The Roller Coaster of Collections | Where is My Money III

By Charles Pritchard

The Ups and Downs of Cash flow Give a Chiropractic Clinic Owner Anxiety

Which areas of Ben’s clinic are most difficult to track?

The roller coaster of collections drove Ben up the wall. He never knew how many of his claims would get paid each month. Some months the money was pouring in like he had won the lottery, and then the payments would suddenly come to a screeching halt. The worst part was the uncertainty. It made him feel sick to his stomach. He felt like he could not even provide for his family’s basic needs, let alone treat them to the long-planned trip to Disney World. It almost seemed ironic that Ben’s wild ride of unpredictable cash flow prevented his wife, Carmen, and his son, Jonathan, from enjoying the rides at the theme park.

Not surprisingly, Ben’s revenue issue was slowly killing his joy of practicing chiropractic. Not to mention how his bad mood put everyone at home on edge, too.

“I just don’t get it,” Ben said as he helped himself to leftover lasagne. “Back in January, we were averaging around 325 patient visits per month. Over the summer, my clinic literally exploded with 487 patient visits. The last few months we have been averaging around 436, but strangely enough, our collections don’t match that one bit. Although this month’s number is close to what we got in January, I have no way of predicting what we might receive next month. It could be thousands of dollars less…. or we could hit the proverbial jackpot.”

“I wish I could use my rolling pin to turn your collections into smooth pizza dough,” Carmen said, jokingly, while placing pepperoni and cheese on her homemade pizza crust. “Your billing issues remind me of a ball of dough. You can’t make pizza with it unless you flatten it out. And at my pizzeria, for example, I have to offer the kind of pizzas my customers like. Otherwise, no one will come back for more.”

Ben chuckled and said, “You compare everything to pizza, honey. At least your customers pay you right away. Imagine waiting for two, three months to receive payment for a pizza!”

“Hmmm,” Carmen said, while putting the pizza in the oven. “My suppliers might extend me a little credit, but I’m pretty sure I would have to shut down if I was stretched that thin.”

“Well, that’s exactly what I have to deal with,” Ben said. “The insurance companies take their sweet time to pay up and I’m left standing in the rain without an umbrella, so to speak.”

After dinner, Carmen gave Jonathan a bath and put him to bed. Ben read him a story to help him fall asleep. Then they sat down in the living room to continue their conversation from earlier that night.

“You ever come up with a menu?” Carmen asked, as Ben handed her a glass of wine.

“Isn’t that your job?” Ben said, sarcastically. “Do you want me to partner up with you in the pizzeria, or are you just out of ideas?”

Carmen punched him in the arm, playfully. “Your menu of services, genius!”

“What about it?”

“OK, let’s look at it this way… how much do you make each time you see a patient?”

“Are we talking about cold, hard cash in my pocket? About 30 bucks per visit. Why?”

“When I created my bill of fare, I wasn’t just thinking about the kind of pizzas I like to make,” Carmen said. “I had to consider the cost of ingredients, time for preparing the dough, and the likelihood of people ordering it regularly.”

“In other words, I should stick to my most profitable options, right?”

“Something like that,” Carmen said. “Based on what I know, your services vary in time and equipment needed. Some of them may not even be in high demand. If you take an honest look at your practice, you can probably find some services that are not worth those 30 dollars– especially when it takes forever to get paid.”

“So you think I should cater my clinic that way?”

“There you go,” Carmen said with a wink. “On that note, I’m dying for a slice of pecan pie. Can I get you one, too?”

Which areas of Ben’s clinic are most difficult to track?