked about NPs who have independent practices in another post.

That was more inquiring regarding liability in taking collaborative agreements for $1k a month to see if it’s worth it

 

[PatBateman]

But why start at np rates to begin with?

$250/120 seems pretty average for the area based on cold calling some offices. This is a rural county and not a big city. I am not sure people could afford much more.

 

[jbomba]

$250/120 seems pretty average for the area based on cold calling some offices. This is a rural county and not a big city. I am not sure people could afford much more.

Yes but insurance would pay more

 

[heyjack70]

I think you’d be better off starting with prices too high then lowering them off needed. Once you fill with patients it will be harder to raise prices. As other posters mention, if you can figure out the 1-2 insurers who pay best and are the least hassle you might as well contract with them because they’ll probably pay you better than your cash rates.

 

[splik]

Yes but insurance would pay more

not necessarily. we don't know where he is located. solo practitioners frequently get offered garbage rates and definitely not the rates that group practices or the big box shops get. In some areas insurances pay less then medicare. Someone told me they get $38 for 99214 and $14 for 90833 (i.e. $52 for a 25min follow up visit) from UBH. Another reported $65 for 99214 and $24 for 90833 (i.e. $89) with BCBS. Also $250 for an intake would be very good from insurance in many parts of the country, and most solo practitioners in many areas should expect less than that.

It's very variable depending on the state, even the zip code, and the different insurance companies. Solo practitioners have little in the way of bargaining, and many insurance companies aren't really interested in expanding their networks. That said there are some states with some plans that reimburse quite well (for example certain plans in WA and OR).

I recently did an experiment and applied to the 3 best paying insurances in my area as a solo practitioner. One company claimed their network was 'at capacity' quite apart from the fact they have no one with my subspecialty in the area of over 1 million people, and the high demand for psychiatric care overall. another never got back to me. The third, offered below medicare rates though they offer competitive rates to group practices and big box shops.

If insurance paid as well as some people think, more people would accept it. Also if OP is an NP then they will get even lower rates from insurance. Sadly, it does not work for most solo practitioners to accept insurance.

 

[TexasPhysician]

On the flip side, I have a solo friend that has negotiated in 1 state (not Texas) for about $200 for 99214 + 90833 to start. That about 80% of her codes now. Assuming only 2 follow-ups per hour, that’s a rate of $400/hr for a big insurance company.

Rates can vary significantly, even just miles away. At $120/follow-up, it’s worth trying.

 

[jbomba]

not necessarily. we don't know where he is located. solo practitioners frequently get offered garbage rates and definitely not the rates that group practices or the big box shops get. In some areas insurances pay less then medicare. Someone told me they get $38 for 99214 and $14 for 90833 (i.e. $52 for a 25min follow up visit) from UBH. Another reported $65 for 99214 and $24 for 90833 (i.e. $89) with BCBS. Also $250 for an intake would be very good from insurance in many parts of the country, and most solo practitioners in many areas should expect less than that.

It's very variable depending on the state, even the zip code, and the different insurance companies. Solo practitioners have little in the way of bargaining, and many insurance companies aren't really interested in expanding their networks. That said there are some states with some plans that reimburse quite well (for example certain plans in WA and OR).

I recently did an experiment and applied to the 3 best paying insurances in my area as a solo practitioner. One company claimed their network was 'at capacity' quite apart from the fact they have no one with my subspecialty in the area of over 1 million people, and the high demand for psychiatric care overall. another never got back to me. The third, offered below medicare rates though they offer competitive rates to group practices and big box shops.

If insurance paid as well as some people think, more people would accept it. Also if OP is an NP then they will get even lower rates from insurance. Sadly, it does not work for most solo practitioners to accept insurance.

Well that's shocking to hear. And also kind of worries me. I assumed setting up shop in one of the big three California cities would set me up nicely if I got in with one of the better paying payors. I also never thought they might tell me sorry we don't need you.

 

[Sushirolls]

They can and do say that.

I had one in my area that said that but was also a weird insurance / health system. I got they vibe they were trying to be more like an HMO without officially being one and trying force their members into their health system only.

I'm in one of those weird rare pockets. Good rates, but still way less than our general medical folks! My cash is $300/consult, $150 follow up. I have only a small fraction of cash patients, and relative to my blended payer mix formula, I am actually 'losing' money on my cash patients relative to insurance. For the time being insurance is the better way to go in my area - at least for me.

Last year I did some digging into a nice [insert my dream description here] area of the country, and when meeting with a PCP and specialist, learned their rates were much, much worse than my current area. So if I were to move there I'd keep my current practice/office and do telemedicine. I could fill in that area, and be the only Psychiatrist but it would also mean working more and doing traditional full psychiatry, LAI, pseudo CMHC populations, etc. Currently I am striving to work smarter not harder. I've done my time in the wRVU mines and giving my 110% to the job, not doing that again.

