Realize when it comes to diagnosis, best practice coding for an acupuncturist, pain. Don’t get fancy. Pain works.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hey, greetings to my acupuncture providers. It’s Sam Collins, the coding and billing expert for you acupuncturists, and of course, the American Acupuncture Council and our network. As always, I wanna make sure you’re up to date. Hey, it is the 1st of September. What’s gonna be changing? Oh, diagnosis codes will update October 1st.

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So let’s talk about it. Let’s go to the slides. Let’s look at what’s going on for 2027, what’s changing. The one thing we’re always careful with, we’re not big on hyperbole. We always wanna make sure we understand the coding, the codes that are important to your profession, and I’m always gonna be a little acu-centric.

Realize when it comes to diagnosis, best practice coding for an acupuncturist, pain. Don’t get fancy. Pain works. Realize you can have lots of diagnosis for the back, spondylosis, disc degeneration, on and on it can go, but yet it still comes back to pain. That’s the beauty and the genius. Realize that pain, symptoms, or neuromusculoskeletal diagnosis are always gonna be the most common payable codes.

There are certainly a lot of programs now that do pay for others, and I want you to be aware, but I wanna focus in on making sure are we getting paid? Do we have the right code? Of course, as is every year, there’s updates to diagnosis codes. This year is no different. So the 2027 diagnosis codes actually begin October 1st.

So here’s a good sort of riddle you can have. When do the 2027 diagnosis codes begin? And of course, most people would say 2027.” Technically, no. They begin October 1st. Now, as always, I’m going to be very acu-centric. You know what I care about? How does it affect us in the acupuncture field? Of course, there’s almost 75,000 codes.

You’re thinking, “Whoa. Are you ever gonna use that many?” Nah. You’re probably gonna use probably on a regular basis 10, and maybe occasionally a few more, with 5 of them being most often. So what I care about is the ones that affect us. We could look and say wait a minute” There’s 190 new codes, 30 deletions, four revisions.

Does that make a difference? Let’s take a look at the overview. There are gonna be changes to infectious diseases. Metabolic conditions, injuries or toxic effects, and this is ingesting things. Pregnancy-related, but pregnancy-related for more obstetrics, if you will. Oncology codes, but not related to what we would do ever, even though it might be pain, and then pelvic conditions, again, unrelated.

So the truth is, no significant changes except one, plantar fasciitis, and I’m not saying you can’t code plantar fasciitis. You can, but you might be coding foot pain anyway. So I will tell you, there’s no changes for high volume pain or neuromusculoskeletal codes. However, I wanna focus on, do I have the best codes?

Let’s look at the changes. The old code, or if you will, the code that’s being deleted, M72.2 plantar fascial fibromatosis, is the code that’s current. So if someone has plantar fasciitis now, that’s the code we use. Beginning October 1st, we’re gonna switch to the new codes, and you notice there’s three.

One says, plantar fascia, plantar fascial fibromatosis, unspecified foot. Let me tell you, never gonna use that code because can you imagine saying they’ve got it, but I don’t know which foot”? Of course you know. Is it the right or the left? Notice the code ends in one is the right, one that ends in two is the left.

Bottom line, keep it simple. If they have it in both feet, put both codes. If they have it in one, put that one code. Now, I have some acupuncturists say Sam, I’m not even gonna code that. Could I just code foot pain?” Technically, you could. Remember, pain is always gonna be a fallback. So here’s the new codes.

You’ll see here we’ve updated them. This is a list, and what I have here is a big list. I’m not showing the whole thing, but a big list of the common codes payable to acupuncture. I’m gonna give you an opportunity for all of you to get it because what this list is the list of payable codes by insurance.

Now, I will warn you, it is a big list. It’s about nine pages. It’s gonna have codes that are payable by insurance, but I’m gonna argue, or not argue, but I will state to you All the codes are payable by insurance, but not all are payable by all insurance. So you do wanna have a little bit of nuance there.

That’s one of the things our seminars note. But you wanna make sure if you’re gonna choose a code to bill insurance, I’m gonna suggest pick from this list because this is the list that there’s references to every carrier. So I’m just highlighting here, this is part of the extremities with the plantar fasciitis, but notice there’s other codes on the list, such as chronic pain, acute pain, and so on.

