243 Revenue Generators

Welcome to the KC CHIROpulse Podcast.  

This week’s topic:  Has your staff been developed into Revenue Generators?

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights.  This week, the show is hosted by Kats Consultants’ coaches Dr Michael Perusich and Dr Troy Fox, seasoned experts in Chiropractic business management.  This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In this episode, we discuss:

• How your staff may be depressing your income 
• Why an underdeveloped team may be putting you in harm’s way
• How a lack of staff training may be running off your patients
• How a highly trained team can quickly drive revenue and profits
• …and so much more…

In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.

Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and personalized practical advice to help you navigate the intricate world of Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.

Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.

DISCLAIMER:  The information presented in this broadcast is for educational purposes only and is not intended to offer legal, investment, accounting, or medical advice, and represents the opinions of the speakers.  Seek the consultation of a professional for advice in those areas. And remember…your results using this information may be different than described.

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KC CHIROpulse Podcast.  Helping Chiropractors keep their pulse on success.  Thanks for listening.

Transcript

243 Revenue Generators

Introduction and Hosts

[00:00:00] 

Dr. Michael Perusich: Doctors, do you have revenue generators or revenue killers? Hi everybody. Welcome to the KC ChiroPulse Podcast, brought to you by Kats Consultants and Chiro Health USA. We are your hosts. This is Dr. Troy Fox. And I'm Dr. Michael Perusich. We are here with you for the next 25 minutes to make your life better. Or however long it takes.

Dr. Troy Fox : What an what, an intro to that. 

Dr. Michael Perusich: What An intro. Yeah. 

Dr. Troy Fox : Yeah. 

Dr. Michael Perusich: We're revved up today 

The Importance of Staff Training

Dr. Troy Fox : and you saying that, I'm like, you know what I do a lot of staff training, a lot of staff development, and even with, you're still gonna have a measure of both because people are human, right? Yeah. But without, oh my gosh. If you let, , I, if you let the prisons or the prisoners run the prison.

Man, they're gonna, they're gonna do it the way they think it should be done. And I see some potential downfalls to that. And I see some big O up, uh, you know, some big o windfalls, uh, [00:01:00] from a standpoint of doing staff development correctly. 

Dr. Michael Perusich: Yeah. So we're, we're talking today about creating. Staff that are helping you generate revenue rather than killing your revenue.

We, we see this all the time and we were talking about some of this off camera before we, before we jumped on the podcast, and you know, we, we see doctors who are allowing their staff to be completely untrained, and yet they're the ones that are managing. Patient communication. They're the ones that are managing patient scheduling.

They're the ones that are, uh, doing your billing for you. They're the ones that are collecting, trying to collect money at the front counter. They're the ones inputting patient information into the system to see if insurance will actually pay, and if they're not well trained. There are so many trip wires in practice that can literally, literally kill your revenue and then all of a sudden you, you wake up one day and you got no revenue coming in [00:02:00] the door and you're like, what happened?

Dr. Troy Fox : Yeah. It can be ugly and it can get ugly quick and it snowballs. And the problem is, is when you start dealing with, especially like Medicare, let's say that your staff member just innocently. Doesn't get stuff put in the right place. You know, I remember way back in the day that you, you youngsters that are listening to this today will get a kick out of this.

Back when we used to use a tractor feed printer. You remember those things? 

Dr. Michael Perusich: Yep. 

Dr. Troy Fox : And the hick forms were like these. They had little holes in the side of them and the tractor feed had roll 'em and had you, you had to line it up perfectly and the software sometimes would be a little bit off and you're trying to get everything put in the right boxes and you know, you gotta have the right modifiers.

We all know that stuff. But if all that stuff is not done correctly, you can snowball into nonpayment. And by the time you figure it out, it's when, because if you're not right on top of your finances and you're not sitting there [00:03:00] on a weekly basis doing analysis on your finances, which I know some of you aren't, because we've unfortunately seen some of you just look at your bank account and if the bank account looks good, you're cruising and you just keep going.

Dr. Michael Perusich: Yeah. You think you have a great practice. 

Dr. Troy Fox : All of a sudden when you see that bank account drop and you decide to start getting to the bottom of this. You're gonna be at a race to zero in your account. By the time you figure out exactly what's going on, and now you're weeks before, now you're going to the bank trying to get a bridge loan to cover until you get to that point.

