Reality Episode With Avi Zinn, PT – Bonus Programs, Dropping UHC, Front Office Guru, Etc.

In the latest of installment of Reality Podcasting with PT owners Avi Zinn of Druid Hills PT, Avi shares with us the challenges he faced in 2022 – stagnant growth and a DECREASE in average reimbursement rate. This caused him to look closely at his practice, assess the numbers and determine what he needed to address. The things he uncovered – a bonus program that didn’t account for the fact that the business was losing money, an $8 per visit decrease in average reimbursements, and a lack of structure at the front desk. By working those issues out he’s seeing a great uptick in production and profit thru 1st Quarter of 2023.

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We are coming back to meet with Avi Zinn . If you haven’t met Avi Zinn in the past, I have been following Avi as a relatively new clinic owner for years. It was in 2019 that we started catching up with Avi after he had opened his clinic and followed him over the course of the last few years. Avi has got unique stories, and I’d recommend you go back and read those episodes about what he had done, what he’s had to work around, and the challenges he had faced over the past few years. This time, we are catching up with him. It’s been months since we last spoke, Avi.

Yes. It is good to catch up. It is good to be back.

Thanks for joining me. Last time, we talked about how you utilized annual strategic planning to move your practice forward. That was a workshop that you and I did for a full day on how to attack the next year. This time around, we are going to catch up with you, see how 2022 went in general, and what you are looking forward to in the future. I will let you go ahead and start. Where do you want to start with this to bring everybody up to speed on what’s happened?

Talking about 2022 is a good way to bring anyone up to speed in terms of what happened with our business and our company. You came in early 2022 to do the strategic plan. Things were going pretty well at the beginning of the year. 2021 was a pretty good year as I was looking at numbers compared to 2022, which was the first year of the pandemic, so you can use those numbers however you want.

In ‘21, about 150% growth in terms of number of visits for the year compared to 2020. 2022 came along. We started off good. You came in. We did a strategic plan. There were a few challenges that started presenting throughout the rest of the year, which were certainly the more challenging obstacles that I had to figure out up to that point in business. As the year went on, it was interesting to figure out what was going on.

In the end, 2022 compared to 2021, we did not grow and we talked about this a little bit in the last interview that I had with you about our numbers being flat in terms of visits. We did have some growth in terms of foundational growth by bringing on our director and getting her going. Visits-wise, we only had about a 15% increase from 2021, so not much. In terms of revenue, it was only about a 3% increase.

We had a small increase in visits but a way lower increase in revenue. That was troubling. That’s where that second half of 2022 was me trying to figure out like, “We are not growing that much. We are growing, but our numbers in terms of what we are bringing in are way different than what I would have expected.” That’s where I had to do some deep dives to figure out what was going on.

That’s troubling for you because you have greater more capacity that you could have seen or maybe your profit numbers where you wanted them to be. What was the consternation about?

First off was the profit. If we were growing in numbers but our profits were decreasing or our profit margins were decreasing, that’s of concern. It was also part of coming off of 2021 where we had a big growth year. It was anticipating this growth and then it was me trying to be okay with different numbers than having projected.

If you are growing in numbers but your profit margins are decreasing, that's a concern.
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I was thinking we were going to have this huge increase. We had more space to bring more patients in, but we weren’t growing as much as we could. Also, it was more so in the decrease in our revenue. As it turns out, looking back, part of it was Medicare had reduced their reimbursement by 1%. That trickled down with a lot of the other insurances. In the end, it was about $8 less per visit that we were bringing in for 2022 compared to the previous year. That was the biggest thing. It took me a while to figure that out. That was the biggest reason why we were bringing in less.

That can be a huge impact on your clinic. That changes the whole dynamic of what you are able to do and the freedom that you have in which to give bonuses, hire people, have promotions, and all that type of stuff. Now you are restricted.

What you bring up about giving bonuses was the hardest part because we had started talking about this bonus structure and getting everyone going on it. In the end, the providers were hitting their numbers for how the bonus structure was laid out, but we weren’t bringing in enough money to pay out that bonus structure. It was hard because providers were doing what they were supposed to be doing, and then we had to come back together and be like, “These are the numbers that we all said. We are trying to figure it out, but something is not going in the way that we can support this bonus structure at this point.”