So to get that list, here’s what you do. Pull out your phone, use this QR code. I’ll leave it up for a moment. What you’re gonna get is a quick bounce back just asking for some information, and off it’ll come to you. It’ll be a nice PDF that you can use on your phone or also on your desktop. What it is, though, is a usable format that actually you could search.

Remember, if you go to the little magnifying glass, click in the click on that, type in a keyword, it’ll bring up every time that code is there. So if you wanna look up cervical, type cervical, and all the codes that have cervical will come up, or lumbar, whatever the case may be. What I wanna make sure is that you should be choosing codes that are specific and come from a reference as opposed to thinking, “Oh, I’m not sure.”

Now, again, always defaulting to pain is still fine, but I’m gonna say a little bit more specificity always can be helpful. What I do wanna talk about, though, a little bit more beyond that is just some recent things about the state of the profession. Here’s what I’m excited about, and I wanna show you something Acupuncture utilization has more than doubled in the last 20 years.

Now, we still treat a small part of the population, but I’m excited about that. Part of the reason, commercial plans now include the benefit. In fact, how many are familiar that Aetna now has mandatory acupuncture if it’s a commercial plan? Medicare Advantage plans, the Part C, have acupuncture. And what about complementary care networks?

They’re out there. Now, here’s something, and I want to show you where I got this. The American Journal of Managed Care from February of this year, this is a group that’s a, support group for the managed care industry that talks about how to position their business. And it says, “The most successful acupuncture providers will likely be those who combine clinical specialization, measurable outcomes, payer knowledge, and strong referral.”

This tells me where we should be looking. Specialization. You cer- deal with certain things. You’re focused on outcomes, and you understand what the payers allow. It says, “The market is moving toward greater acceptance, but payers are also becoming more focused on authorization,” meaning understanding diagnosis restrictions, utilization, and proof of functional improvement.

It then goes on to talk about, according to the CC, CDC, opioid prescribing is declining. If you think about why is the VA beginning to use acupuncture, it reduces the need for opioids 50%. It’s showing, “Our findings indicate,” and again, this is the Journal of Managed Care, “a large commercial insurer is increasingly covering acupuncture for its beneficiaries.

Unlike Medicare Part B, which limits coverage for chronic low back pain, these insurers are reimbursing acupuncture for a more myriad of conditions.” Think of for those of you in Massachusetts, they cover any diagnosis. And it says here, look at this, “Insurers should consider systemic reviews, meta-analysis, and other rigorous studies when expanding acucover, acupuncture coverage to new indications.”

Why is that? Their business strategy will be one that if they include more acupuncture, they will get more insurance. It says, “The greatest growth opportunity for acupuncture is not simply expanding the number of services offered. It’s positioning acupuncture as a measurable, evidence-informed component of conservative pain management in integrated healthcare.

Providers who understand payer requirements, document objective fun- functional improvement, and build strong referral relationships will be the best positioned for growth.” These are insurance companies that are then dictating how they’re going to do it. I want you to get on board. Doesn’t mean you have to bill all insurances, but I would certainly say I would cherry-pick a few.

Remember, though cash is king, I get that, you always wanna make sure, am I there to make sure I understand the insurance side? What I will tell all of you is I wish you really well. I hope you do fantastic. If you’ve never been to one of the HJ- or excuse me, American Acupuncture Council seminars, we’re here for you to help.

We’re always a support. Our network is there for you as well. And that’s more than just insurance. Diagnosis coding, small update this year, not a big deal. But make sure that if you need information or help, AAC is always there for you, and of course, I am as well. Until next time, my friends.

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How do I make sure that I’m getting the revenue that I deserve?

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Greetings to all my friends, to all our members, and of course, the profession of acupuncture. This is Sam Collins, the coding and billing expert for acupuncture, giving you a little bit more on this month about dealing with an office. How do I make sure that I’m getting the revenue that I deserve?

Because we have to remember what always is gonna be true, cash is king, and don’t move away from it. I’m not saying insurance is not viable, but there’s gotta be another place for it. Let’s go to the slides. Let’s talk about this. What about doing cash, prepaid packages, and membership plans? This is something a little different.

