Cash vs Insurance for Your Services: How to Decide?

Should I focus on cash or insurance collections?

I get asked this question a lot – whether to go all-in with insurance or to stick to cash payments in your practice. Here’s the deal, and it’s something I want you to consider deeply: at the end of the day, your practice is a business, and we’ve got to make choices like any business would. Does this mean get rid of your goal and love for helping others? Absolutely not, but it does mean you need to make the best decisions for your practice so that it can continue to grow and then most importantly, help others.

Now, opting for insurance or cash isn’t just about choosing payment methods; it’s about deciding what kind of game you want to play. And let me be frank – diving headfirst into insurance is no walk in the park. If you’ve been in the game as long as I have, you know the score. What insurance companies coughed up last year? Don’t expect the same this time around. It’s a dwindling reimbursement, my friends, and it’s not getting any easier to squeeze a decent payout from those firms.

But here’s the kicker – even if you’re billing insurance left, right, and center, you can’t afford to take your eye off the cash ball. We’ve got to be on top of collecting deductibles and copays, while putting together cash packages and services to help patients with a number of ailments.

Let’s cut to the chase – running an all-insurance practice feels like you’re paying one business at a time, scraping together those 25 or 50 bucks every visit. Talk about a tough road to scaling your business!

Insurance and Cash Collections Together 

A mix of insurance and cash can work wonders for those situations where insurance is a must for the patient but otherwise cash is going to be the way to go. Picture this – you’ve got a 24 or 36 visit package lined up, but insurance only covers a dozen. No sweat. You set up a plan where insurance kicks off the journey, and then the patient picks up the tab. It’s a smooth ride if they see the value in what you’re offering.

So a hybrid of the two can work well for you in those situations where insurance is a must but in most areas, the writing is on the wall that we are headed towards an all cash-based practice. It’s just the truth, plain and simple. Once you master this by implementing The Business Academy’s program, your practice will skyrocket in visits and collections – I have even seen half a million get collected in under 30 days.. All cash and all he did was follow The Business Academy’s program.. Yes, I am serious..   

Here are some more reasons why all cash-based might be considered the best approach:

  • Predictable Revenue: Cash payments are straightforward and eliminate the uncertainties and delays often associated with insurance claim processing and reimbursements. You receive payments directly from patients at the time of service, ensuring a predictable and steady cash flow.
  • Reduced Administrative Burden: Managing insurance claims can be a complex and time-consuming process. It involves dealing with paperwork, coding, claims submission, and follow-ups for denials or incorrect payments. A cash-based practice significantly reduces this administrative burden, allowing you and your staff to focus more on patient care.
  • Enhanced Patient Relationship: In a cash-based practice, the relationship is directly between you and the patient, without the interference of a third party. This can lead to more transparent and straightforward communication regarding treatment options and costs, potentially enhancing patient trust and satisfaction.
  • Price Transparency: Cash-based practices typically have clear pricing for services rendered. This transparency can attract patients who prefer to know upfront what their healthcare costs will be, without the surprises that sometimes come with post-treatment insurance billing.
  • Freedom from Insurance Constraints: Insurance providers often dictate the terms of treatment, such as the number of sessions allowed or the types of procedures covered. In a cash-based practice, you have the autonomy to recommend and provide the treatments you believe are most beneficial for your patients, without needing to conform to insurance company policies.
  • Attracting Self-Paying Patients: There’s a growing segment of the population with high-deductible health plans or health savings accounts (HSAs) who may prefer the straightforward nature of a cash-based practice. Additionally, some individuals do not have insurance and therefore are self-pay by necessity.
  • Potential for Lower Overhead Costs: Without the need to manage insurance claims, you may require less administrative support. This can translate into lower overhead costs for your practice, potentially increasing your profitability.
  • Faster Payment Processing: Insurance claims can take weeks or even months to process. With a cash-based practice, you avoid this waiting period, as payments are made on the spot.

Educate the patient, tap into what they value, what drives them. Get that right, and they’ll happily pay for your services, paving the way for your practice to not just survive but thrive and be abundant with happy patients getting real relief. That being said, I go into more detail about converting into an all Cash-Based Practice in my earlier article here.. 

You can also speak with Quentin directly for a free consultation and The Business Academy can help you the same way I was helped all those years ago:


Should you go all-in with insurance? My two cents? Probably not the best move. We’ve got to learn the art of the cash transaction, tailor our approach based on where we’re setting up shop. Some states are a goldmine for insurance practices, while others scream cash. It boils down to where you want to plant your roots and how the insurance scene plays out there.


So, that’s my two cents on this whole insurance versus cash debate. I hope these insights shed some light on your path. My personal recommendation is getting your free consultation and asking how you can implement an all-cash based practice and watch everything else fall into place. Schedule with Quentin..

Dr. Gary Rademacher founded Downtown’s Healthcare in Denver in 1997, eventually growing that chiropractic practice to 600 patient visits a week. In 2011, he integrated medical providers into his office, believing that the combination of chiropractic and medicine would provide the best care for his patients. He fully believes in the innate power of the body’s ability to heal itself and that medication and surgery should be a last resort. Dr. Rademacher received the Colorado Chiropractic President’s Award in 2011 and currently co-owns The Business Academy and owns My Injection Training a medical training company that has trained over 200 medical providers on ultrasound guided joint injections. 

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