Need help from anyone working for a Chiropractor

[bytchass]

I have recently started working with a Chiropractor.  He supplies the room, makes the appointments, bills insurance, etc.  He pays me once a month of which he takes 40% of whatever I have made that month (which I don't have a problem with).  My problem is that if the insurance company doesn't pay then he takes it out of my check (not all but at least 50%).  I'm wondering what is the way other Chiropractors handle this sort of thing.  Do they take the loss (which they don't really have a loss, they are making money off of us) is that part of the 40% that he is getting all ready, do we take the loss, what.  I feel like I'm being ripped off somehow and want to quit but then I wouldn't have any money coming in, so I'm putting up with it for now.Someone please let me know what your Chiropractor does in this situation.  I am a independent contractor if that makes any difference.

 

[Aunty Joyce]

Need help from anyone working for a Chiropract

The Chiro I work for pays me the same no matter what the insurance pays or doesn't pay.  It is a perceneforum.xxxe of the charge not the payment.   Think back to when you made your payment agreement with the Dr.Did you agree that your perceneforum.xxxe was based on the charge or on the payment?If you agreed that it was based on the charge, then you should be getting 60% of the total charges for the month.  This should have nothing to do with the Dr.'s insurance payments.  IMO, I wouldn't agree to be paid based on the insurance payment.  I have only worked for the 1 Chiro, so I don't know if being paid based on insurance is a normal practice or not.  Just something that I thought of.  The office I am in tried to collect my clients deductibles from me(which they don't ever collect from the clients) once when the office was having financial problems(and still have).  If the massage wasn't covered due to the deductible not being met, they tried to tell me that it was my loss.  I told the Dr. that wasn't part of our agreement and I was not responsible for paying my clients deductibles.  I did the therapy, I deserve to be paid.Hope this helps.

 

[taurusphere]

Need help from anyone working for a Chiropract

I worked for a chiropractor for a short time as an independent contractor. He paid me a certain amount for each hour of massage I did for his patients. He billed the insurance companies, but my payment was not contengent on the insurance company paying him. Because the chiropractor is contracting labor from you, I don't think that your pay should be dependent upon the insurance companies paying up. Imagine contracting someone to come in and replace the carpet that was ruined when your hot water heater broke and then telling the person laying the carpet that he wouldn't be paid until you got the check from your insurance company to cover it.  hmmm... I don't think it would go over well.-Melody

 

[518]

Need help from anyone working for a Chiropract

I've worked with a chiro for 2 years, and just recently we have run into this problem because of the change in some policies. We go back to the patient and explain that their insurance does not cover massage therapy, therefore it is their responsability to pay for the massage. And they do!. We duduct the amount at the end of the month from my total insurance check. If the doctor is the one who perscribed the therapy he should take the loss not you. Don't quit! Most of these people get hooked on massage and start to understand the great benefits is has on there well being. I have alot of clients who have been with me since I started there and even if I don't see them for a month, they always end up coming back for more sooner or later. Also don't forget that your 40% pays for all the office work, room etc...

 

[Greco]

Need help from anyone working for a Chiropract

Make shure that when signing a contract with the chiro, that everything is laid out in black and white.when dealing with insurance, in ontario we just went through major cut backs, have the insurance company approve the treatment plan before you do anything more than an assesment, also have the patient possibly pay for the treatment first and let them get reimbursed by the insurance company, and/or have the patient sign a agreement stating that they are held responsible for any cost incured not covered in there treatment.in the end if the patient is not willing to agree, then forget them, in the end we are all here to help get people better but it's not a charity we must eat, and pay rent.i've had this situation several times both as a MT and as a buisness owner, if you are not willing to take a risk not being paid  for these, then don't have some type of gaurentee.

 

[nerdcore]

Need help from anyone working for a Chiropract

I have been working with a Chiro 3 yrs. Most Blue Cross/Blue Shield and some others pay for up to 2-15 min treatments of myofascial release, and some other modalities. When a client is recommended to me by the Chiro, I keep good records and his office bills for 30 min. If the client has a 60 min massage, they pay the difference between my regular 30 min massage and the 60 minute. Recently we had trouble with some insurance that said they would only pay for one modality per day, so clients had to come in on a separate day for the massage. But, recently the secretary went to a meeting for BC/BS and they said for them to bill using a moderator #59. If you bill right, they will pay. There is a limit as to how many times they can see you in a year, and you have to share those times with a chiro. The clients know up front that if their insurance doesn't cover the cost, they will be billed by me. It has not been a problem, and so far, insurance has given me a good income, and clients feel they can actually go to the Chiro and Physician much less when they get massage.

 

[Deirdre B]

Need help from anyone working for a Chiropract

My problem is that if the insurance company doesn't pay then he takes it out of my check (not all but at least 50%).

Kimmey, What you are describing doesn't sound right to me.