You’re all familiar with cash discounting and so forth. Let’s get a little bit deeper. Insurance coverage is growing. But unfortunately, people often face very high deductibles, limited benefits, and therefore, there’s still a lot of out-of-pocket costs. I’ve seen acupuncture policies where the patient has had a $75 copay.

They might as well pay your cash rate or maybe do something where you’re doing a membership. That’s something to take instance to. Okay, let’s talk about this. What is a membership plan? A membership plan’s gonna be a little bit different from the prepaid packages. Prepaid packages are still viable, and it is a way of doing larger discounts than the typical 5 to 15% pay at time of service.

But when you do a prepaid package, they’re buying generally a good number of visits. In doing so, what we run into often is patients wanting refunds or have other issues, or just committing to that long-term care. What about offering something else? This has been the way that you’ll see with a lot of these ca- I shouldn’t say chiropractic, but acupuncture groups, particularly modern acupuncture, has moved away from membership for…

excuse me, away from prepays towards membership. Why? Because it creates an easier access. Think, if you wanna create a value and a value add that someone is getting a good amount of service and thinking, “This is fair, and I’ve not prepaid thousands of dollars.” So here’s gonna be the rule, and this is gonna be generally across, All states.

I will say do verify if you’re a network member with me. Definitely get with me and say, “Hey, Sam, what about me and this particular state? Is there anything that I have to do differently?” For the most part, no. For the most part, it’s being transparent. However, let’s make sure. So in general, you may offer a membership plan.

It’s different than outside of insurance. It allows you to offer a membership for a fee that includes certain services that doesn’t become beholden to your regular fees when you bill insurance or pay on a single visit. There are real common ways of improving access to services where someone’s gonna have predictable healthcare costs.

Maybe you can say to them, “Hey, let’s deal with this chronic issue.” And what we do is a prepaid, if you will, membership monthly that will offer you two acupuncture visits or four, and maybe a therapy within that. That way it’s predictable. They know they can come in, they’re gonna set up, and I would have them set their appointments well in advance.

However, this plan has to be structured in a way that it’s showing that it’s not insurance and not gonna be based on any state issues. So membership plans generally should be limited to self-pay patients, meaning I’m not using any insurance, I’m just paying out of pocket, or if I have insurance, maybe it’s for an excluded service.

Now, this would be a typical for a regular Medicare Part B. This might be very attractive to them. Clearly state the services that are included, okay? Don’t just say it’s an acupuncture visit. What does that mean? Is that gonna be a 30-minute visit, an hour visit? Is it gonna include a certain number of sets?

Is it gonna include massage, cupping, Tuina, whatever the case may be. And I’m not saying no to any of those, just clearly outlay it. But make- be careful of overlaying that you’re gonna give a lot of extra things. I would make it an acupuncture visit, and then if they want additional things, maybe there’s a small fee for it.

Do explain, of course, there are cancellation rights. If the patient decides after a month they don’t wanna do it, no problem, just cancel, 30-day notice, okay? Here’s what’s good about these as opposed to a prepaid package. Prepaid packages require refunds of unused. A membership plan, you didn’t buy a visit, you bought a membership that includes something.

If they don’t come in that month, they just lost it, a gym membership in a way. Make it clear to them, though. So if you don’t come in for a month, those visits don’t roll over. Put that in the contract, otherwise they may think it will. At the same token, if they want more, they can buy maybe a bigger plan.

Key factor here is explain to the patient that it is a membership That if they don’t use it, that’s up to them, but it’s just a lost service they’ve gotten. Realize also we’ve got to make real clear it’s not insurance. It’s not a health plan. Doesn’t satisfy any health insurance for them thinking it’s got to be some type of insurance.

It is not. Indicate what services are included. Indicate what’s not. What are exclusions? What about cancellation? I would love for them to set up their appointments every month, have it set up already, and for the next month set it up again. Then if they cancel, as long as they reschedule, but what about cancellation if they don’t cancel within time?

Do they lose a visit, or will we roll it over for another week or two? Maybe. Make sure if they’re not using it and want a refund, you just refund the month. So it would be a 30-day notice, so it means the current month is good. It’s the next month you can cancel. And I love these ’cause they’re automatic renewal.