We've seen it happen. It's so unfortunate, but. Once it starts, it's like falling off of a cliff. You can't unfall off of it and you gotta stop the bleeding once you hit the bottom and then figure out how to get back up top and it, it, it's, it Wouldn't it be much easier to not fall off the cliff? 

Dr. Michael Perusich: Exactly.

Exactly. It's, yeah, don't, don't turn yourself into a snowball. 

Revenue Generators vs. Revenue Killers

Dr. Michael Perusich: So we're talking about staff development here. We're talking about creating revenue generators [00:04:00] with your staff as opposed to revenue killers. So we gotta take a quick break. We'll be right back.

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Effective Staff Development Strategies

Dr. Michael Perusich: We are back. You're tuned into the KC ChiroPulse podcast and we are talking about revenue generators versus, versus revenue killers.

And tree brought up a great point before the break that wouldn't it be great to never fall off the cliff and the way, the way you do that and. Maybe, I can't say never 'cause it can happen still, but Right. The way you do that is you spend the time to train and develop your staff. You don't just throw 'em in and give 'em a, a manual that says, here's how to do these tasks.

Because left to their own accord, human nature, they may not do everything right. And as we know, there are so many little things. The entire practice is a, uh, what'd you call it? A tractor feed. Printer, if you will. Yeah. Everything has to line up just right, right. Or we're way off base. You know, it's, and it's the little things.

It's not understanding. That, uh, you, you [00:06:00] have to put in a patient's insurance information. Exactly. Perfect. It can't be wrong 'cause what happens if it wrongs, it gets kicked back. A, a staff person not understanding how to re an read an EOB and what to do with that information, it can be damaging to your practice.

Staff who doesn't know how to communicate the, the financial component of care and talk to patients about, about that and be able to communicate value to patients. So they wanna stay in your practice and pay you, um, rather than just drop out how to not create surprises for patients. There's so many things, um, that staff can do to, to really hurt us.

Dr. Troy Fox : And at bare minimum, just think about this, an untrained staff member that isn't getting things in the computer, right. Could, because of the increased workload, let's just say there's no other negative thing that happens. The increased workload to get it right could be 30 to 40%. You may have to 'cause at this [00:07:00] point, sure.

Now you're playing detective trying to figure out if you, if you have looked at insurance and said. Oh my gosh. I don't know why they didn't pay this claim. And now you gotta go back and look. It's not like a a, a red screen just pops up and says, here's what you didn't do and here's what you need to do to fix it.

Fix this right here, right now, and resubmit. Boom. If I could do that in 10 seconds, it'd be really easy. But the problem is now I gotta go back and figure out. What didn't I do? Oh, I didn't put a modifier on that. It's missing the, it's missing the GA modifier or the at well, at modifier, if I want to get paid.

So it's missing the AT modifier, but I may have to go back and find that. That's a simple one. That's probably a 32nd fix now. But now you gotta reprint it, right? You've gotta re process it. It's still cost you the whole thing, and it costs you money. That's the bare minimum that it costs you. But you talked about things like EOBs being incorrect.

You wanna frustrate a patient. Yes. Tell them they owe a bunch of money that they do they shouldn't have to owe, or you [00:08:00] made promises to them. 'cause sometimes we see people that will, rather than saying, this is an explanation of benefits, but there is no guarantee when we submit your insurance that's gonna get paid.

It's not a guarantee of benefits when we do it. Right. 

Dr. Michael Perusich: Right. 

Dr. Troy Fox : And as a result, if we get complacent and start telling patients, oh, your insurance will take care of that. Notice, I just said, your insurance will take care of that as a patient. You know what that says to me? I don't know anything. 

Dr. Michael Perusich: I don't know anything.

Great. 

Dr. Troy Fox : And so when I get a $250 bill, or even $110 bill, it doesn't matter. What matters is is you told me it would be paid for. So what happens at that point? Well, if it's a Medicare patient, you can't just eat it and go, you know what? I'm a complete screw up. I shouldn't have said that. I'm just gonna write that off.

Well, I can't do that. 

Dr. Michael Perusich: Yeah, you gotta be careful with that. That's 

Dr. Troy Fox : enticement. Wow. Yeah. That's enticement. So now I'm stuck between a rock and a hard place. I can say I'm an idiot, but you owe this amount. Medicare didn't pay it. And I'm sorry that I didn't say that to you. How does that make you look? [00:09:00] So with staff members, we have to be very careful.