Do you mind if we go into the weeds about that a little bit? There are always people asking me about how to set up a bonus program, and there is no one way. There are an infinite number of ways that you can set up a bonus program. You can do it based on total visits. You can do it based on production. You can do it based on profits, even do profit sharing. There are a ton of ways you can do it. I have got two questions for you. The first is, what would you have done differently in setting up your bonus program?

I don’t know that I would have done it any differently. That’s not true because, at the time, it was working until it wasn’t. What I would have done differently is what we are doing now. The way it was set up was to start off, we are a one-on-one clinic. There are only so many visits a provider can see per week. There’s a max capacity.

You can’t say if you treat 60 patients, you get this bonus. We can only see so many. We had to design our bonus structure based on the utilization of their schedule. If you can see 50 patients, we need you to see 85% of those visits, whatever that comes out to 42 or something. That’s us breaking even. Once we are in that 90% and you are seeing 90% of your schedule full at the end of the week, then we are in a position to bonus you. There are other statistics that we are following as well. There is an arrival percentage.

It was based on the utilization rate. If you have 50 visits, if you hit 90% of those appointment slots and patient visits, then you get a bonus. There are also some other criteria that your arrival rate has to be so much. We had the same thing. You had to at least bill so many units per visit.

That was the third component as well. What we found out, and we will get to it as we talk a little bit more about my deep dive into the numbers of 2022 and how we got past it, is that even if you are billing 3.5% or whatever the build units on average per visit are, that doesn’t mean you are billing the best codes. Now what we are doing is we have a PT report card and now we have our clinic director humming along and getting our weekly or monthly check-ins with each provider and tracking a little bit more the specifics.

Not just an average skilled unit, but we talk about which are the better codes. If we are a one-on-one clinic, then we should be billing those higher codes such as therapeutic activity versus therapeutic exercise because we are not a clinic where you have three people at a time and you are working with a tech. You are working directly one-on-one. That would, a lot of times, constitute a therapeutic activity. It’s about choosing the better and more appropriate codes that our profession has for us, and if we don’t use them, they are going to pay us less.

It’s unfortunate because most PTs, if you talk to them, they are going to go straight to the TherEx and manual therapy.

Those are the two lowest-paying codes.

Of those two manual therapy pays less than therapeutic exercise.

Manual therapy is what everyone wants and you think that’s what you need to do hands-on.

You called it a report card. A friend of mine, Mark Moore, in Arizona, has what’s called the billing sheet. I wonder if it’s similar to yours in that he has at the top of an Excel spreadsheet all the main insurances that they see, and then on the left-hand side are all the CPT codes. It will show for each insurance that there are some insurances that won’t pay for manual therapy. The therapists need to know that you cannot bill 97140 on such and such insurance. We will not get paid for that.

He has these laminated throughout the clinic at each laptop for every provider to know what codes they can do with what insurance, which insurances allow for a re-eval every two weeks or which ones don’t, and take advantage of the opportunity to do a reevaluation and see how they are doing and do a full writeup. With that billing cheat sheet, then you are able to squeeze more out of each visit and do what’s best for the patient by providing this skilled care.

In our EMR software, we use the prompt. There are some pretty cool features they have in there that you can have specific to the payer. You can have notifications pop up when you try to bill a bundled code, code manual therapy, and therapeutic activities at the same time. You can have something pop up to give you a notification. With this insurance, you can do it specifically. For Aetna, you can say whenever these two codes are tried to be built together, it will pop up and say, “These codes can’t be built together as a bundled code up for this insurance.” It’s cool to have that pop up for the providers when they are submitting their claims.

That’s a scary conversation that you have to have with your team. It can be scary to say, “Remember that bonus program that we are on? We have to change it now.” How did you approach it? How was it received? How did you get through that part?

I will start off by saying I luckily have a good team and we all want what we have and we want it to succeed. Starting off with that, it was still a hard conversation to have, but having the sense that they would understand and try to do what they could to make it work was a good feeling to have go into this conversation.

