New and need help - Chiro office

[carbefangirl]

Hi gang,I spent yesterday reading and looking thru a lot of the posts and this board has a lot of helpful people.I have a situation that I need some other brains to help me with, so here is some background.Current Situation:I rent space 2 - half days a week and am slowly building a clientel, so this is something I plan to stick with and not give up.  Now:I have been offered a MT postion in my Chiropractor's office, for whom I have been seeing a few of his clients that he has reffered to me in the past and I help him out by doing Chair Massage at his Patient Appreciation Days.Here's the offer:  He hires me as an employee, I supply the table, lotions, linens etc to start (he has indicated that he could probably supply linens and lotions in future if necessary).  He plans to have every new patient come in for a 15 min free massage, so they can meet me and hopefully become my client.  He also plans to have some patients have MT as a part of their treatment in his office and he will bill the insurance company.  His office will set up my appointments and I will only be working 6-9 hours a week to start (more  my choice because of lack of daycare for my son).  Here's the kicker he wants to pay me only 40% of the massages, he gets 60%.  This seems really low to me, what do you guys think?  I think 50% is as low as I would be willing to go, but I don't know what the split should be in a situation like this.I know spa's pay at least 50% and they supply everything.He is not interested in me paying rent, because he does not feel there is any motivation for him to send me clients and do the insurance billing.HELP!!!!  Thanks in advance!Kim

 

[Will]

New and need help - Chiro office

I don't have any experience in a chiro's office, but I would like to point out one thing. If each of his new patients gets a 15 minute professional massage for free, it sounds like you will be building HIS practice, for free. (Right? 40% of nothing is nothing?) Assuming they remain his patients, and insurance covers their massage, they probably will not become your direct clients. Personally, I think he should pay you something for the free massages. It really adds value to the treatment he is offering.Best of luck!

 

[Anony Moose]

You getting 40% or even 50% is WAY to Low!!!  If you charge 40/hr massageyou only get $16.00 and HE gets $24.00 for doing nothing. Even at 50% the Chiro should be supplying your linnens and oils.  I have never worked in a Chiro office but when I did work in a Salon I got 60%.  I supplied my linnens an oil my own client intake forms etc.  I feel that him saying: He is not interested in me paying rent, because he does not feel there is any motivation for him to send me clients and do the insurance billing.  Is just an excuse to get you to agree with his terms.  I dont mean to sound harsh but I dont want you to get  "worked over" pun intended )  I think it could be a great way for you to build up a clientell.  Its just that a lot of red flags went off in my minde when reading that.Also I do think that an introductory idea is good BUT instead of doing it for free try 15/min for 15$ or somthing along those lines.  I would also sugest writing a list of what you want, what you will take and what you wonte.  AND STICK TO IT!!!  That is somthing I have learned very recently.  Agian I think its awesom that you got this offer, but it just needs a little tweeking so it is more in your favor.Good Luck!!!

 

[Shay ley ley]

kstan011Insurance is billed in 15 minute increments (for example you can do 4 ice packs in an hour because you can bill that cpu code once every 15 minutes.) You need to find out if he is paying you 40% of what he is getting from insurance, because they pay way more than say $40 an hour. This is important, because if he is paying you 40% of a going rate for massage while billing insurance you are getting ripped off.  Be very clear on what you will be making. Ask him, 40% of what amount.

 

[Poon Tang]

THANKS!!!I appreciate all of your replies.I think we will be charging $60 for a one hour massage.  He did say that auto insurance pays a higher amount per massage so i would be making more on auto cases.  I will clairify with him that i will be getting a % of the insurance.  But I also plan to tell him today that I am not comfortable with the 60/40 spilt and see what he says.If anyone else has any other suggestions, please keep them coming!Thanks again!Kim

 

[Savvylee]

I currently work part-time for a Chiro and will soon be leaving.We have a 50/50% split and I am an IC. آ I supply everything, but the table, cd player, and room. آ They make my appointments(which they mess up all the time) and bill insurance.I have a background with insurance(so I understand the paperwork) and have seen the insurance explanations. آ My rate is $60hr and $30 half-hour at the office. آ He bills $75 to the insurance and receives about $60 or less. آ With a lot of clients he receives nothing. آ They are not very good with collections and lose a lot of money by not making the patient/client responsible for co-pays and deductibles. Auto accidents he bills the same as regular insurance, but jacks up the chiro costs that he bills. آ He usually gets paid for these, but has also lost big too.  He is not very ethical with his billing practices and I have a lot of issues with that tour verbal agreement was 50% of the charge. آ I do not get paid more when he gets paid more and I do not pay him back if he doesn't get paid. آ Which I shouldn't have to.40% is way too low. آ So is 50%. آ By getting a massage, the client is not adding any real additional work for anyone in the office. آ The insurance bills would be going out anyway and the appointments would be made for the adjustments.I have been taking advaneforum.xxxe of my hours and steady pay there to build up my home-based practice. آ I will soon be able to leave that office. آ Asking for a higher % is useless as he would rather I raise my rates(so he can too)I don't think that this situation you are talking about would be the best. آ I think that you deserve much better. آ I too get a bad feeling about it from your post.Best Wishes!