Verbiage is important. Intent when we talk to patients is important. We don't wanna promise things we can't pro that, that we can't fulfill, right? So we gotta be careful when it comes to this as well. But I love that concept when we talk about the EOBs, because that is a, that is one that if you wanna, if you wanna fire somebody up a real quick, that's a really easy way to do it.

It 

Dr. Michael Perusich: absolutely is. Those EOBs are so important to know. To understand number one, how to read them. Yeah. And know what to do with the information. And, and so that's one area of the practice. Your, your billing insurance. Front desk. 'cause I say that that way 'cause it's all coordinated. I think a lot of times we wanna say billing's, just the separate unit, front desk.

It's not. Yeah, it's not, you know, billing has to bill correctly so the EOB comes back correctly. So the front desk knows what the patient actually owes or how their account needs to be handled. So it's all interconnected. Right? But that, that's one way they can be, your staff can be revenue generators.

Another way is having them help you with. [00:10:00] Services in your practice therapies and those kind of things. Keeping the doctor at the high level stuff, the exams, the diagnosis, the adjusting, and having staff do the, uh, especially the non-covered type services. So what, what would that be? Maybe laser therapy, maybe shockwave, uh, muscle stem, sometimes, those kind of things.

And having staff help, if that's okay. In your practice law, in your state? In most states it is having them help. It increases your return on investment because they're much lower paid and when they get efficient at it and get really good at it and good communicators with the patients, the patients want that service more and more and more.

Now, that staff person is a revenue generator for you. 

Dr. Troy Fox : A pro tip on that is this you. You know what people want? They want to be recognized that work for you. Right? Here's a great way to recognize 'em. In my shockwave room on the wall, there's the wall of fame of my staff members that have been through advanced shockwave training, the therapy training.

They got to go [00:11:00] on a trip to Atlanta, Georgia. They got a certificate when they completed it, and they got tested to do this, and they're very proud of their certifications in Shockwave. So guess what? They became a revenue generator because they're now a subject matter expert in shockwave as well when they go in there.

And so for me, that was one I didn't, I could have trained them. I could have sat and trained him, but I thought, you know what? Here's a real way to create what I'm looking for in my practice. I want experts. I want people that are confident in what they do and, and aren't unsure or unclear about what they should do with the patient.

And I want them to feel confident about telling a patient, you know, this is what needs to be done with Shockwave. I can confirm with the doctor, but this is what, uh, this is what, uh, this is what our training recommends us at this point. And man, I'm telling you what. That's cool that way. Now, if you don't wanna send people to Atlanta, Georgia, or wherever that might be, you don't wanna pay for a plane ticket a few nights, a hotel and, and, [00:12:00] and a somewhat expensive training method for, for, you know, some of your methods.

What you do is one of two things. This is really, this is really easy when you do this. Docs, you don't have to do everything when it comes to training. Sometimes you guys shirk it because you're like, I don't have time for this. I need to see patients. I need to do this. I need to, I get it. Dope. Totally. I am so protective of my free time.

It's crazy. I treat it like it's solid gold, but here's what I do. If I've got one staff member that is well-trained, number one, we're gonna write an SOP. You guys know what an SOP is? Standard operating 

Dr. Michael Perusich: procedure. 

Dr. Troy Fox : Standard operating procedure. We are gonna write a manual that has standard operating procedure that says, hit the power button, push this button, push this button.

We're gonna go through step by step. Bridget who writes all my SOPs, or most of them, is really good at that detail because she wants to know every detail before she does it. It's a big deal to her. So she's a perfect [00:13:00] person to write an SOP. So Bridget writes the SOP. Guess who also wants, she's trained on how to do it.

Does a lot of the training. Bridget. Yeah. So if you have somebody that's a really good trainer that can write SOPs and deliver that SOP to the other staff members, you have an in-house trainer, which is fantastic. Now, if you're not married to your in-house trainer, you gotta be careful about that because if they leave, you just lost your in-house trainer.

But if you are married to the in-house trainer like I am, sometimes it becomes much easier, and I have a huge advantage by doing that. But you know what that means? I don't train everything, but I will say. When it came down to working on a new HIPAA manual and getting all, all the little tiny details in place, did I shirk that responsibility?