It could be something set aside. They have predictable amounts. “Hey, I’m gonna pay $59 a month.” Okay? What you want to be careful of is don’t promise unlimited services. Don’t just say it’s everything. There is no assumption of financial risk like an insurance plan, meaning you’re not assuming any risk.

You’re gonna just pay for two visits. And don’t represent it’s replacing insurance. It’s just another way of access. A lot of providers who are doing cash are moving towards this, and this is why you’re seeing the move in modern acupuncture and other plans of that nature that do this. By example, what if you said it’s $99 a month.

You get two acupuncture visits, and if you have additional visits, maybe they’ll discount them. It’s a month-to-month enrollment, cancellation any time before the next billing cycle. So before the next billing cycle starts, you can cancel. Once it’s started, then you’ve got that month, and then the next month we won’t be.

A clear statement, it’s membership. You’re buying access. It’s not insurance. Okay? And this is ge- this is generally more defensible because when you’ve sold a big package, and a person’s unhappy, and they’ve, spent thousands of dollars, and all of a sudden now they want their money back, sometimes I don’t want to pay it back.”

Generally, you’re gonna pay back what’s unused because they’ve actually bought visits. With this, they’ve bought access for up to two in a month, and that’s it. So if they don’t use them, no refund. If they want to continue for the next month, good, we continue. If they want to cancel. Okay? Do keep in mind, though, some states are gonna put a little more scrutiny, and this scrutiny really, I’ll say, is use it and think of it anywhere, consumer protection.

Be upfront of what your charges are. Okay? This is the cost. It can be something that the patient can say, “Okay, this is good.” There’s not gonna be something, they go, “I thought it was gonna be cheaper.” Lay it out. This is exactly what it costs. Avoid statements that it’s insurance. Define the services. Don’t make it like it’s whatever I want to do.

I know some of you for cash patients, one day you do an hour treatment, the next day you do 30, which I’m okay with. But then, of course, what if the person’s prepaid a package, and one visit you’re doing a 30-minute massage, some, Some gua sha and then cupping. The next time they come in, they might say I want that, too.

You wanna make sure for me it’s gonna be acupuncture.” And then the additional services may be added as necessary as long as they’re willing to pay for them, if you will. Be careful, long-term plans must have cancellation refunds. This because it’s not long-term, the cancellation is just 30-day notice. And then rights to refunds.

What the big thing here is you can see consumer protection. Think of it as you would want to be treated elsewhere. I like these. They’ve become popular because it’s easier for someone to commit to this. The difficulty is what if after a couple months they don’t like it? That’s up to us to create the value.

Make sure they set up for the appointments. ‘Cause when people come in, they feel better, but they get away like, “Oh, I should be going.” This is where you wanna start setting up, “Oh, we have a recall. Let’s get you set up to s- schedule maybe two or three months in advance.” Okay? Remember, for a contract, there’s gotta be cancellation provisions, refunds.

Refunds because it’s month to month shouldn’t be a big deal. Don’t mislead with advertising about something unlimited or that it’s insurance, and then make some clear expiration terms, which means 30-day notice. Okay? Excluded services, if you have insurance, become a problem because if you’re an in-network, like with ASH, ASH includes everything except massage.

So you could do an excluded service. So I’m generally gonna say stay away from this if you’re with an insurance, unless they have a service that’s excluded. Okay? That the insurance-covered services we bill, but this would be separate. I think it’s difficult to mix this. I’m not saying you can’t, but I would be- have some concerns with doing that.

Remember Medicare, I don’t see a problem. Regular Medicare Part B, there is really no direct access to you. These would be perfect patients for that. Medicare Part C patients may be a little bit different. With them, you wanna make sure they understand the parameters. And I’m gonna say certainly no for auto and workers’ comp.

Why would I do this for an auto and workers’ comp? That is a fee-for-service where they could be using that insurance. I just think this is another avenue for you. This is something we’re gonna go over in a lot of detail at our upcoming seminar at the end of this month. And if you’re a network member with me, you can reach out before then.

But let’s start doing some things to get proactive, to change how revenue streams come in our office. You don’t wanna have one funnel, but many. And it’s not limited to just paying cash at time of service. Bottom line, best practice, clear financial disclosures. What’s the plan? What’s the refund policy? If you resolve those, generally people are pretty happy.