 

[Rick420~57]

New and need help - Chiro office

I'm currently working as an employee at a chiro. office. I do massage for him (15 min incriments) 1 morning per/week and chiro. assistant/reception 3 afternoons per/week. My situation is very different from yours, but I'm offering it up just so that you can see how tricky working as a MT in a chiro office can be.I'm paid $12.00 hourly. Aaaagghhh...You say! And, some days I say the same thing. I seems like such a small amount for the service I offer. But, it is a double edged sword... He pays my taxes and books clients. I recently attended a chiro convention which he paid for and I got 6 CEU's from.He bills massage only sometimes, since most insurance won't even cover it. It's billed in 15 min. incr. for ( I think) $55-$60. But, it can only be billed to pst. that do not recieve chiro. manipulation at the same apt. He can only bill for manip. or massage. He currently doesn't have the space to over massage only visits. So, for now no msge re-imbursment.Your doctor may say that auto ins. pays more for massage, but legally he can not charge more to PIP cases than others. It's more likely that PIP cases will actually re-imburse for massage whereas most ins. will not.I don't use linens at his office and only small amounts of massage lotion. Our pst. where shorts and a "smock" like thing that closes in the back. Most of my work is deep tissue so the lotion is used very sparingly if at all. I do 15 min. "warm-up" massages on the area that he'll be working on.Like I said, I have struggled with the pay issue, but I have settled my thoughts and decided that I am benefiting. I see the doctor do a lot of manipulations and soft tissue work. He's very good at explaining to me what he's doing a lot of the times. He has clinical discusions with me regularly and is becoming very good at recomending my massage outside of his office. It was a slow start for me in getting the referals, but it is starting to pay off. The clients that I see from his office are very interested in maintining there health. It can be tough for some since their insurance will cover chiro. and they have to pay full price at my space.Just another point of view. I hope it helps you. I had never even been into a chiro. office before I began working for him, so I had no idea of what I was getting into. It has been a learning experience and I have met a lot of influential people from around town. Some situations may not apear to be financially lucrative at first glance, but you may have to alter your perception a little to see it for what it really is. Good luck!

 

[Joe Finkle]

New and need help - Chiro office

Graci, do you also get benefits like health insurance or free chiro???? You are right your situation sounds like it works for you.

 

[Raynah]

I get free chiro  ...  No health  :'(...About a month ago I re-injured an old knee injury (torn ACL-surgery 3 yrs ago). As soon as it happened I called the chiro and he had me in his office within the hour. He was wonderfull at getting me back on my feet quickly. I still may have to have surgery but, I can't afford the MRI w/out ins.Anytime he sees me stretching my back or rubbing my aching low back he gets me into a room and does a manip. Yeah...some days it's a good thing!

 

[aishahj1110]

Do you have 2 tables or are you hauling one back and forth?   From what I've seen (may be different elsewhere), chiros usually supply the table.  If you are hauling, you may want to consider the effects of that on your body and the extra time it takes to set up. Are you getting a decent wage/hr. for all your time? Are you getting a 15 minute break b/t clients? Good luck and smarts. Keep us posted please.

 

[Khushbakht]

Hi Thanks again, lots of good things for me to consider.I will be going in to the office in about an hour, so I will bring up the  % split then.  I am curious to see/hear his response.As employee he would be taking taxes out for me, which is one very nice thing that i would not have to worry about.  But someone mentioned not knowing how much insurance will pay or who is paying with insurance, so this is a good question for him.I do beleive he is fair and we are friends now, after working with him and seeing him for adjustments on a regular basis.  But I need this to work for me not just him.  He thinks he can have me fully booked most of the time, so he sees that as a benefit to me - building my practice.  BUT if they are his patients and are only going to see me in his office if insurance is paying, that is not really building my practice at all if i choose to leave.Thanks again everyone, I will keep you posted!!  

