Common Misconceptions & Mistakes about CashPT | CashPT Lunch Hour #1

Hello, this is Dr. Aaron LeBauer with Labour Consulting. It's time for the Cash PT lunch hour. Oh, good. Awesome. I see there are a handful of people here. Hi, how's it going? Happy Wednesday. If you can see, there's a chat box to your right. Everyone, please let me know if you can hear me and that you're here and where you're. Where you're listening in from. That would be awesome. And we'll just get started in a few moments. I'm going to wait for everyone to get into the room. Awesome. I see that. Eileen Teer, Mary Ellen, Marcia, Cheryl, Carmen, Dan, Brenda, Kevin, Miriam, Susie, Taylor, Victoria and Elise. How are you guys doing today? Thank you for joining me. So I already had my lunch. I'm not gonna eat lunch while I present, but hopefully you guys found some time during your day and maybe it's lunchtime where you are, maybe not. In a few moments, we're. What I'm going to do is start a presentation and we'll do a little bit of presentation at the end. I'll come back on and we'll do a question and answer. There's a chat box to the right where you can ask questions. Awesome, thanks. Yeah. Okay, thanks, Cheryl. Thanks, Brenda. You can ask questions in the chat box and I'll try to get to them at the end. Or you can hold your questions or write them down and wait to the end. And there's a little bit of a delay between when you write in the chat box and when I see it. And that's part of the live broadcast. And remember, we are live, so if you have any technical difficulties, something freezes up, try to reload or refresh your browser, come back in. You'll be able to come right back into the room and there'll be a replay that'll get sent out to you so that you don't miss anything. All right, thanks, Cheryl, Kevin, Victoria. All right, great. Thanks. Awesome. Okay, let's see. I'm gonna wait a few more minutes to see if everyone else comes in and then we'll get started. All right. I'm really. I'm super excited to start this Cash PT lunch hour. It came to me this winter. I was chatting with a couple other people, and I wanted to put together some kind of live video presentation where it's interactive and I can also have a recording that's saved for everyone. And this just kind of came to me, and I'm really, really excited to be here. Hey, Mary Ellen. Thank you. All right. Okay. Awesome. Well, I'm going to go ahead and get started in just a moment. Remember, there's a little delay, but if you have any questions, you can enter it in the chat box to the right. If something happens and your screen goes out, try refreshing your browser. This is a live Google hangout and so we're subject to all the things that might happen during a live presentation. Awesome. I see people from all over the country. Boston, Pennsylvania, Minneapolis, Minnesota. I'm in North Carolina, in Greensboro. I'm really stoked to be here. So. All right, this is what I'm going to do is I'm going to go ahead and get started and if you're popping in, just follow along. Oh, there's Mariah from Colorado. This is great. And Dan from Tessie. Dan from Boston. Okay. Yeah, I'm getting a little delay, but okay, cool. All right. So thank you for being here. And this is the Cash PT Lunch hour. You know, it's lunchtime get together. My name is Aaron LeBauer I'm a physical therapist and massage therapist in Greensboro, North Carolina. And my blog is labour consulting.com and it's also my consulting practice. Just for being here today, I'm going to give you a book I wrote on blogging for your therapy practice. So stick around until the end and I'll make sure we get that to you. And this is a book that talks about the importance of maintaining an online presence even if you're not a business owner. Just as a therapist. And blogging and websites are a great way to reach your patients, interact with patients and your family, friends and those around you to help educate them even if they aren't your patients. A blog is a great way to start to develop your presence and social media presence as well as your authority. So this book goes through why and how to create one and how to start one from scratch. And it's a way to take a blog and you can also in the future repurpose it or build it out into a website. So a little bit about me. My practice is labour physical therapy and I'm in Greensboro, North Carolina. I have a 100% cash based physical therapy practice and I started my practice directly after graduating from Elon University's Doctor of Physical Therapy program. We graduated in December and I took my, I took my board exam review class and as soon as that was over I started working on establishing my practice and one of the things I had to do is wait for the board exam results to come back. But by March 1st I was practicing as a physical therapist so it took about six weeks so halfway in between, in February, I got all my results, got all my ducks in a row and I think it was in February. But by March I was practicing as a physical therapist. I've never worked for another clinic as a physical therapist, as an employee or contractor. So a lot of people said it couldn't be done. Oh, you're crazy. You can't do this. The cash based practice can't exist, much less you haven't worked anywhere else. So I'm here, it's been almost six years and I'm really excited to share my experiences with you. What I provide are one on one treatments using hands on manual therapy, myofascial release, soft tissue mobilization education, pain education, exercise. We don't do anything in my clinic during that one hour that the patient can do at home on their own. I teach them what to do and then they will do it at home. And I see one patient per hour and my typical patient comes in once a week for five to eight