No. And here's why. And, and this will bring another point that you can talk about because I was afraid of the liability if I didn't get involved in it. 

Dr. Michael Perusich: Mm-hmm. Sure. 

Dr. Troy Fox : Is that, is that, is that bring up another point we need to talk [00:14:00] about? Maybe. 

Dr. Michael Perusich: Well, it does, you know, the, when your, when your staff is a revenue killer, it, it's not just money, trans money transacted between you and the patient all the time.

Dr. Troy Fox : Mm-hmm. 

Dr. Michael Perusich: It could be putting yourself at risk for audits and those kind of things. Um. You know, and, and HIPAA is a great one, you know, yes, doctors, you should be involved in it. But at the same time, like Troy's talking about, you can delegate some of that so you don't have to do all of it. And that, that, that's where the importance thing comes in.

So when you, when you tell me you don't have time to do some of this stuff, Hmm, I'm gonna call you out on that because you do have time. 

Dr. Troy Fox : You don't, you don't have time not to. 

Dr. Michael Perusich: You don't have time not to. Yeah. 'cause I'm, I'm gonna tell you, two of the busiest practices ever were yours and mine. And we met, we found time to do that, so, 

Dr. Troy Fox : right.

Dr. Michael Perusich: Um, part of it is you just gotta get it scheduled. You gotta realize the importance of it. You gotta realize that if you're not managing your Medicare correctly, you're not doing no surprises, act correctly. You're not doing your HIPAA [00:15:00] correctly. You could get in trouble. And so spending the time to develop your team so they get good at it and finding that one person, whether it's a spouse, which is a great one.

Um mm-hmm. You finding a spouse or having just a killer office manager like I did. Yep. Um, don't get Bigheaded or Rosa. Um, you, you know, those kind of things allow you to delegate some of that. So when you say you don't have time, I'm gonna say, Hmm, maybe you don't delegate. Maybe you just don't schedule these things.

Look out on your schedule docs. Look out five weeks from now. Look out on Wednesday. We what, what day do you normally have a, a staff meeting? Tuesday, Wednesday, Thursday, whatever it is. Look out five weeks. Are you really that busy that day that you can't schedule something? Mm-hmm. Because if you schedule it, then you'll work your patients around it and you won't lose any patient visits.

'cause that's what you're thinking. You're gonna lose patient visits if I stop and do this stuff and you won't. 

Dr. Troy Fox : Well, you'll find a way to schedule around it. The interesting thing about this as well [00:16:00] is. That when we look at this and you start talking about this in a way that says you don't have time, you know what, I see this as, this is a hobby for you.

So do you know who Kevin Ner is? 

Dr. Michael Perusich: Yeah. 

Dr. Troy Fox : Yeah. Kevin Ner played on the PGA tour. He is now a broadcaster. Right. So he had a thing that he always said. He said, this ain't no hobby.

And the truth of the matter is you think about how hard a professional golfer works at their craft, right? It ain't no hobby. No. If you wanna be, if you wanna be the best, you gotta work at it. So what that means to me. Is that this is not an eight to five job folks. It isn't come in when patients start and leave when patient's in, and we get into that grind a lot of times, oh, I'm exhausted.

I saw X number of patients today. I need to go home and, you know, do whatever, have a drink, mow the yard, eat dinner, whatever, whatever that may be. But this ain't no hobby, right? So the truth of the matter is, is you have to look [00:17:00] around, figure out what needs to be done, and how do we, how do we make that better?

Staff meetings, number one. Number two, increases in training. Because the other downfall that I see, and I think it's as dangerous as an audit, if not more dangerous, is complacency. 

Dr. Michael Perusich: Complacency. You bet 

Dr. Troy Fox : if you aren't moving forward, you're going backwards. 

Dr. Michael Perusich: It's 

Dr. Troy Fox : exactly right. And complacency will take you off of a cliff.

Um, and, and here, you know, sometimes we learn things by experience. Sometimes you think that you've got things covered. I wanna throw this in there, because this happened to me. I had a situation where Medicare wasn't being billed correctly or at all. I thought it was. I had somebody on it who said, is being taken care of?

Trust, but verify. Yep. Whoever you're working with needs to meet with you and show you, show me the money, or show me the numbers. Right. I wanna know, just [00:18:00] because you said everything's in order. Show me. And so you should have short meetings with staff members that have been delegated authority. You don't just trust that it's being done 

Dr. Michael Perusich: right.