 

[Trenton]

New and need help - Chiro office

This is what I see as the ideal for the Chiropractor to do: Offering clients a first-time discounted FULL-Body Session at 1/2 the price and you get to keep the money for "building" HIS practice...Hosting a "Client Appreciation/Meet & Greet" where he has a raffle and gives away a Free Session (or coupons for 1/2 off etc.) with you (which he pays you for) and paying you to give 10 minute Massages with a sign-up and pays you by the hour for your time to "build his business" during this party (the expenses which are a tax write off and boost client-retention and referrals!)...

 

[Ace271]

New and need help - Chiro office

BUT if they are his patients and are only going to see me in his office if insurance is paying, that is not really building my practice at all if i choose to leave.

BUT if they are his patients and are only going to see me in his office if insurance is paying, that is not really building my practice at all if i choose to leave.

This is the one thing that really stuck out to me. If you're massaging his clients on insurance only, and you don't even get experience in billing the insurance, it won't be building your clientelle at all. The client is going to go to the same office and see the next therapist that walks through the door after you leave. Even with the 40/60 split, as Pete said, the chiro is filling your appointments for you, which some of us would gladly take. I would have no trouble working for a 40/60 split if I didn't have to do any advertising, started out with full books, and things were billed on insurance (which we still don't know, is it a perceneforum.xxxe of what the chiro earns? or is it a perceneforum.xxxe of a set price you two are discussing?), having a receptionist available, etc. Basically all you have to do is show up to work, then see how he advertises, find out how to bill insurance, develope a relationship with the clients you see, then move out of there. You won't want to be working there forever, but for the time being, a little extra income and the experience you will earn never hurts!

 

[Lea Lea]

I've worked for a chiro for 2 and a half years.  I love the setting, but the pay isn't great.  Here's what I've learned:1.  Sometimes insurance doesn't pay.  If you're making a perceneforum.xxxe, that means you get nothing.  Go with a regular hourly.  If the claim is denied, you still get paid.  On the other hand, if he bills a code that pays more (say you're making $30 hourly, but he gets paid $72 on the claim) then he gets to keep a little more.2.  Chiro's like to use massage for marketing, but they play down the benefits or treat massage as a luxury rather than a therapeutic treatment.  Many chiro's can't tell you why massage is beneficial or what a therapist actually does.  (Neither of mine can.)3.  They seem to think a massage therapist can work long shifts with back to back massages.  They'll book 9 hours back to back and expect you to be happy because you're making good money.4.  You need to make at least 40% of the standard hour massage rate.  If you're supplying linens, table, oils, etc he needs to pay you more. 5.  Ask him to include your services in his marketing materials.  He should be more than happy to do that because it's good for his business too.6.  Somebody else mentioned unorganized billing practices - not always collecting co-pays and deductibles, not following up on denied claims, etc.  This happens frequently.  It's his job to collect.  Make sure you are appropriatly compensated for your time.7.  And...don't give away those 15 minute massages.  People don't value free things anyway.  You'll get a lot of no-shows.  Ask him to make it 30-minute sessions and charge a low first time rate.  $25 maybe.Make your expectations known from the beginning, and don't underestimate your worth.  This is a great opportunity for the chiro too - if he has the space, it should be utilized!Good Luck,Katykangaroo

 

[DeweyWatermelon]

I have a pretty good situation in a chiro's office. I pay rent and $3 per set of sheets for laundry service. The room is nicely furnished with a table, rocks, everything. I provide my own lotions and forms. The DC's office manager has copies of all my forms so she can give them to a new client if I'm not there. I get a file cabinet and some drawers to store personal items and office supplies. The room is a separate office just a couple doors down from the DC's, so I have the presence of a separate business, yet conveniently located. The chiro's office manager is also his wife, who is also a MT. I share the room with her. I do my own practice-building and insurance billing. They do some scheduling for me. We also have shared on some marketing costs. They have been invaluable to me in learning how to market and  bill insurance and since we share many of the same clients, it's easier. I get a printed referral with diagnosis codes, claim number and number of treatments authorized for insurance clients, they usually even give me two copies...one for billing and the other for my records. Plus when ins companies balk at payment, I have a tought nut at my side as to how to deal with them. I am building my own practice, but the referrals from this DC have been what has kept me alive so far financially. I have referred a few clients to him (who weren't already clients of his)...but he has referred far more to me.They are really good people and I feel lucky to work with them. I feel fortunate because this DC has more respect for the real value of MT than many.If you get the sense that your DC doesn't really value massage as a true form of healing, I wouldn't waste my time. Find a DC who does. I truly believe that those acute injury clients of mine who are also receiving chiropractic treatment generally heal faster. People usually like to [glow=green,2,300]heal[/glow]fast!