visits, sometimes more and sometimes less. It just depends. But a lot of people are really motivated in this model to do their work every day. And patients will spend a half hour to an hour or two hours a day doing the things that I've recommended they work on at home. And it's pretty amazing. So in our chat today, what I'm going to talk about are the three most common misconceptions about the cash based therapy model. Then I'm going to address the number one mistake most cash based physical therapists make when starting out. And it's a mistake that I made as well. And then what I want to do is introduce to you the Cash PT Blueprint which is my brand new online training course. I'll spend a little bit of time with that, but I created it because I've made mistakes and, and I want to share with everyone what's worked for me and make it easy and step by step. And we'll go into that in a few minutes and then we'll have time at the end for questions. So the three most common misconceptions about cash based therapy, number one, only wealthy people can afford to go see a cash based physical therapist. Number two, it costs a lot of money to start a private practice. And number three, my town is too small for a cash based physical therapy practice. The other way to say this is a cash based physical therapy practice only works in a big city. The number one, only the wealthy can afford to pay cash for physical therapy. I'm going to say, you know, that's, that's False. In my experience, there are a lot of people on the upper edge of wealth, you know, in the top, you know, few percent who have such pay so much every month for their health insurance. There's no reason they would go outside of it and use it. They've got great insurance. And number two on the lower end, it's not about what people earn, it's about what people value. In my practice I have people come who are certainly wealthy and I have people come who certainly have good jobs. The common denominator between everyone who I see is that they value what I provide. Your patients in a cash based therapy practice are people who value high quality service. They value the one on one care, the amount of time you spend, the fact that you can listen to them, you know, they value the hands on care. They've been somewhere and been seen by a therapist for 10 minutes and then attacked for, you know, 20, 30 or more, going a few days a week. And you know, a lot of my peers say I was there and I could do that stuff at home. You know, it's. And that's not necessarily the therapist's fault in that, in the insurance based model, but and it certainly works for people. What I'm saying is the people that come to a cash based therapy practice are people that value the fact that we are experts and knowledgeable about pain and dysfunction in the musculoskeletal system and that we have time to spend with them when maybe their physician only has five to 10 minutes and the patient wasn't even able to tell the physician their whole story and they can do that with us. So these are people that want hands on manual physical therapy, myofascial release, soft tissue mobilization, etc. They want skilled hands on care. And I can't say how valuable that knowledge and skill has been for me as a clinician to help patients feel better, have less pain, to provide valuable service, to be able to put my hands on someone and have them say, oh my gosh, that's exactly where I hurt. You're the first person who's touched me there. You know, you're the first person who has been able to reproduce my pain. And now I know that it's not just in my head. You know, these patients in a cash based therapy practice value your expertise and time. They, they understand that what we have is worth their money in exchange for their money. They want to be able to tell their story. You go to the physician and we have to wait a couple weeks to get in 20, 30 minutes to see the physician. And then when you're there, you only get like 15 minutes. And maybe you've got, you know, three or four things going on. How are you going to tell your physician everything that's going on unless they actually have 30 minutes or more to spend with you? Sometimes in my practice, we'll spend the first 10, 15 minutes just talking. And sometimes the evaluation. It's really hard for me to move on because this person I can tell they haven't been able to tell a clinician, a healthcare worker, someone of knowledge about their full problem. And that is one of the most valuable things that we can provide as physical therapists. Okay, number two, the number two misconception that I hear a lot is that it costs a lot of money to start a private practice. It really doesn't cost a lot of money to start a private practice. If you want to have a ton of equipment, 3,000 square foot clinic bikes and the anti gravity machine and all the modality equipment and things that cost thousands and thousands of dollars, it can cost a lot of money, but it doesn't have to. I spent almost less than $4,000 in my first month in business, and that included my APTA membership, which was like 500 bucks. My liability insurance, which was 500 bucks. My first month's rent and deposit, which is about six months, $600. And so there were already up to, you know, close to $2,000 plus licenses and fees. And so really a bulk of those items were really not even business expenses and ongoing business expenses. There are ways. I already owned a treatment table and I recommend getting the nice ones because they last the longest for 800 bucks. But there are ways to find really nice treatment tables for a couple hundred dollars or four hundred dollars online on Craigslist or ebay, or just through your local community of people. And we can also start by subletting space in someone else's