 

[deleted1100659]

I agree with one big point here in that, the people who are willing to shell out a few hundred dollars to see you arent going to care about paying 20-30 dollars extra for a follow up. Why do people buy designer brands? Because of the name, and the price gives the idea that they're paying for some high end item that others dont have access to.

I think youll attract a lot of people who want to "get what they pay for" and if thats the case then they should pay a a rather large amount, which if that bothered them, they wouldnt be pursing a cash only practice.

I think having a strong digital presence is key as well. A website that looks professionally done (which is easy to do by yourself these days), social media presence, etc. I think a good online presence would set the tone, because affluent people tend to google their doctor before they go to him/her

 

[mojetter]

If it quacks like a duck... OP, are you not an NP?

I can't imagine many psychiatrists would think referrals from a marijuana doctor is a good idea. Or would charge such hilariously low rates, especially any psychiatrist who is seeking referrals from pediatricians (i.e., a child psychiatrist).

i think you nailed it lol ..yeah rates way too low

 

[splik]

Well that's shocking to hear. And also kind of worries me. I assumed setting up shop in one of the big three California cities would set me up nicely if I got in with one of the better paying payors. I also never thought they might tell me sorry we don't need you.

The latest development in healthcare insurance is called "narrow networks". Basically insurance companies have found that the fewer providers they have in their networks, the cheaper it is. Plans offering narrow networks with a limited number of providers have been shown to be cheaper than HMO plans. In addition, newer plans on the market place (and by a small number of employers) no longer have OON benefits, so patients are forced to stay in the plan and can't get reimbursement for going out of network. For example, Anthem BC (one of the largest insurers in CA) quietly stopped offering OON benefits for their ACA exchange plan a few years ago, and many people don't realize it.

Now, you can complain to the department of managed care or state insurance commissioner if you can prove that the network is not really "at capacity". But you have to ask yourself whether you really want to be part of a network that doesn't want you, and will make your life difficult. Interestingly I was reading a lawsuit about a physician who was denied joining Anthem BC and successfully sued. The insurance company claimed there were 137 docs located in the vicinity of the doctor's office, but in court were unable to name any. As you may know, insurance companies deliberately keep "ghost networks" with providers who are dead, no longer in the area, no longer part of the plan etc. I have been in my office for nearly 5 years, and still get calls from pts wanting to see the previous doc after searching the insurance company list of in-network docs, though he has not been in network in 5 yrs.

 

[PatBateman]

Just did somewhat of a soft opening and saw 3 people today. Have 10 more scheduled for the rest of the week. Haven’t really gone door to door yet to market but I will. Still doing remote visits for a big box shop but I hate working for others. For those bashing my rates feel free to some to my rural Florida county and see how successful you are. If I didn’t inherit 40 acres here I’d probably still be in a different environment but peace and quiet is pretty nice.

Luminello is turning out to be an awesome EMR. Much easier to use than other platforms I’ve tried.

 

[clozareal]

I recently did an experiment and applied to the 3 best paying insurances in my area as a solo practitioner. One company claimed their network was 'at capacity' quite apart from the fact they have no one with my subspecialty in the area of over 1 million people, and the high demand for psychiatric care overall. another never got back to me. The third, offered below medicare rates though they offer competitive rates to group practices and big box shops.

I'm applying to insurances one offered me 80% of medicare rate and one matched medicare prices for 99214+90833 for my area. They both took 2-3 months to get back to me. I'm still waiting for another insurance who told me it would take 120 business days for them to respond.

 

[splik]

I'm applying to insurances one offered me 80% of medicare rate and one matched medicare prices for 99214+90833 for my area. They both took 2-3 months to get back to me. I'm still waiting for another insurance who told me it would take 120 business days for them to respond.

That doesn’t sound good - can you share which companies these were?

 

[jbomba]

The latest development in healthcare insurance is called "narrow networks". Basically insurance companies have found that the fewer providers they have in their networks, the cheaper it is. Plans offering narrow networks with a limited number of providers have been shown to be cheaper than HMO plans. In addition, newer plans on the market place (and by a small number of employers) no longer have OON benefits, so patients are forced to stay in the plan and can't get reimbursement for going out of network. For example, Anthem BC (one of the largest insurers in CA) quietly stopped offering OON benefits for their ACA exchange plan a few years ago, and many people don't realize it.

Now, you can complain to the department of managed care or state insurance commissioner if you can prove that the network is not really "at capacity". But you have to ask yourself whether you really want to be part of a network that doesn't want you, and will make your life difficult. Interestingly I was reading a lawsuit about a physician who was denied joining Anthem BC and successfully sued. The insurance company claimed there were 137 docs located in the vicinity of the doctor's office, but in court were unable to name any. As you may know, insurance companies deliberately keep "ghost networks" with providers who are dead, no longer in the area, no longer part of the plan etc. I have been in my office for nearly 5 years, and still get calls from pts wanting to see the previous doc after searching the insurance company list of in-network docs, though he has not been in network in 5 yrs.