People love going to acupuncturists. They feel better. Give them good access. As always, we’re here to help. Network members, get ahold of me. Get to our seminar end of the month. For those that aren’t, come and talk to us. This is something … We wanna make sure you’re successful. We have a vested interest in all of you.

The American Acupuncture Council is your advocate and always will be, and we’re here to support you. If you need help, come and see us. Until next time, my friends.

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Let’s talk a little bit about something that I’ve gotten a lot of questions about. Let’s talk about, what if I get a bad Google review?

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Greetings, friends, colleagues. This is Sam Collins, the coding and billing expert for acupuncture for you, for the American Acupuncture Council, and of course, for my AAC network members. Let’s talk a little bit about something that I’ve gotten a lot of questions about. Let’s talk about, what if I get a bad Google review?

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Let’s go to the slides. Let’s get into that. What if someone puts an online statement about you that’s false, bad, inflammatory, you name it? Let’s be careful. What if you do get a bad Google review? The first thing to do not let your emotion run away. When a patient makes a complaint or something less than flattering on an online platform, our immediate visceral response, of course, is going to be a little bit of anger because it is our integrity, and I do understand that.

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But you have to take a moment, take a breath, start to understand what’s going on and how to respond because no one’s ever going to have 100% good reviews. I’ve been to a lot of services and places that I think, “How did this person write a bad review?” Everyone’s experience is different, but remember, there’s a lot of reviews.

Here’s where we have to be careful. You are a healthcare provider. You are bound by HIPAA regulations, so be very careful. When the patient even identifies themselves and discusses their treatment, you should never, regardless of what they’ve done, even confirm the reviewer is a patient Don’t even get into it.

I saw that when you came today. No. You got to make sure that you do not discuss diagnosis, treatment, appointments, billing, or outcomes, nothing that I would identify them. So for the most part, it would be a very generic response, of course. Now, obviously, factual inaccuracies by revealing protected health information.

You may think that wasn’t true.” You can’t correct it. Again, you’ve got to always remember, your greater violation will be the issue of protected health information. You may have a much bigger lawsuit against you than just someone saying, “I didn’t like the office.” Be careful. Do not engage in any type of argument or back and forth.

It’s not worth it. It’s like arguing religion, politics. You’re not going to win that. So be careful. Always think of, “What is my best practice?” You get a bad review, you should have thousands of good reviews. Make sure they’re there. Make it available. Encourage reviews. Aid patients in making access. Maybe not the first visit they’ve come, but after a few, get a lot of reviews going.

I think something that a person can go through and see that there’s, hundreds of reviews, and you’ve got one or two that are bad, oh, come on. You ever been to a restaurant that was fantastic, but there’s still a couple of bad reviews because they didn’t like the waitress, or there was too long of a wait?

It’s a good restaurant. That’s why there is a wait. Now, sometimes the best practice is no response at all. But if a review is negative but not defamatory, okay. What if the reviewer is angry and likely to continue the dispute? Not worth it. You can tell by the way they’ve done it. They’re trying to prompt you a little bit.

And realize a response may draw more attention, and y- all of a sudden now, instead of there being that one response, you’ve got lines of responses, ’cause it’s gone back and forth, and they’re taking it even further. Realize often just putting something in there that just says, “We would love to address this with you.

Please, give us a call or reach out to us,” may be the best response. Prospective patients are more influenced by a pattern of reviews than a single review. I know that’s true for me. I don’t think I’ve ever not chosen something, oh, there was one bad review. I’m looking for a pattern. If I see a bunch, now I’m concerned.

But realize, never argue or be defensive. Never. Never. You’re never gonna win that. De-escalate it. Make them come to your side. When you choose to respond, first thing you do, take a breath Breathe in and think, “Okay, what’s the best way to respond?” Maybe give yourself a little time. Don’t respond right away.

Take some time. Keep your response brief, professional, and frankly, just generic. Being calm and generic will reflect well, as potential patients can see that the office remains professional even when you’re criticized. You ever see someone that when they’re being criticized, when they have a measured response, you’re like, “Ooh, wow.