office. Massage therapists probably only treat 16 to 25 hours a week. In an office that is available another 16 to 25 hours. And if someone's starting out doing one on one care, you can sublet a space during, during the time that it's already empty for much less than it would cost to rent that room or rent a bigger room and it's already furnished. Mobile technology makes a huge difference in creating a lean and low overhead practice. And that's what I've tried to build in my practice is as low overhead as possible to maximize my profit, but also minimize the amount of liability I have. I don't have to take out any loans I didn't have to have to pay anyone back. Number three, my town is too small for cash based physical therapy. No town is too small for cash based physical therapy. Cash PT works where people value it. The number one thing right now that's creating more value in cash based physical therapy are the changes in healthcare. My personal healthcare plan for next year is a $5,000 deductible. With I've got a family out of pocket maximum that's like 12,000. But that's not really the part of the point. But my physical therapy benefits are. I've got 30 visits for physical therapy and an $80 copay. So if I go somewhere as a patient twice a week, not even three times a week, but twice a week, I'm paying $160 out of pocket every week to go somewhere where I might not be spending the whole hour with a physical therapist. In a cash based practice, you can spend the whole hour with a therapist and pay less than general $160 an hour. So those changes right there are ripe for cash based physical therapy. But what it's doing, these changes are creating more consumers or better consumers out of the healthcare consumer out of the John Smith who has to get his own health care this year. He's becoming a better consumer of where his health care dollars go. Also, I heard even just this morning on or last night on npr, that Aetna, one of the things that they're. Is it Aetna insurance or one of these large insurance providers, they're raising their base hourly salary to $16 an hour and change, not because they need to, but because what they want to do is create more retention among their call center staff and the employees who are doing these more remedial jobs so that they're not dissatisfied and they stay because they want to create a better experience for the consumer so more people choose their networks. That's huge. That's just spelling out this huge change in the landscape of healthcare coming up. And so people are going to start to value what we as cash based physical therapists provide even more. Like I said, this is cash. PST is going to work where people have high deductibles and cash based physical therapy is going to work anywhere. You can offer a higher quality service for a better value. If you could take the same therapist and put him in a position where he sees one person an hour or one person for 15 minutes, the therapist's techniques aren't different. But can he provide a better service or better value? Of service in an hour, in 15 minutes. And I believe that you can as well. It's can I get my patients better, faster, because I'm seeing them for longer and can they miss less work? So there are people who value the amount of time that they don't have to miss their job and be out of work. So it's either the person that has to take the whole afternoon off to travel to your office or the person that doesn't have to reschedule a bunch of meetings this week because they have to be out three, three afternoons a week or three mornings. And there's a whole lot of other reasons that we can provide a higher quality service in network practice, can certainly provide a higher quality service. But the point is that a cash based practice can work anywhere, that you can provide a high quality service to a unique market, to the person that values what you provide. And a big part of that is educating the public and educating the people you come in contact with and educating your patients. Okay, the number one mistake that I made and the number one mistake that I hear and see people make and is marketing to doctors. And this is there's many levels here. And I'm not saying that having relationships with physicians is bad. What I'm talking about is marketing to doctors. Number one in that patients aren't ready to buy in a patient that goes to see their orthopedic specialist and they pay a $50 copay, or let's say they pay a $25 copay, that person is going to come see you now and they're going to pay three or four times as much. Patients aren't really ready to buy in for that. They're also expecting to use their insurance. I get a lot of calls from physician's offices. We want to schedule a patient. Well, I pretty much know right there that they're calling me based on my location, not based on a recommendation from the physician or even the patient's desire to come see me. And when I talk to the patients, they say, oh, you charge $100, I can't do that. You know, don't you take my insurance? And there's no convincing people when that's their expectation. So the patients aren't really ready to buy in. Patients buy in when they read about you. They learn about you as an expert and they understand from a friend, family member, a testimonial or an online review or your website or blog what you can do to help people and how you can help them. And then people are able to buy in and the buy in is big. In a cash based practice, patients have a lot of skin in the game and they're really compliant with their home exercise program suggestions that I make. The other reason marketing to doctors is a mistake is when we market to doctors and use the term doctor, we're creating in our own mindset, in our own expression of the term, a