Dr. Troy Fox : Not that I don't trust my staff members, but in this case, guess what? We ended up with about $50,000 in Medicare that hadn't been billed. Well, now who's scrambling to Bill Medicare? Not me. Well, I mean, I, I point the finger at me, but basically all of a sudden my staff who. Had thought everything was in place and we had everything running like a, like a well-oiled engine, all of a sudden had to jump into Hyperdrive because we knew that our checking account was gonna do that.

We were falling off a cliff. Right? 

Dr. Michael Perusich: Yeah. 

Dr. Troy Fox : We're trying to brace your impact at that point. That happened about 20 years ago. Um, and I learned a real valuable lesson from that trust but verify. So those are my two tips for you today. Great. And this is a hobby. You, you gotta be on it. 

Dr. Michael Perusich: It's not a hobby. And you know, build.[00:19:00] 

Team development into your schedule. It, it's important. Mm-hmm. And we gotta take a real quick break here at the end. Um, and I wanna kind of wrap up with that thought so we'll be right back.

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That's where the real strain begins. Most clinics face the same set of hurdles. Inconsistent new patient flow, operational bottlenecks, and the constant challenge of staying visible in an overcrowded digital space. National reports show that over 60% of clinics struggle with scheduling efficiency alone and even more lack of clear marketing strategy that reliably converts.

[00:20:00] But the good news, these challenges aren't roadblocks. They're signals with the right procedures, smarter outreach and guidance built specifically for ChiroPulse practices, clinics can turn daily stress into sustainable growth. Stronger clinics start with smarter strategies. Grow your practice with confidence.

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Dr. Michael Perusich: We are back. 

Conclusion and Final Thoughts

Dr. Michael Perusich: We've been talking about creating revenue generators as opposed to revenue killers. We talked about a whole bunch of ways that uh, we can be revenue killers and one of the biggest thing is never doing any kind of team development. I'm telling you, schedule it. The one thing that would regenerate me, revive me and practice other than a vacation.

Was having a two to four hour block of time once a quarter to strategically plan and develop with my staff, and I would come out of that so revived and so energized and ready to go. And so I know we, we talked to a lot of you guys who [00:21:00] get burned out in practice, it's 'cause you're not doing this stuff.

That's another revenue killer when you allow you and your team to get burned out. So I'm telling you. Team development is incredibly important, and if you need help with that, this is one of the great things that we do at Kats Consultants. We help with team development. In fact, four times a year we force you into some team development, and every doctor always says the same thing.

Wow. That was amazing. So get on board. 

Dr. Troy Fox : Yeah. If you've never done it before, what you're gonna find out is that you have a very adept. Motivated staff that when you do that, team development is gonna come, they're gonna shine like rock stars. Some of 'em are now, there are always some people that are just like, Hey, I'm just here to do my job.

And that's cool. You gotta have those. You gotta have worker bees and then you're gonna have some rock stars come outta that. 'cause you're gonna have somebody that never really said a whole lot in your practice before. That is gonna go. Here's what I think. And they're, and you're gonna stop talking and listen because they're gonna blow you out of the water.

And then you're [00:22:00] gonna 

Dr. Michael Perusich: of brilliance, 

Dr. Troy Fox : why did I not know this about you? Whoa. And that's, that's where having two to four hours, not 30 minutes, not, let's rush through this and grab a, a quick lunch while we're at it, and then get back to work. Because then everybody's focused on what, getting through the meeting as quickly as possible.

If we have two to four hours, somebody can raise their hand and go, I don't know if this is valid or not, but here's what I think. And they'll do it. At that point, they all of a sudden come out. It's, it's like walking, watching, you know, uh, watching a turtle come out of it. She, it's slow. It may, they may not move very quickly, but sometimes what they have to say when they come outta that shelf is profound.

So do those things because you may find out something about your staff you didn't know. 

Dr. Michael Perusich: Yeah, exactly. Exactly. So team development, incredibly important. So if you need help with that, Kats consultants.com. Go check us out. There's some free downloads on there too. We're helping doctors create not only efficient practices, but hyper profitable ones at at the same time.

So Troy, thanks for [00:23:00] jumping in the studio today. To all of you from Kats Consultants, we wish you the best. We'll see you soon. See ya.