That’s the type of person that I want to be.” I want you to be that way ’cause that’s what your patients are looking for. I don’t want a doctor that’s off the hinges. Now, what about someone that re- reported something that’s just false? Okay, demonstrably just way out of line. Preserve screenshots, okay? And then obviously check the platform policies.

Realize most are not gonna remove something. They really aren’t. Now, maybe something exceptionally defamatory, maybe, but I find most people have tried, they pretty much won’t, so that’s why I say always bury it. If you are going to say anything about, “I’m gonna sue,” or anything like that, please don’t do that until you’ve consulted legal counsel.

You don’t wanna make any statement you don’t already know the answer to. I’ll give an example. Both my son and daughter are attorneys, and when they’re in court, the one thing they’ve always told me is they never ask a question they do not already know the answer to. So before you start to make any statements about, “I’m going to sue you,” better make sure, “Do I have standing, and can I actually sue?”

Chances are probably not anyway. But I get it, because it’s your integrity. So make sure you stay calm, but also make sure your staff understands, too, because sometimes your staff is defensive for you. And remember, designate who’s gonna respond to these. Are you going to allow staff, or is it gonna be the doctor only?

Make a rule that no employee may disclose any patient information online under any circumstance. They’re not responding probably at all, but they have to follow the same rules, that responses should be approved by designated management, meaning by you. But again, I’m still gonna go back, should be us. And then when legal counsel should be consulted.

Before you make any statements, “Eh, is this something maybe I want some legal counsel.” Maybe you wanna check with your malpractice carrier. Remember, American Acupuncture Council does protect you for when there’s lawsuits against you or when patients… I’m not saying they’re gonna defend you for a bad review.

But should that person turn into something legal, they will be there to help you, and they are there to help. I will say responding to a bad review requires a calm, prompt however, and professional reproach. Your primary goal is not to argue, but to show potential customers, ’cause this one’s probably gone anyway, that you’re attentive, empathetic, and committed Focus on commitment to service and next steps to contact you directly.

Make sure they’re aware, “Oh, no, I- here’s how you get in touch with us.” More though, have a lot of other reviews. What I see too often is reviews get old. When you get a new patient or someone that’s come in that’s been helpful, encourage them. I know I certainly like to. If I’ve had a good service, I love to give them person a review.

Realize that is part of what we do in society now with the way we have online platforms. Give yourself a chance for that. The American Acupuncture Council, myself, we’re here for you. Network members, you’ve ever run into this, please contact me. Let’s do a one-on-one Zoom. If you’re not a member, think about it, because we’re really gonna be able to help you.

But wholeheartedly, we want to make sure you’re successful. Your practice is always gonna have challenges. We’re here to meet those challenges. Until next time, my friends.

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…talk about what type of practice protocols do we need to have when we’re navigating a challenging economy, because our patients are navigating it.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello to my acupuncture friends and family. This is Sam Collins, the coding and billing expert for acupuncture and for you. Obviously, the American Acupuncture Council is always a resource for you as the American Acupuncture Council Network. Network members spay pay special attention, if you will.

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Let’s get into what’s going on in our world right now. Let’s go to the slides and talk about what type of practice protocols do we need to have when we’re navigating a challenging economy, because our patients are navigating it. We hear on the news every day, gas prices, grocery prices, everything. So we’re gonna be challenged now for that discretionary income.

When I say that, it’s for patients coming in, let’s face it, when they think of acupuncture, what are they really thinking about? When an economy tightens, an acupuncture practice that depends on cash pay patients needs to make some pivots. You need to make adjustments because shifting from a visit-based revenue to a value-based revenue is what you’re going to look to.

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And what I mean by that is shifting from something that’s value. Understand needs versus wants. This is something I’ll give credit to my mother, taught me when I was very young. People will buy what they want and beg for what they need. Think of how often you’ve had a friend that comes to you to borrow money to pay a bill, yet you notice they have on new shoes or they went out to a concert.

That’s, they wanted that concert, but they need to get their bill paid. I wanna put our category of care more to a want, the patient’s seeking it out, not creating that, “Oh, I need it.” ‘Cause I don’t think people often are gonna feel that need in the ways that we think it is. So keep in mind, though, discounting alone is a weak lever.