gradient. Okay, if I talk to patients and say, well, what did your doctor say you need to do? Or what do the docs think? I'm taking myself as a therapist and putting myself below the docs because I am Dr. Aaron Labourer and if I'm Dr. Labour and I talk about the doctor, well shouldn't I be talking about myself or should I be talking about the orthopedic surgeon or the internist? So I feel like the best thing to do is to use the term physician when speaking about a patient's physician. Because what that does is that keeps us on the same gradient. There is no gradient. We're on the level playing field. Because I am a primary care physical therapist in a cash based practice, we need to have that mindset. And because that's how we're going to reach patients, patients come to see us directly. So physician, physician, physician is choosing the words and language that we use and how does that land on our patients? And so in that is, I feel like a mistake. And I also, I tried it, I tried marketing to physicians and I just hit a bunch of brick walls because I said, you know, I'm not going to bring lunch for 40 people just to have an opportunity to meet with you and say hello and find out who you like to treat, etc. I feel like that's something that Merck and Pfizer can do, but that's not something that Aaron Labourer is going to do. What we have to do is create this primary care physical therapist mentality. This is the mentality of I am the person that a patient can see directly, that the patient can see first and if their problem's not a musculoskeletal problem, I know who to send them to and I can send them back to their physician for further medical workup, or I can send them to massage therapist or personal trainer or over to yoga or do they need to go see the vascular specialist, et cetera. We can be primary care physical therapists. And when we have that mentality that sets us up to have a successful cash based practice because that's really what is necessary. Patients don't come from physicians and they may for some people who've had these relationships prior. But then there's always the danger that the physician group gets purchased by the hospital and the hospital says you have to refer within the hospital system and goodbye referral sources. Right. So where do I market. If not to physicians? Newspapers, magazines, TV or radio? There's one more. Okay, newspaper, magazines, TV or radio. Well, what this is, this is like brand advertising. No, you can't spend $250 a week to get a quarter size ad in section C, page six of your newspaper. Who's going to see that? That's half of your rent for the month. That could be your rent for the month. Four times a week, that's $1,000 a month. That's a chunk of change. That's a ton of money. And yes, if you're going to do that type of advertising, you do need a lot of money. And if you are going to do that type of advertising, the best thing to do is to make sure you write an educational article that goes along with the ad at the same time. When I did that, it didn't convert as well as some of the other things that we'll talk about in a moment. But brand advertising is like what Coca Cola does. It is. Hi, we're Coca Cola, you love us, we're great. Hi, this is Johnson Physical therapy. We're great. We're your experts. That doesn't do anything to the patient, it doesn't tell the patient anything about you and it doesn't really ask the patient to participate. So what I propose and what is extremely successful for me and a lot of other therapists is direct to patient marketing or direct access marketing, using the Internet, marketing to your niche. So and creating referral partners and marketing in person. So by using the Internet we set ourselves up so that people can find us on Google, people can find us when they search for physical therapy in your town. Marketing to your niche is something like saying, I love riding bikes. I've been riding and racing bicycles for years. Let me start with the people that are at the bike shops who are doing bike fits. The guys doing bike fits a lot of times will say, if you've got a knee problem, I'm not going to change your bike to accommodate your knee problem. Until you go see a physical therapist or until you go see Aaron LeBauer or creating a. I practice yoga. And so we created a back care and power yoga workshop at one of the local yoga studios here. It's been a great place and great way to market and then creating referral partners. These are, these are Physicians, these are fitness professionals, yoga instructors, other physical therapists, people that you partner with to create relationships where you create win win relationships where each, you know, refer each to each other. It's an avenue that goes back and forth, not a one way street and marketing in person. One of the biggest referral partners that I have is myself. When people write down how did you hear about our practice? And they write down, I know you, Aaron LeBauer we're friends. Something that it's the people that I know in town, eventually when they know like and trust me or they know like and trust you, they're going to come to you when they have a need for physical therapy or they'll turn to you for advice first. And that's huge. So being out in your community, participating in religious, social, community organizations and events is an amazing place to market. All right, do you want to spend 30 to 90 minutes with each patient? Do you want to be able to treat just five to six patients per day? Spend more time with your family? Do you want to have no hassles from insurance companies? You don't have to wait 90 days to collect payment at 60% of the rate that they promised. Do you want to be paid on time and have more freedom in how you practice? So why the Cash PT blueprint? Why