If one is denied in one location could you reapply from another location? Or do you have to wait a period of time before reapplying?

 

[clozareal]

That doesn’t sound good - can you share which companies these were?

The one that matched medicare rates is Cigna and the other is a university health insurance plan in my area. Still no word from Aetna since submitting my application in November.

 

[splik]

The one that matched medicare rates is Cigna and the other is a university health insurance plan in my area. Still no word from Aetna since submitting my application in November.

Interesting. I have yet to hear from Cigna/Evernorth it was like it went into the ether though they claim to respond in 20 days and do accelerated credentialing. Aetna was the one that claimed to be "at capacity" when I applied recently.

 

[clozareal]

Interesting. I have yet to hear from Cigna/Evernorth it was like it went into the ether though they claim to respond in 20 days and do accelerated credentialing. Aetna was the one that claimed to be "at capacity" when I applied recently.

That's interesting. I followed up with one phone call a month and maybe that's why they responded more quickly. I tried to get credentialed with Anthem but then I had to get something notarized which I didn't with the other insurance companies so I haven't done so.

They also get confused because I'm credentialed/contracted with another org that I'm working for and tell me I already have a contract. I respond to them saying I want an individual contract for my private practice and the timer seems to reset. Evernorth/Cigna told me 90 days from when my individual contract request for my private practice was sent which happened 2 months after I submitted my initial application.

 

[Psychresy]

Are there companies you can hire that will expedite/handle the credentialing process for you? Like there are with obtaining state licenses.

 

[Sushirolls]

Haha. Oh, the pain of contracts. The lack of quality organization by insurance companies to know that docs work at multiple places or businesses with separate contracts. Such a pain getting them to delete those old entries.

Companies do exist to apply for you, I used them. And no they don't save you time, and no they don't make things easier. They still will have an abundant amount of paper work that only you can do, and at times is essentially the whole application. Secondly, they will also screw up your details that you the later have to fix.... Save your money, save your motrin, don't use them.

 

[PikminOC]

If it quacks like a duck... OP, are you not an NP?

I can't imagine many psychiatrists would think referrals from a marijuana doctor is a good idea. Or would charge such hilariously low rates, especially any psychiatrist who is seeking referrals from pediatricians (i.e., a child psychiatrist).

And op thinks cannabis doctor is legit...

 

[clozareal]

Haha. Oh, the pain of contracts. The lack of quality organization by insurance companies to know that docs work at multiple places or businesses with separate contracts. Such a pain getting them to delete those old entries.

Companies do exist to apply for you, I used them. And no they don't save you time, and no they don't make things easier. They still will have an abundant amount of paper work that only you can do, and at times is essentially the whole application. Secondly, they will also screw up your details that you the later have to fix.... Save your money, save your motrin, don't use them.

For me, I made an excel spreadsheet, the dates that I submitted and contacted, and what the response was and to record the reference numbers if they gave it. I made sure to have all the websites and logins. This is basically what these companies do and you can figure it out for yourself. I think the value added would be in the negotiation and comparison between what other providers in that area are getting.

 

[birchswing]

I think you should throw a parade.

You can throw the tins of cookies at the onlookers from the main float.

 

[Candidate2017]

And op thinks cannabis doctor is legit...

It is legit.

Because where are all those rural cannabis patients going to get treatment for their attention issues, anxiety, weight, and sleep problems? Adderall IR TID for focus, Xanax TID for anxiety, Xanax QHS for sleep and Xanax PRN for middle insomnia. Amirite?

 

[ElanaMD]

It looks like the OP of this post was banned for some reason but still wanted to share my thoughts with others on marketing a private practice.

There are 3 good ways to get patients when you are starting a private practice:
1) Psychology Today
2) Networking & referrals
3) Google Ads

The mistake everyone makes is not that they're doing the wrong marketing efforts, but that they assume their marketing efforts aren't working too soon and then give up way before they should.

These are not as good methods for marketing your private practice (at first, at least):
- Organic search (organic search is a long game, and unless you're targeting location-specific keywords like "Michigan psychiatrist" you will get search traffic from people outside of the state where you're licensed
- Social media (takes too long to build, and also all your traffic will be from outside your licensed state(s)

Do not pay anyone to do marketing for you until you know what marketing efforts are working, or else you are wasting your money. You pay people when you know what's working so that you can leverage your time better (you outsource what's working to someone else). In the beginning of your practice building the limiting factor for you will be money, not time. Later it will be time, not money. When time is your limiting factor is when you want to start paying others to do things.