Ultimately, we had to have a conversation about the numbers and the reality of things and talk about we are bringing in less than we used to. If we want to maintain ourselves as a one-on-one clinic, something has to change. This model will not be able to sustain itself if we continue as we have been for 2022. It wasn’t like telling anyone they necessarily did anything wrong. It is more of we all want this to succeed and we need to make some changes for us to continue to be able to sustain this model.

How transparent were you? Did you show them numbers, or did you say, “We are not making money?”

I am pretty transparent in general about the numbers we got together. We talked about the difference in average per visit. It was down $8 per visit. We talked about the difference in codes, what they pay, and how they pay differently. If we are a one-on-one clinic, then we need to be making sure we are billing appropriately. That’s not just for us bringing in money. It’s also for the profession too. We need to show what we are doing and value what we are doing and build those proper codes for the time that we do them.

Did your team come to you with some solutions, or did they say, “We understand and we will follow you our courageous leader?”

We opened it up to have a discussion to ask for any input from anyone, but there weren’t that many options. It was more of like, “This is what we need to do.” There were conversations about how to make sure our patients come to all their visits, and those are things that the providers can help with gaining agreement and making sure we get them scheduled properly. It came down to using the higher-paying codes for the therapists in order the changes that they could make.

Something that I heard you talk about on a show with someone else was focusing on your total visits per new patient. It is making sure we are not scheduling people once a week, but maybe we start them out three times a week for the first two weeks and then we drop them down. Take advantage of the early stages of getting them in and filling up the schedule while they had surgery. They already invested all this time and money in the surgery. They clearly want to get better, so why are we not seeing them three times a week for the first few weeks? That was the other statistic that we had talked about with the providers on their end as far as what they could do to help change some of the numbers.

That’s a helpful statistic to know in terms of benchmarking how you are doing compared to other PTs across the countries. It’s typically called episodes per plan of care or a number of visits per new patient like you said. If I’m not mistaken, the numbers are typically around somewhere around 11 or 12, and that’s average.

We knew if we were doing well, that number is going to be closer to 13, 14, or 15 because most clinics have a poor completion of the plan of care rate. If we have a good completed plan of care rate with all of our new patients, inherently, we are going to be significantly higher than that national average. We use that to see where we are at.

Also, it’s something that we didn’t do back in the day, but what many owners are doing nowadays is scheduling out even the full plan of care at the initial evaluation. It is no more of this week-to-week stuff like, “Your therapist says you need to be here for 10 or 12 visits. Get out your calendar. We are going to schedule them now.” It’s easier sometimes to do that and set the standard than it is to go week to week and allow them to eventually fall off potentially.

You get them the times that they need. If they always need to come at 8:00 or whatever, then it doesn’t make sense to try and schedule that week because that time is already going to be taken. If you get it ahead of time, you are going to get the times that work for your schedule. You are going to have more compliance with those people showing up.

Were you able to correct the $8 drop in average visits or average reimbursement per visit?

We have, thankfully. We are focusing on the skilled units that we were billing and making sure we were billing properly for what we were doing and taking advantage of some of these higher-paying codes. One of the bigger things that we did was drop UnitedHealthcare.

When did you do that?

Our contract was terminated as of March 4th, 2023.

I love hearing that. That’s awesome.

To anyone who doesn’t know about UnitedHealthcare, which I’m sure everyone does, they certainly don’t pay enough for a one-on-one model. Let’s put it that way. This was already the third year that I had a call with them to try to negotiate my flat rate with them, which was pretty low. Having them for the first few years, even though they weren’t paying a lot, was still important for our growth getting people in where if people had a good experience and they told their friends and maybe their friends had a not UnitedHealthcare.

There was nothing bad about having them. It was just once we looked at our numbers from 2022 and realized that we couldn’t sustain this model if we were going to do one-on-one, we had to figure out some ways to improve our numbers. It was dropping UnitedHealthcare. This was the third year. They were like, “We can’t do anything,” and I was like, “I’m going to terminate my contract.” Within an hour, I got a call back from the person saying, “I can increase your rate by $5 a visit.” I was like, “It took that for you to come back, but $5 a visit wasn’t anything anyways.”

