Show Me the Money!

By Reuven Lirov

What can Ben do to correct his cash flow problems?“You ready for lunch?”

Ben looked up from the pile of bills on his office desk to see his wife, Carmen, standing in the doorway. “Only if you’re buying,” he said.

“That bad, huh?” Carmen replied, closing the door behind her. “I’m a little surprised. On my way in, Pam told me that you’re booked solid.”

“Patients aren’t the problem,” Ben said. “Revenue is. Seems like no matter how many adjustments I do, I’m never sure if I’m going to meet expenses that month.”

“I thought you had someone who took care of billing,” Carmen said, perching on the edge of the desk. “Isn’t that their job?”

Ben laughed, weakly. “That’s how I looked at it. And if it were just a matter of a few patients with payment issues, I’m sure my staff could handle it.”

“Then what’s the problem?”

“It’s a combination of collecting from insurance companies and then figuring out what the patient owes. Seems like we have to chase after the insurance companies for every dollar we’re due.”

“I don’t get it,” Carmen said. “Your staff files the claims. Doesn’t that mean you automatically get paid?”

“I thought so,” Ben said. “But I guess that’s why I’m a chiropractor and not an accountant. Come on, I need to get out of here.”

Ben wasn’t really in the mood for lunch, but he needed to clear his head. He and Carmen walked to their usual lunch spot and found themselves a booth. As they slid in, Ben’s phone chimed.

“What is it?” Carmen asked.

“It’s a tweet from Richard,” Ben said, reading the display. “He says, ‘Life is a series of adjustments.’ Hashtag ‘chiropractics.’”

“You spoken to him recently? His practice seems to be pretty successful. Maybe he can give you some advice.”

“That’s not a bad idea,” Ben said, sliding back out of the booth. “I’m going to give him a call. If the waitress comes, order me a turkey reuben.”

It took a couple of days before Ben and Richard could carve out some time. Finally, they got together on Saturday, when Richard was cleaning out his garage.

“It drives me crazy,” Ben said. “Cash flow is so inconsistent. Feast or famine, and I never know which. Sometimes the drought lasts for weeks, no matter how many patients I see.”

“You’ve got to get down to brass tacks,” Richard said, hanging his hedge trimmer on the pegboard. “Figure out what your best sellers are.”

“My what?”

“Your moneymakers. Start by checking which CPT codes, POS items sold, referring physicians and employee productivity generates the highest revenue in the shortest time possible.”

“I’m guessing my billing department could help me with that,” Ben said as he coiled up an extension cord.

“There are no guarantees,” Richard said, “but that’s what works for me. For instance, you want to avoid using the worst CPT code for the best payer. And trust me; once you’ve gotten your system straightened out, you’ll be better equipped to make vital practice decisions.”