It really just compresses margin. You just, you make it cheaper, great, but it makes it more commoditized. I want a practice that focuses on doing things well, and these things are gonna be retaining a patient, repackaging and differentiating what you are that are different from others. Where do I get these?

Realize that often when you think of going out and marketing just to the public, that may not work as well. I start first with where’s the return on investment? It’s with existing patients. Think of retention first. Think of all these patients that have seen you over the years that are familiar with what you do, but they’ve just forgotten.

Acquiring new cash patients gets harder and more expensive in a downturn because where’s your marketing? I had a friend this week that said he was trying to post a job on Indeed and he wasn’t getting results. It just kept getting more and more costs from Indeed. So he had to think of what’s the return on investment.

The return is gonna come from your existing base. That’s gonna be your most reliable stream. Identify your patients. Reactivate who’s already there. Send them out emails, maybe a phone call, maybe a text message, and look for patients that have not been in for maybe 60 to 180 days. You could certainly go longer, but I would start there.

Think of the number of people who are familiar with that go, “Oh, yeah.” Make sure you use it as condition specific. Don’t just say, “Hey, come back in, get some acupuncture.” Get specific to your patient. Go into and get each one. Don’t send a blanket. Ask them how their low back pain is holding up, how maybe they’re dealing with home and work.

How about stress, anxiety? Realize acupuncture helps a great deal there. Patients often forget those changes. What about someone with headaches or how about athletes? A lot of athletes are realizing now recovery and their ability to participate in their sport comes to how well their body can maintain function.

So focus in on these types, whether it’s high school, club, or otherwise. There’s often a lot of help that you’re giving that I think sometimes we’re missing out on. Keep in mind, every professional team has an acupuncturist. Why aren’t you getting some of those patients, not necessarily maybe the professionals, but the other athletes who look up to them?

Now, I’m gonna suggest, though, outcomes. The beauty of acupuncture is its ability to work. Now, obviously, if someone comes in and they’re in a lot of pain, what is acupuncture going to do? Reduce the pain. I like that. But is that all they’re coming for? I don’t think so. This is why you wanna use simple outcome tools, whether it’s the Oswestry Dis- Disability Index, neck disability, or the PROMIS pain scales, or general pain ind- pain index.

I wanted you to in- demonstrate improvement trends, not just a reduction of pain. If all you’re looking for is to get rid of pain, that may go on a visit or two, they’re gonna think, “I don’t need anymore.” I want to see the progress so that the patient now understands the value. The value of the service makes price less of an issue This is the want.

Define the care. You’re taking them from acute to corrective to functional. Notice this is not about just getting them to maintenance. I want you to avoid terms like maintenance or wellness. That is where people don’t see the need. I want it to be their ability to function and maintain their ability to their lifestyle.

Maybe you wanna start to change your pricing, but pricing is not a race to the bottom. It’s not so much changing a price to make it the cheapest, but making it more affordable. Realize if you go to purchase a car, you’ll notice they never really advertise the price of the car, ’cause if they told you the car was eighty thousand, you would never wanna buy it.

But if they tell you, “Oh, you can get this car for six hundred and fifty a month,” all of a sudden now it seems affordable. So this is where it comes to you. What about monthly debits? Maybe where they get two to four visits at a preferred rate. Maybe with that, they join this package, they’re gonna get some priorities, maybe priority scheduling, maybe same-day visits, or discounts on other things.

Maybe they get discounts on your herb programs. But focus on the access and continuity of the care, not that it’s cheap. Tie it to a specific diagnosis, condition, or a goal. Maybe you have lumbar pain and stabilization program. Maybe it’s a stress program. Maybe it’s a headache program. Any of those are fine, but it’s gotta be anchored to the value of an outcome, okay?

Not just the cost of the visit. I’m looking more to the outcome, and don’t tie the outcome only to pain, but their ability to maintain their lifestyle and function. Now realize prepaid packages could be a good start to this. Realize in every state you can do it. Some states like Montana and Florida do require that you put money into a trust account.

But for the most part, just keep it simply compliant that the patient understands what they’ve purchased. Maybe the single price is eighty dollars a visit or a hundred. But if you buy a package of ten, maybe it’s only sixty a visit or six hundred, but that’s six hundred paid up front. Make sure it’s a good financial understanding, meaning if the patient knows what they’ve pur-purchased, they sign a financial document.