That’s not enough. If you are like most places where you are only going from $60 to $65 or $65 to $70, that’s still not enough.

It was lower. It was $55 to $60. When I first started and had my contract negotiations, I didn’t know anything when I started, so I signed the paper. That seems standard. I didn’t know that I could potentially negotiate. Maybe I could have squeezed out an extra $5 from the beginning. Either way, we were getting $55 and we had to do all that they put you through for all patients. We couldn’t sustain that.

The good thing about the way that they terminated the contract was they gave me only a month, which was nice because I was anticipating three months or however long, which was a little tricky because I had to figure out how to have the conversation with our current patients. It was like ripping the Band-Aid off. We had to get it over with and get it out of our system. That was very helpful in terms of our average per visit.

About 13% of our case was UnitedHealthcare. It is not a huge percentage but enough that if we double that amount essentially, then if we double it either by getting other patients or if those same patients come back and pay self-pay or out-of-network, we are coming up on improving those numbers right away from dropping UnitedHealthcare.

Are you at a point now where you can tell how the dropping of UnitedHealthcare has changed your reimbursement per visit, or do you not have those numbers yet?

I don’t have the official numbers. I can tell you that our numbers in general are way better overall for the first quarter compared to 2022. The 2022 first quarter was when it was still going okay. It was still pretty good. 2023’s first quarter is 25% more than 2022 already. It’s certainly helped our coding by dropping UnitedHealthcare. We did increase our self-pay rate. It was the lower side. Out-of-network is helpful as well. We charge our self-pay rate, and if we can get anything else back from the out-of-network, great.

The other cool thing was side thing about UnitedHealthcare, which maybe people out there don’t realize. In the UnitedHealthcare or Medicare Advantage plans, patients or at least the PPOs only have to pay the same copay, and as a provider, we get paid for the Medicare rates instead of the UnitedHealthcare rates. If you are not ready to drop UnitedHealthcare altogether, maybe drop the Medicare Advantage plans. For a lot of people, they will still pay the same and you will get paid the higher rates.

I’m sure that might be region specific.

Maybe. Don’t take my word on it.

Be sure to consult your contracts before you do anything. Dropping UnitedHealthcare is an amazing move. I’m all for promoting dropping your lowest payer in general, and that typically tends to be healthcare. Whatever it is, drop it because, like you said, you can fill in that 13% of patient visits with higher-paying patients that might want to come in more often than what your schedule is available for. Why not see them more often at a higher rate and get paid what you are supposed to get paid?

That also could go directly back to the visits for a new patient. Like you said, maybe there wasn’t space on the schedule. When we drop the lowest payer, then we open up 13% of our schedule. It’s not like we necessarily have to go and get new patients. We already have patients that couldn’t get on the schedule because the schedule was full. Now we are not even having to do that much work to fill that part of our caseload.

There are two questions about this. Did you receive any negative feedback or blowback from those UnitedHealthcare patients based on your messaging? Did you get any feedback or blowback from local physicians?

Mostly not. The patients were very understanding. A lot of them stayed on. Some of them, because they were already there, we worked out some deals with them in terms of what they were paying and switching to out-of-network. Some of them were totally fine. A few of them were like, “I’m going to look for a place that takes my insurance.”

No one was upset. A few of them were surprised because we didn’t have that much time to notify our patients. On the flip side, there were patients that were supportive of us saying, “You guys need to be getting paid more.” They see what we get paid. They get the EOBs. They know that when the patients were paying their $25 copay that we were only getting an additional $30 on top of that. They saw that and they understand what that means. There were a lot of patients that were supportive.

To your question about the local physicians, no. We don’t have enough relationships on that level that the physicians would even care. We have physicians that send us patients, but I don’t think the physicians necessarily know if they are in-network or out-of-network, what insurance they have, or if they are paying cash.

I do have to remember that you are a unique model and that you haven’t built a lot of physician relationships over the years. If you haven’t heard about Avi’s story over the years, he did a lot of his growth via Google ads.