the Cash PT blueprint? Well, I've been over the last few years, I received a lot of the same questions and a lot of people have the same questions and fears and are asking about the things that I had problems with when I started. And what I did is I put together this program to help create an efficient way to get past all those mistakes that I made and start with the things that were successful for me. Start with the marketing and mindset and administrative tasks that have worked already and it's like a shortcut to practice. So the CashPT blueprint shows you step by step how to create, grow and market a cash based practice. It is an online training course and a community of therapists who can work together. There's premium video trainings with PDF and MP3 downloads and a step by step template on how to start your practice. One of the biggest things that I'm going to teach you is how to market your practice effectively. And these are marketing techniques that should work for everyone in network, out of network, cash based, traditional home based, et cetera. And there are also resources, handouts and worksheets available as downloads in the Cash PT blueprint. It includes six video training modules. There's a bonus module, a Facebook group that's A private Facebook group just for people in the online community. There's a monthly live Q and A that's very similar to this event that you're attending right now. I also have exclusive resources that are there just for people in the blueprint and I have a no questions asked money back guarantee. If within 30 days you're unsatisfied or it's not meeting your needs, just contact me and let me know. So how I successfully operate and market my practice is a big component of what we're going to learn. We're also going to discuss and dissect the mindset necessary to start a cash based practice. There's a training module that talks about my Blueprint for Success. We go over the steps you need to take to transition your current practice if you're in an in network practice. And importantly, we talk about when you can and cannot treat a Medicare patient in your practice and other compliance issues and how to market directly to patients who pay you cash for services. Then there's some bonuses when you join. There's my Cash PT toolkit which are all the forms and administrative documents that I use in my practice like SOAP notes, history forms, consent forms, Excel spreadsheets to estimate income, etc. There's the dominate the first page of Google Ebook on how to create a Google search listing that shows up your practice and the blogging for your therapy Practice Ebook is also included in the blueprint as well as the cash PT resource guide and an additional 40 minute video training on building value for patients and cash based models. Again, I want to stress the Facebook community is a great place to connect with other therapists and help each other and support each other along the way as we build and grow and create our dream practices and the live monthly Q and A. All your questions are answered in this and it's a great forum to participate in. And it's also posted on a separate page in the Blueprint so that you can see all the past months. So now that you've seen the Cash PT blueprint, let me break it down. Okay. There are over 6 hours of video trainings and let's say if you want to spend six hours of consulting at $197 per hour, that would be almost. That would be over $1100. You've got the live Q&A and they're $270 in bonuses for a total of like $1400. If you look at the lifetime value of one new patient as being about $800, so that's about five to eight visits plus anyone they refer to your practice. That's a great deal. Now we've also got this community support, the Facebook group. I think this is priceless. I mean there's so much possibility and potential in these online groups. Some people get together. There's so many things that I've already learned by participating in this myself. So all packaged together I've priced this at $497. But today, just because you're on this call, you can have lifetime access to the blueprint for $297. Remember, I've got a 30 day zero risk money back guarantee and the cash PD blueprint importantly is about creating community the the cash PT nation and creating the practice of your dreams and marketing directly to patients. So join because you have the gift of healing others. You have the power to transform lives because you are excited to practice in your own way and because you want a life of freedom and fulfillment. So my special offer to to you is the CashPT blueprint. You go there, you can go to the site cashptblueprint.com and use the code Lunch Hour in checkout to get your $297 price. So thank you for being here. The blogging for your therapy practice ebook is yours will include a link in a follow up email at the end of the presentation today as well. You can just go to labourconsulting.com freegift so I want to tell you about this next month. Join me. I will send out an email for the next one and I have a lot of different things planned. I've got the Cash PT lunch hour. We're going to do this again. We're even going to try a Cash PT Happy hour which will be at night. I'm going to talk about new topics and have interviews. So some of these lunch hours will just be interviews of other therapists or other people who have something to add value to marketing, to mindset, to showing and displaying the possibility of what is potentially available to each and every one of us. And we'll also include time for Q and A. Okay, so now what I want to do is answer some questions. And I see that there have already been a couple and so thank you very much. All right, so I see that. So type in your questions in the chat box. One of the ones