Some cash-based practices, like my physical therapy clinic in Austin, aren’t billing out-of-network (OON) on behalf of their cash-paying patients who have insurance coverage. However, many practices do offer this service. Especially those that have transitioned from in-network to out-of-network… and that’s where things can get really tricky.
This interview is from an in-person interview Aaron LeBauer and I did with Jerry Durham at the 2016 PPS annual conference in Las Vegas. Jerry and his partner, Sturdy McKee, have a 3-clinic practice in San Francisco that has transitioned completely OON with all private payors.
He has spent years perfecting the art of billing out-of-network and having conversations with prospective patients that leads to the patient to going OON rather than sticking with their in-network PT options. This interview is absolutely packed with high level strategy as well as nitty gritty details and logistics of how billing insurances completely changes when you’re no longer in-network with them.
More specifically, we discuss these cash-based practice topics:
- How to Survive When Insurance Companies Try to Strong Arm Your Practice
- How to Set a Fair Fee Schedule and Balance Bill Your Patient for “Out-Of-Network” Benefits
- Learn The Difference Between In-Network, Out-of-Network & Cash-Based PT
- How Being “Out-of-Network” is Better for Everyone
- The Customer Lifecycle
- The Benefits Call Back
- The Best Way to Respond When Asked “Do You Take My Insurance?”
- What He Is Doing with the Patients Who’s Insurance Don’t Pay…
- Essential Advice to Anyone who Wants to Get Rid of Money-Losing Contracts
- Jerry’s Top Strategies to Develop Customers for Life
Interested in the cash-based private practice model?
Let us know if you enjoyed the show:
[Click to Tweet] Thank you @Jerry_DurhamPT for being an awesome guest on the Cash-Based Practice Podcast w/ @DrJarodCarter & @LeBauerPT