That’s correct. Not to say that we have developed some over the years like physician referrals and some partnerships. Over the last months, we have been tracking our new patients. We are close to 50% as internal referrals. Return patients are them telling their friends. We haven’t necessarily done a huge push for that. It attests to our reputation and our service. I think we have a good reputation and so people are telling their friends to come or they are returning.

When you have a good reputation, people tell their friends to come or return.
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It is not that there’s no room for us to start making some efforts and do some more marketing toward the physicians, which was certainly one of the things we had talked about in our strategy session at the beginning of 2022. We have been able to grow without having to do as much of that. I do always remind myself that even though we are growing without putting too much effort into physician marketing, that doesn’t mean we shouldn’t be. I have to remember to do that sometimes.

One of the other things I noticed amongst my friends that have dropped UnitedHealthcare is, like you said, they did retain a number of their UnitedHealthcare patients who decided to stay with you and said, “Go ahead and bill my out-of-network benefits,” and they were willing to pay more. I don’t know if this is the case in Georgia, but in other states, the out-of-network benefits from UnitedHealthcare paid well.

They do. They pay well. Some people are out-of-network. Deductibles aren’t even that bad. Occasionally you get some that have a $10,000 out-of-network deductible, but some of them are $500. After two visits, you pay your deductible.

We talked about your bonus program. We talked about increasing the reimbursement rate, dropping UnitedHealthcare, and also increasing your visits per patient episode per plan of care. What else have you been focused on in 2022?

The thing that I haven’t mentioned was, besides what we are collecting, 2022 what we realized was we did not have very good systems at the front desk, and we were losing a lot of patience that way.

It can be such a sinkhole. If you don’t have the right policies and the right person up there, you can lose a ton of money.

I don’t even know that it was the wrong person. We just didn’t have the systems, unless if they are the wrong person for sure. Who we had at the time was she didn’t have the tools. We hired Dee Bills front office guru who you have had on here. Maybe I was talking about it already, but the last time, we had spoken. I don’t remember.

We went through her program, and it was so helpful. She has a new patient routing form, and she has a whole system. There’s how you speak to patients and understanding their thought processes and in fear if they want to trust you or whatever. It is having a system as to how to keep track of who called and when to call them back because not everyone’s going to necessarily make that appointment the first time they called.

If you don’t call them back, you are probably never going to hear from them again. It is having a system for all of those different variables. Once we started that, it was almost within a week or two that we were retaining patients better. We were having a lot less patients falling off of the schedule and being able to keep our schedule full. That was something that was killing us last 2022 until we got those systems in place. Before up until that point, we hadn’t grown enough for that to affect us. I’m not sure why that’s true, but once we got to a certain point of growth, we needed those systems.

It can be painful sometimes when you implement things that make a profound difference in your clinic and it’s productivity that you think, “Man.”

I should have been doing this for a couple of years.

“What could my numbers have been and how much different would my bank account look if I had implemented this earlier?”

I do mean this. I try not to think that way because what are you going to do first of all? Even that whole year last 2022, I’m trying to figure this out. I filed it away as a good business lesson for the year like, “Not everything is going to go exactly as you want. Not everything is going to be perfect. There are always going to be challenges. What can we learn from this? How can we improve? How can we grow from this? How can we take what happened to us to make us even better moving forward?”

I tried, and I did a pretty good job of not losing hope and feeling depressed about last 2022. It wasn’t terrible. It was just for a long time could not figure out what was going on. Once we looked at all of these things and implemented some changes already this 2023 with our growth compared to last year, we are seeing huge differences.

Isn’t that interesting? You had to go through some of those challenges to figure out what was wrong or what needed to be done. If you hadn’t faced those challenges, you wouldn’t be improving, learning, and making things happen that are better for your clinic. You had to go through those challenges to shore up your front desk. You had to go through those challenges to make sure you were focused on being as efficient and effective as possible with your billing and collections. Who’s to say? I know you have greater dreams of doing more and expanding, but it’s probably in your best interest to get that figured out now before you open up a second clinic, go to a larger facility, or something like that.