Differentiation - Before you even THINK about marketing though you need to first understand what differentiates you from other psychiatrists that would make a patient choose you as opposed to someone else.

If you don't differentiate yourself you will essentially be a commodity (although a highly trained one), which means that patients will see you as interchangeable with any other psychiatrist and will therefore shop based on who is cheapest/has the worst boundaries/will just prescribe them Xanax or whatever. If you look at my website ZenPsychiatry.com - you may or may not like me but you will KNOW what I do and what I'm about. The more you communicate what makes you unique on your website or when communicating with patients, the more the "right" kind of patients for you will self-select into your practice. I could give a whole diatribe on how to differentiate yourself but I'll save that for another time so this post isn't too long.

Psychology Today - Almost all Psychology Today profiles I see are mediocre at best, which means all you have to do is have an above average profile and you will get all of the PT traffic in your area. Think about it from a patient's perspective and what they would look for in a psychiatrists as opposed to trying to impress other psychiatrists in your profile. Don't use jargon, speak the language the patient speaks, have a clear and professional photo, and don't be vague. Say what's unique about you that would make a patient want to see you as opposed to someone else. Have a video, even if your video doesn't really say anything other than "Hi, I'm Dr. so and so, welcome to my practice." Patients want to see your pic, hear your voice, read a little about who you are, and then contact you. Patients don't want to waste their time contacting 100 people, they want to contact one person who seems like the best fit.

Networking & Referrals - You already know the obvious stuff like reach out to therapists and other psychiatrists. You can think a lot bigger than this -- who is your niche (target demographic of your practice), and where do they hang out? Do they go to certain online forums, see other non-MD providers, purchase other wellness services? You can network with anyone whose niche overlaps with yours who isn't a direct competitor. Networking is a numbers game - don't just reach out to 5 people and give up because nothing has happened.

Google Ads - Before you get into paid ads you really want to understand the concept of return on investment (ROI), because the mistake people make is either putting $100 on ads and freaking out they don't have a patient yet and then giving up, or wasting thousands on bad ads without monitoring or being willing to learn how ads work. Running successful ads has a learning curve, but if you learn how to do it you can have total control over where you advertise, who sees you online, and when you turn ads on/off to get patients.

Your website/social media/blog - Like I said earlier, organic search and social media aren't useful as marketing strategies generally, however they are useful as SALES strategies. By this I mean, if a patient hears about you from somewhere else (Psychology Today, referral, ad, whatever) they first thing they will do is visit your website and/or Google you, and if you have good content that communicates your uniqueness/values/practice philosophy it will make patients more likely to reach out to you as opposed to any of the dozens of other psychiatrists they could reach out to or other referral sources they were given.

 

[Monocles]

OP double your rates

 

[Ludwig2000]

Incidentally, does anybody happen to know why OP was banned?

 

[ElanaMD]

Incidentally, does anybody happen to know why OP was banned?

I was wondering this myself...

 

[liquidshadow22]

If you only take 1-3 insurances, it can be relatively painless. I take insurance. Here are workflow steps to reduce headache:

1. Know people’s coverage beforehand. Whether they are active under the plan, have a copay, or a deductible. This can be done my utilizing the insurers’ database (BCBS uses Navinet).
3. Utilize an EMR with integrated claim submission, ERA receipt, and credit card payments.
2. Enroll in the ability to electronically submit claims through your EMR and to receive ERA reports. Enroll in the insurer’s direct deposit system.
3. Yes, I do have to look into unpaid claims sometimes. However, more often then not, it’s my error and it takes re-submitting the claim with correct info or just filing a secondary claim.

If it helps, I have not called an insurance company in 2-years. Granted, I’m not contacted with any of the known bullies.

Just thought you may appreciate a perspective from an insurance practice!

You manage all the claim submission, copay, deductible, and reconciliation of the EOB by yourself? Do you think using a biller is a waste for this?

 

[romanticscience]

You manage all the claim submission, copay, deductible, and reconciliation of the EOB by yourself? Do you think using a biller is a waste for this?

Once you get your EMR set up with online claim submission and ERA receipt, it mostly becomes an automated process.

The patient has their visit, co-pay is billed (they get emailed about the balance). I write the note. Submit the claim. The ERA is received and adjusts the patient's balance. If there is a remaining balance, the patient is emailed with an outstanding balance.

Doing it myself allows me to catch things very quickly. Also, before I take patients on, I've already looked up their insurance coverage and know their co-pay.

Billers cost ~8% of the collection, which becomes a significant figure at some point.

I know cash practices get most of the press here but a lean, efficient, solo, premium insurance-based practice can work very well too!

 

[gyngyn]

Incidentally, does anybody happen to know why OP was banned?

I was wondering this myself...

He was banned for promulgating political disinformation regarding the Russian invasion of Ukraine.