What troubles me about this is at first you say he gets 40% of the income you bring in then follow it with the above statement saying he's actually taking 50% out when the insurance company doesn't pay.  If he's taking 50% are you then collecting any unpaid claims directly from the patients?  Unless you were hired with the understanding that you would be responsible for collecting payments from patients whose insurance didn't pay then I think he's doing something rather strange.

If you are supposed be collecting from patients then I would suggest you instigate a new policy immediately stating all massage services must be paid in full prior to the appointment.  Tell whoever is filing the insurance to "refuse assignment" for massage services on the insurance claim and let the clients insurance company reimburse the patient directly.  Then you can handle your money and pay him the appropriate 40%.  Most chiro offices frown on this though.

In my experience, insurance payment rarely turns around in one month's time.  It is really important to remember what was said initially and if it is written in a contract -- what is written.  Have you asked him why he is taking 50% when he's only supposed to get 40%?  Do you have your agreement in writing?  

If it is a verbal agreement and you specifically remember that he said he would pay you regardless of insurance payments and he is now deducting these amounts from your paycheck then, IMO, yes indeedy you are being ripped off.  

If on the otherhand, he said he would pay you when he got paid, then he should not be paying you anything till insurance renders payment for each service you performed and he should only collect 40% out of that payment.

From what you have written there is a possibility that he paid you before he got paid and he is now deducting that amount from your check.  From the sound of it he's apparently taking an extra 10% -- where did that extra 10% come into play?  Have you asked him about this?

In the past when I worked in chiro offices the chiro's paid me regardless of whether they got paid by insurance.  If they are doing the billing and referring clients for work it is their risk to accept insurance payment and up to them to collect payment from the patient.  Generally speaking, any uncollected debts are usually written off for tax purposes.

The only way to know if you have been paid properly is to figure out the exact income you have brought into the office.  To know this you need to know how many clients you have seen, what has been both billed and received from the insurance company, then compare your numbers with what you have actually received.  If you find he's not paid you properly then it is important to address this situation immediately with the chiro.   The best way to do this is present him with an itemized bill of what was billed, what has been paid and what he has taken from you and the amount he still owes you.  Ask him to pay you for the work you have done.  If he doesn't pay you I would get out of that office as quickly as possible as it will most likely only get worse.

(((Let me know if I misunderstood the situation but from my take on reading your post that is my two and a half cents worth.)))

P.S.  There is another thread in this section titled "Fair Deal?" which has some interesting info to consider if you decide to work in another chiro or spa type setting.  Worth your read.

 

[ginkgo]

Need help from anyone working for a Chiropract

have recently started working with a Chiropractor. آ He supplies the room, makes the appointments, bills insurance, etc. آ He pays me once a month of which he takes 40% of whatever I have made that month (which I don't have a problem with). آ My problem is that if the insurance company doesn't pay then he takes it out of my check (not all but at least 50%). آ 

dittio on Intuitouch. آ This doesn't sound right at all.If you are working FOR him. آ You should be getting a paycheck for your work, rather he gets paid or not. آ If you are working for the price that he collects, then you should be getting checks based on dates when he gets paid for the services rendered. آ But, taking money he gave, back out of your check seems pretty hokey to me. آ You know, I don't have a problem with someone making money off of me.  That is part of "working for" someone.  Checkers in a store make $8 bucks an hour.  The store obviously profits, and the list goes on... but I just don't think it's right to give someone a paycheck and then remove money on the next paycheck based on what the business did not make that month on on the clients/patients coming in.   I mean... you wouldn't be able to figure out which bills you could pay each month with this method.  You don't know how to even prepare to pay for your rent, unless you have an unlimited supply of income coming in, I wouldn't think....No, I don't agree with this at all.

 

[Just a Guy]

Need help from anyone working for a Chiropract

i have worked for 2 chiros. and I have never had this happen, If the insurance company isn't paying then they would get payment from the client.  That is how it goes, If I were you, I would start looking for another job and when you get one, QUIT!!! He definetly sounds likehe is screwing you!!  I just want to add,  Like I said I have worked for 2 chiros and I quit both after a relatively short amount of time!!  Just be weary of ther practices!!  I am by no means implying that chiros are all bad. but I just rather work for myself or a fitness center! ;D

 

[Sudhakar B]

Need help from anyone working for a Chiropract

My big downfall was that we do not have a written contract.  But he did say that I would get 60% of what the cost of the massages are.  In regards to to the 50% I was talking about, the chiro paid me before the insurance reimbursed him.  So instead of taking the 60% back that he paid me he basically split the difference between myself and him.  So if he paid me $100 for work and the insurance company didn't pay he only took back $50.  He also gave me some line about since he is a bc/bs provider he can not bill the client for amounts that the insurance company didn't pay.  Since he agreed to take what the insurance company agreed to pay.  My thought was but I'm not a bc/bs provider so tuff.  I have finally set up a financial agreement between myself and the client that says if the insurance does not pay me that we will bill.

 

[John V]

Need help from anyone working for a Chiropract

My big downfall was that we do not have a written contract.