I have always felt that way also where I have always come in with the mentality of not to grow too quickly. Maybe I have to figure out at what point. Let’s say I open another clinic. I want to make sure that I can essentially have the book to not have to relearn anything the second time. If we started a new clinic last 2022 and then had two clinics with all these same issues, that would have been devastating. Now that we have figured out all these things knowing that these are potential issues that we now have the solutions for, we now build that in, and once we start a new clinic, it’s going to be that much easier hopefully for growth and doing well.

You can face the additional challenges going to come with growth naturally. What are your plans then for this next 2023?

Now, where we are at, especially with how our numbers have been looking for 2023, we have already talked to our team in terms of getting that bonus structure going. Now that we have addressed those numbers, things look to be good where we are not breaking even, but we are profitable and so much so that we can give back to everyone.

That’s the first step in our growth. Everyone is putting in the effort. We are going to give back for that. In terms of our growth at our location, we are at the point where we are getting close to maxing out the space. We are not there yet. We do need to have a few or maybe one more FTE or something. It will probably have to be split between two people based on how our hours are. Maybe two part-time people. That might be a little bit of a challenge. To max it out perfectly, that might be hard to say like I want to use up every single possible hour.

We are getting to the point where this space is once we get the book down. That’s something that we are focusing on now with me and the directors. It is making the policies and procedures, all of the handbooks so that when we are ready to, which could be by the end of 2023, open another clinic, we are able to have those training manuals, those handbooks, and those SOPs to be able to hand them over, get going, and not have to relearn anything and be ready to grow.

That’s great. Congratulations. That’s exciting.

It’s very exciting. When I first started, I had dreams of not having more than one location because it seemed easier. Looking at the numbers and private practice, financially, you have to. One clinic of my size can’t do all that much, especially if I want to hire leaders, put in bonus structures, and give back. I’m not going to take everything for myself. We do need to grow. I feel a little nervous about it because the nerves that I feel are more about anticipating how much work it’s going to be. Hopefully, with these handbooks in place, it will be a lot significantly less work than the first time around.

It always goes back to when you hired your first PT. You are going from 1 person to 2. That’s a huge jump because you are increasing 100%. When you go from two and you bring on a third person, that expansion is significantly less because that’s only a 50% effort to go from 2 to 3. When going from 3 to 4 is only a 25% effort. It gets easier, and you have noticed the same thing as you have hired more therapists. Hiring a therapist is no big deal anymore whereas hiring your first therapist, which is like staying up late at night and sweating bullets. “I’m not sure how this is going to work. What am I going to do?” Now hiring a therapist is no big deal because you have confronted it so many times. It’s like second nature. It’s very similar to growth and expanding your clinics.

That makes sense. Even though this will be one clinic and then adding another clinic, that’s a 100% increase, it will be a lot easier because I know what to expect this time around, and I’m not doing it all by myself. This time, I will have more people and my director and admin people, whereas the first time around it was me doing it all and learning through. It is learning from doing it and learning from mistakes, going as we went along.

You learn from doing things and from making mistakes as you go along.
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Where are you at this point? You found those issues in 2022. You are sitting at this point in 2023. There’s still some growth to be had and there’s a level that you want to get to before you expand to that second clinic. Where are you at this time? Where are you spending most of your time? What are your focuses?

I have been feeling a little bit trapped almost. I’m at the point where, mentally, I think I’m ready to start focusing on the new clinic if we are going to expand to try to figure out how that could work. We are creating a pro forma, looking at a business plan, finding a location, and seeing how that might work. In our existing clinic, we still don’t have all the people in place.

Like I said, we are pretty close. We do need another admin person. The main thing is we need all of the policies and procedures fully written up. Until that happens, I am unable to move forward. Maybe that’s not true. Maybe there are certain things I could be doing now that we are at a certain place. What I’m trying to figure out now is how to develop all those so that I am essentially not needed in this clinic so that I can start focusing on the second clinic, networking, building it up, and getting that off the ground.