that Brenda asked is I live in a state without open access to therapy. Every client must have a physician's referral. Yes, and that doesn't mean you need to turn patients away or market only to physicians. You can still have a successful Cash based practice in a state that does not have direct access officially, according to the apta, there is direct access to evaluation in every state. I'm not really sure what state you're in, or Indiana, it says so I'm not really sure what your specific laws are, but I would look at them again to see exactly what your limitations are. But the main thing you can do is market directly to patients. Patients call you and you can offer, if you can offer an evaluation and no treatment, great. Get them in for an evaluation, tell them what you can do, set them up with an appointment to see their physician, contact their office for a referral to be faxed over to you. Some states, if the patient has seen their physician or provider within a year, then that allows them to treat them. Or you might have 15 days, 30 days, 90 days. But what you're doing is you're creating and building a relationship with the patient so that when they do go see the physician and the physician says, oh, come to my practice, we can take care of you. The patient says, no, I want to go see Brenda. And the physician writes down referral to Brenda. Or the patient says, I've already got an appointment with Brenda next week, I need the referral today so that I can go see my appointment. Go to my appointment. All right, so the next question I see is from Susie. How did you find a reasonably priced space to rent? That's a great question. The number one thing to do is to survey your market. Look around Craigslist, a lot of the local real estate businesses have listings and see what prices go for. And go take a look at the spaces and see what size is the space, what is their, and you get a feel for it. And you also get a feel for is this place been available for a long time? Is the owner willing to negotiate? A big part of finding a reasonably priced rent is negotiation. And in negotiation, you always want the other person to set their price first. You want to ask them what's the best price that you can give me? Or what are the best terms that you have on this right now? And they may say, oh, well, it depends. You say, well, for instance, you know, tell me what you would tell me what you need to have to make this happen. And you really try to get them to set their price first. But as I mentioned earlier, one of the best things to do is find another therapist locally who has a space that's underutilized. So that might be a physical therapist. If you do a lot of manual therapy, you might find a massage therapist. Who has a clinic with a table already set up and all you have to do is walk in with your cell phone and some files and see your patients and treat them. And maybe you pay them $20 an app every time you treat a patient up until a certain point. And then you can start paying a monthly fee. That's a great way to start out. It's a way that I recommend doing it a lot. Okay, I'm reading some of the other questions. Okay. Brenda says, in Indiana, clients can come in for health and wellness. If they have any other diagnosis, they must have a prescription or a referral. Brenda, as I said before, great. You know, get them in or get them on the phone, get them contacting you first. And then you can let them schedule them and then let them know what steps they need to take next so that they can get in to see you. Okay. Marcia says, I'm in Florida and I specialize in hip and pelvis, including a large population of young athletes. Post op hip arthroscopy. How does it change the approach for my practice? And what I would say is it doesn't. It changes the approach in a way that you create a presence about you and your practice that you're the go to person for post op. And then, you know, someone contacts you and saying, oh, I need a hip surgery. You say, okay, great, let's get you in for some therapy or an evaluation. Okay, you actually probably do need surgery or you need more medical diagnosis or imaging. I want you to go see, you know, Dr. So and so the orthopedic physician who specializes in this problem and you have the patient go there, then you call their office and you say, I'm sending over my patient, little Johnny, and he's got this issue and it's something more than physical therapy can address right now. Please evaluate him and keep me in the loop. Send me his your evaluation notes or let me know what's going on. And you can call them and you can also send them a note that says, this is what I found. This is why it's not congruent with physical therapy. Please let me know what you find out. And hopefully what you'll do is start developing relationships with physicians that are two way streets where the patient goes there and it's not a black hole. The physician says, great, now that we've done this, go back and see Marcia. And so in that way, what you're creating is an avenue. And the other way to create avenues is not to go and ask for referrals, but to go Ask for what can I do to help you? What kind of patients do you like to treat? Who do you like to work with? I have a newsletter. Can I leave copies in your this educational newsletter. Can I leave copies in your waiting room so your patients can get some education on what a meniscus tear is or what arthritis is or what, etc. And then so in that way you're providing value. You can also offer to interview or post about the physician on your blog and give them publicity to your own patients and your own list. Okay. Okay. So Cheryl asks, my husband and I already run a small, high quality physical therapy practice. How do we change over to cash based all at