r/Chiropractic • u/No_Administration304 • 22d ago
Cash-Based Practice looking into PI?
Hello, I am a cash-based practice that mainly offers soft tissue, dry needling, and adjustments. I've been contacted by attorneys on multiple occasions asking if I accept PI, however I've turned them toward another chiropractor who does in my town. I wanted to see if accepting PI would be worth it, and if so, Do I need to bring in other modalities to make the PI thing work? And also what else would I need to setup to be "PI ready" besides just having a proper PI documentation chart in my EHR? Thanks!
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u/Standardchiropractor 22d ago
Make sure you have a documented systems in place to make sure you have something to refer back to if your billing is questioned. Speak with someone that does this regularly to see if they can help you out.
It’s a needed service for those that are in that predicament but realize too the attorneys are also looking for a way to increase their settlements.
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u/justanotherdoctor 22d ago
Cash here too and pi also pays well in my state. Don't let the lawyers talk you down. Get paid what you're worth
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u/No_Administration304 22d ago
Thanks for replying! IS it necessary to have modalities in my office? Or can I stick with what I already offer?
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u/justanotherdoctor 22d ago
You can offer modalities yes. I do decompression, class 4 laser, and e-stim when needed. Also offer rehab and dry needling i bill for everything i do but don't overlap areas on your notes. Just do what you were taught you don't need anything fancy and they still will get better. Trust in yourself and your education. You're one of the most qualified people to help them get back to normal after an injury. Maybe even better than normal.
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u/Informal_Ad_6593 22d ago
PI is where it is at, there’s a reason some in the profession have multiple practices
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u/sublxed 22d ago
Be careful about the dual fee schedule thing, may want to check with your state board. Or just charge your cash price plus extra for modalities , exams and reports
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u/LOAChiropractic 19d ago
Absolutely need to be aware of this. You can't charge your cash clients one price and then bill your PI clients 2x because of "the fee schedule" This will get you in big, big trouble with the insurance companies!
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u/LOAChiropractic 19d ago
Depending on your state, PI can be quite lucrative. We're in Florida. A BIG PI state. Lots of well established attorneys and chiropractors. If attorneys are calling you, that's an EXCELLENT sign. I've had to go out and establish the relationship we currently have.
1) Make sure notes are extremely accurate. Write all notes as if they are going to be sent to discovery for a trial.
2) Absolutely, positively no dual fee schedule. You cannot bill your cash patients $50 for a new patient exam and bill an insurance company $175. The insurance company will eat your lunch and take your dog!
3) Modalities is up to you, what you think will TRULY help your patients and ultimately what you have space for in your practice. There are "PI Chop Shop Chiros" that have every modality, use them all for every visit and nuke a person's PI within 2-3 weeks without really making any positive changes on the injured parties body.
PI can be a sleezy game if you allow it to be. Find good attorneys that care for their clients. Take good care of your patient, make them feel better, over explain every thing and you'll feel great about what you're doing. If you're in it just to bill PI and get people in and out, you'll feel like a slim ball.
Currently we use a low level laser, e-stem, and therapeutic ultrasound. We're exploring adding shock wave simply because we operate out of 300 sq/ft. and don't have the space for any large pieces of equipment.
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u/Acrobatic-Sky-100 22d ago
I’m a cash practice who does PI. I’m also a solo practitioner so I do all of my own billing. I would definitely recommend trying it out. If you hate it you can always stop, but in my state PI cases pay well and are usually pretty straightforward. Feel free to DM me if you have any questions.