You seem like you are in a limbo state. Things are going well at the existing clinic even though you could add some expansion or build up a little bit more into the capacity that you have. You are not quite there where you need to be in the second clinic, but it’s never exciting to work on policy and procedures. That’s not fun. I don’t think anyone wakes up every day thinking, “Great. I get to work on another policy. I can’t wait.” That’s the grind. You know it’s necessary. You know it needs to be there. You know it’s an ongoing and ever-evolving process. It’s difficult to get that motivation from that particular task.

I wish it was done with already.

Anything else you want to tell us about the story over the past months or what you got looking forward to?

You have talked about it. I’m not going to say dropping UnitedHealthcare, but dropping your lowest-paying insurance if you are out there. Even though they made it easy by not giving me the run around about how to cancel my contract. For the first month, one of the things is we are still showing up as a network, so they were processing incorrectly and then you had to call Optum, and Optum was like, “You should call UnitedHealthcare.” UnitedHealthcare was like, “You should call Optum.”

For the most part, it was fine. I will say that there was a fear of losing patients if we dropped the insurance, but it was fine. No one was upset. There were a few people that were maybe a little bit annoyed because they had to try to find a new place because, financially, it wasn’t working out. We did try to work with people at least letting them finish the case that they have already started and we worked with them. For the most part, patients were very supportive. Some do. At least they understand how to read the EOBs and look at them.

They were very supportive of us. They wanted us to succeed. They were invested in us in their community PT place. They are advocating for us. A few patients even wrote letters for me to send to UnitedHealthcare. I didn’t end up sending them in because, by that time, I had already decided to drop the insurance. There was a fear of losing patients. What it has done was showed me that it didn’t lose patients. Patients were supportive of it and it’s helped us. Our numbers have been better. I’m not saying that’s the only reason our numbers are better. It’s certainly helped.

That’s something that, as private practice owners, because the insurance companies do control and short changes and do not pay PTs what we should be getting paid, it’s important for us to look at that and decide if you can manage it and look at the numbers. It’s not a risk, but take the risk of dropping that lowest-paying insurance and realizing that you are only going to get better from doing that.

Based on that experience, have you considered dropping other insurance?

At this point, no. We are good for now. The other insurances that we have are fine. There’s one that’s a little bit on the lower side, but we do get a good amount of people from them. It’s Aetna. I’m in Atlanta, and Emory is the largest employer in Georgia. It’s not just the university. They have all the hospitals and all the healthcare systems and their internal insurance.

There are a lot of people around here in Atlanta that have Aetna. It doesn’t mean that we can’t either do self-pay, out-of-network, or find other people, but for now, that would be the next one that I would look at. At this point, if we pay attention to what we are billing, doing that appropriately, and making sure our patients schedule as they should like their plans of care, we should be good.

With someone like that, have you tried negotiating with them or not yet?

I haven’t, and that’s something that I probably should do. That’s a good thing I will take away from this like who I can call. If they say no, they say no. The other thing I was going to say was about Aetna. I can’t remember exactly. I will save that for the next interview.

We will leave a teaser and leave them hanging out there. If you want to know what Avi wanted to share about Aetna, you will have to read the next episode. Thanks for joining me again. It’s cool catching up. I appreciate you sharing your experiences as a business owner with the audience and giving us some insight into your practice because I strongly believe that what you have gone through can be a valuable lesson for other people to learn from. Thanks for being willing to share.

I had a lot of fun coming and talking. I have said this in the past. It’s always fun because now I have a documented history of my growth, and I can look back and read these interviews. Every time we do a new one, I will read to the 1 or 2 before and get a good sense of where I have come from. It’s so important to reflect on where you have been and use that in ways of motivating yourself to move toward the future.

It's important to reflect on where you have been and use that to motivate yourself to move toward the future.
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Thanks for joining me. I appreciate it.

Thanks a lot.

Avi’s main mission for Druid Hills PT is to provide high-quality, personalized care to each and every one of his patients. Avi has his doctorate in physical therapy from Touro College, and is a Certified Orthopedic Clinical Specialist. He lives with his wife and three children in Atlanta.

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The post Reality Episode With Avi Zinn, PT – Bonus Programs, Dropping UHC, Front Office Guru, Etc. appeared first on Physical Therapy Owners Club.