Make sure there’s expectations from you as the provider, what you’re gonna give to the patient, but also to the patient, the expectations of the visits, the, continuity of care, what happens if they miss a visit and so forth. I would just say, “Okay, good. We’re gonna extend it.” But do make a plan.

Don’t just leave it open-ended ’cause realize to be compliant, there’s gotta be some type of refunds. Now, refunds would be if it’s unused, they get it back. But I would suggest just p-push it forward to a different plan. Make sure you’re making clinical differentiation. Again, not just pain, but conditions.

Maybe they work at a desk. Maybe they have a neck or back issue from that. Maybe they’re a runner. Maybe they’re, again, headaches, stress, sleep. You can name almost anything that you deal with. Think of the myriad of services that acupuncturists can help someone with. Start to tie it to that, not just the reduction of pain, but how those increase function.

Realize if I’m reducing a headache and the headache is gone the headache’s not there, but how does that tie into their sleep or to their lifestyle, their stress level, how they’re dealing with relationships? What about integrating some care? Pair your services with other things. Maybe you’re gonna pair it with some type of exercise program.

Maybe you pair it with some massage. Maybe you pair it with stretching. But think of the myriad of things. It could be yoga, tai chi, qigong. Think of all the places you could go with this for a patient to go, they’re gonna come in and get this 30-minute visit, then they’re gonna get maybe some guided exercise or an ability to just have a p- a space in your office to do it, even if you’re not one-on-one with them.

Bottom line, though, is give me some outcomes and objectives. Give them something they can measure and see, not just, “I feel better,” but there’s things they can do that where they’re better. Expand your cash-friendly services. What about setting up a community acupuncture? Think of this is why the j- not the joint, but modern acupuncture.

Realize modern acupuncture is struggling. I’ve seen a lot of them close because I think more and more offices like ours are beginning to integrate that in that you can offer that style. But what about adding to it? Again, soft tissue programs, guided exercise, or how about short tune-up care plans?

Something that, okay, this is a three-visit care plan or a four-visit, but make it something that’s accessible. What I would avoid is across-the-board discounts, okay? That’s the death knell, because you’re gonna attract price shoppers. Someone’s gonna go, “Who’s the cheapest today?” That’s not the type I want.

Remember, you’re not a 99-cent store. You’re a doctor. When I pick a doctor, I’m picking a doctor because they’re good. Now, it’s gotta be affordable and reasonable, but I’m gonna pick you because of what you’re offering, that outcome. So make sure that you’re giving them function and necessity, not wellness.

Make an emphasis towards how your care gives them an ability to work, sleep, daily function, athletic function, and recovery. If you wanna get a good place to get patients, join a gym. Get in there and work out. Dress nice. But the more people learn that you’re an acupuncturist, trust me, you’re gonna get people that wanna come to your services.

Realize people who go to the gym generally have higher than average incomes if they have a gym membership. They may even have decent insurance. Realize this doesn’t negate using some insurance, but this means we’ve gotta pivot for these types of patients. Bottom line is your proof. Measure the outcomes.

Now, what I say about bottom line is not the proof of the patient, your outcomes. When you make these changes, anything you do, whether it’s taking insurance, not taking insurance, doing packages- Track your visit averages. Track your revenue per visit. What’s the retention rate? Did this really work? You’ve gotta have a metric.

Think of it, it’s like going onto Shark Tank a little bit. You have to go on and say, “Did this work?” And if it doesn’t, that’s okay. We pivot and adapt. Realize a practice is always changing. This is why we call it a practice. It’s not a perfect. You wanna start to learn what to works. What does your community look for?

What are your goals? Your goals are what my goals are. You have a good, successful, fun practice. Acupuncture works well, but often people don’t understand it because they’re tied to the pain model. Let’s get them going beyond that. The American Acupuncture Council is always your support. My network is the big support.

If you’re a network member with me, reach out. Let’s get into some details here. Let’s do a one-on-one Zoom. Let’s spend some time together. If you’re not a network member, take a look here. This is something we’re really here to help you. Our goal, make your practices successful because without you, I lack success as well.

Until next time, my friends.

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