Yes, a written contract would be helpful.  Is it possible for both of you to create one now to eliminate confusion in the future?

But he did say that I would get 60% of what the cost of the massages are.  In regards to to the 50% I was talking about, the chiro paid me before the insurance reimbursed him.  So instead of taking the 60% back that he paid me he basically split the difference between myself and him.

So you are making 50% which means he has reduced your rate without discussing this with you.

He also gave me some line about since he is a bc/bs provider he can not bill the client for amounts that the insurance company didn't pay.

It sounds like he has signed a contract with bc/bs.  So, this probably has something to do with whether he is an "in-network provider" for bc/bs.  Someone who is "in-network" has agreed to take a reduced rate for payment of their services whereas an "out-of-network provider" can expect the patient to pay what insurance does not.  The contract most likely agrees to a specific rate or discount on his services -- and consequently your services since he is billing for your work.  Regardless, you should still receive 60% of whatever payment comes in from insurance.  Again, the only way to know if you are being paid properly is to have all the numbers mentioned in my post above.  

I have finally set up a financial agreement between myself and the client that says if the insurance does not pay me that we will bill.

I'm assuming you mean you will bill the client for the remainder.  This is a tricky situation if he has indeed signed a contract with bc/bs regarding their members.  My guess the contract umbrellas your services since he is filing for you.

 

[DOLL]

Need help from anyone working for a Chiropract

Beware of this chiro, he sounds fishy. FInd out exactly what your payment agreement was. This will be your leg to stand on with him. My sister worked for three different chiros and two of them tried stuff like this when they weren't getting the insurance  turn around as fast as they wanted. She did exactly what intuitouch said to do. She made an itemized statement and gave it to the chiros. They both tried to say that they hadn't been paid, when they actually had. So they were stiffing her the money she had earned, and they were taking some of hers to compensate for their "non payment". Get this settled ASAP because the longer it goes on the harder it is to collect what he has taken, if it wasn't in the contract. My sister ended up taking both to court because they refused to pay her what she had earned. She won both cases, but it took 2 years to get the money. So fix it now, not later. Let him know that you would like the money that has not been paid. Do it nicely at first, and if that doesn't work, take more aggressive action. I am sorry if I sound harsh about Chiros but it was a messy deal with the two my sister dealt with. I know there are good chiros out there, and I hope yours turns out to be one of them.

 

[Twilight fan!!!]

Need help from anyone working for a Chiropract

I had worked for a chiropractor fo ra brief time. He payed me for the massages I did minus 50%. Then he'd let me take about 80% of the insurance checks that came in. Then I found out that it is illegal for a chiropractor to pay a massage therapist by the hour. He is only allowed to take one into his place of work as an independant contractor. He can charge rent in that case. Or, he could hire a massage therapist on a salary so he pays by the hour whether or not there is a massage available. He knew this. I also found out why I didn't seem to be making any tips on my massages and that was because he took my tips for himself even if the person just came in for massage. I dont' know how many tips he stole because no one told me if they left any. It just seemed fishy that I was getting so few and some of those were return customers. Why would they tip some of the time and not others and then return? He even got mad at one of my co-workers for insisting she get the tip that her client mentioned he left for her at the front desk. I think he still owes me but I'm just glad I'm out of there. I quit. He was rude and obnoxious to everyone working there. He was not even conciderate of my clients by screaming at me in front of them about either not being ready within the 1 minute notice he gives me that I have a client or that massage therapists don't know what they are doing. The other thing he'd do was interrupt my time with my clients to tell me to work on someone else. For goodness sake! give my clients the time they want to pay for and don't interrupt me! I can't even think of talking to that man again.

 

[I wanna know?]

Need help from anyone working for a Chiropract

Then I found out that it is illegal for a chiropractor to pay a massage therapist by the hour. He is only allowed to take one into his place of work as an independant contractor. He can charge rent in that case. Or, he could hire a massage therapist on a salary so he pays by the hour whether or not there is a massage available.  

Could you please confirm this with some "legal-ese" info?

I am just wondering what the actual law about this is named or called and what state or states this is found in.  If you can provide a statute or code that would be helpful.

Thanks in advance.

 

[Andy J.]

Need help from anyone working for a Chiropract

I currently work with a chiropractor as an independent contractor...I actually pay half of what i make..I am able to set my own prices...it was real tricky at first...before i began a contract was written up and at first this person wanted to put down that i could not work 10 miles from the clinic..which of course meant that i may as well give up my cliental that i had already established and there was sooo much more...well i got on the computer and researched exactly what a independant contractor was and  rewrote the contract brought to her attention that she was wanting the benefits of me being independent..yet wanting to treat me as an employee..NOT!!! I personally don't except insurance as of yet...when i first began i didn't even accept creditcards...she now pays me  my half for the credit card patients and just keeps the money when it comes in..if she is willing to pay me up front for the visit from an insurance patient then i would except..always have a contract written up because in too many cases i'm finding out is chiropractors want their cake and eat it first...it doesn't work that way..