once, weed out the worst payers first? Yes, you can go all at once. You know, I started all at once and in that way you might have a lot more of a drop off at first, but then the right patients, the patients you want will find you. The thing that I suggest is finding the lowest payers. Weed out the worst payers first. Like you said, anyone that's not paying you what it costs to provide treatment in your clinic. So the number one thing you need to know is what is the cost to provide treatment in your clinic? And when you know that, then you know if someone's, you know, worth keeping or not. If someone's coming in at $40 an hour and it costs you $41 an hour, then they're not paying the expenses. So those are the things. That's how you do it. First start there. Mariah asked, what's your insight on offering an out of pocket discounted rates as well as remaining in network with primary insurance to also capture families who will only seek out services if we bill insurance. Okay, discounted. So out of pocket discounted rates. I think you're talking about discounted rates while also being in network for out of pocket expenses. The number one thing you need to do is double check your insurance contracts to see if that's explicitly prohibited. And then. I'm trying to reading the rest of your question, see if I understand it correctly. And remaining in network with primary insurance to also capture families who only seek out services if we bill insurance. You know what the reality is that a cash based practice isn't for everyone. It's not for every family and it's not for every therapist. And if you find that you need to remain in network so that people come to your practice and you have the practice that you want and you have the cash flow that you want, then there's nothing wrong with that at all. Some people have a mix. They're out of network with some insurances and in network with others. You can be out of network and still provide the service of submitting that the insurance claim on behalf of your patients. And if you are in a traditional clinic, in network clinic, that's what you do. You submit the claim on their behalf. In my cash based practice, I don't file the claim on the patient's behalf. Some clinics that transition do because they already have that avenue and that pathway set up. Okay. Colby asks one of my questions is the feasibility of growing this type of business beyond myself as a sole practitioner? Yes, it's possible. There are definitely practices that have multi therapist cash based clinics. The main thing is, is that each therapist has to be able to provide that same level or similar level of service and value to the patients. But it's definitely possible. But they also have to be on board with marketing and with creating the mindset and creating a community and getting their own kind of following of patients. You can have that and brand your business and get the following from your business. But a lot of it is going to depend on the therapist as well. It can't be, I don't think it can be someone that just wants to punch in and punch out and be served up patients to treat all day long has to be someone who's really going to put in their time and effort. Okay. Susie asks if patients are cash based, can they use their FSA account? Yes, yes, yes. Patients can use their FSA card or their HSA card. And that's one of the biggest changes that's happened in the last year is I've seen a lot more HSA cards. In 2013, I saw a lot of FSA cards. So more people have health savings accounts. They can use their health savings account checks to reimburse themselves or pay you. They can use their cards through your reader. Okay. Kay says and I'm reading, gonna read this out for everyone who's watching the replay. She has a suggestion for limited access state providing to provide free PT screens. And she says she I made my own form for this. Give them a copy of the form to have signed by the physician at their visit. You can even fax it to the physician. If they fax it back with signature, then you have your referral. Exactly. And that's a big part of creating that physical therapy referral to medicine. Sometimes all you need is their signature or agreement with your plan of care. So you can create a form that says if you agree with my plan of care, Please sign here and please fax it back. And voila. Awesome suggestion. Kay, thank you very much. Okay, I think I got to everyone's questions. Are there any other, any other questions? I've got a great, I've got a great. I got a poll coming up. Do you currently work in or own a cash based therapy practice? See if you can answer the poll yes or no. It'd be really cool to know. And remember, if you're here today and you have any other questions, if you're not answered now, you can always find me@labouerconsulting.com check out some of my blog posts that may answer your questions. Send me an email infoebauerconsulting.com or even tweet at labourpt. I'm on Twitter and I'm happy to answer your questions. And the blueprint is for you today at a discounted price, $297. Use the discount code lunch hour at checkout. And it's all that discount code is not going to be available forever, but it'll be available for the next few days. So take your time. Let me know if you have any questions about that as well. All right. Okay. Let me see if there are any more questions. So if there are no more questions, thank you so much for being here today. I've really had a great time. I was really excited about being here. I hope you got a lot out of this. Join me again next month. I've got some great things planned. Tweet to Bowerpt if you have questions at the CashPT or CashPTlunch hour. Thank you so much for being here. I've really enjoyed it and have a great day. So thank you so much.