Nohava Chiropractic Health Center

SUBJECTIVE
Life was not good for the Shoreview, Minnesota chiropractor Stephen P. Nohava. He had graduated from Northwestern College of Chiropractic in April of 1999, and by late 2005 was seriously considering a change of profession. His practice had never been profitable and despite efforts to attract new patients, he experienced no consistent growth. He was losing money, treating only 80-90 patients per month, 80 percent of them on a cash basis. Fortunately, his wife had an excellent job and Dr. Nohava’s low patient load allowed him to assume most of the child care and household responsibilities.

OBJECTIVE
Dr. Nohava was afflicted with a common practice ailment: poor business management skills. Intimidated by the complexities of dealing with government agencies and insurance companies, he had opted to focus on cash patients. He spent thousands of dollars on practice development measures, including a “killer ad” newspaper insert that he employed annually for four years. The first of these brought in 26 patients; succeeding ones yielded almost none.

ASSESSMENT
Working with ACOM’s Healthcare Business Consulting Group in early 2006, Dr. Nohava was able to isolate key factors that were holding him back. Among them were lack of understanding of coding practices; inconsistent preparation and flow of paperwork; and lack of disciplined business processes. Frequently, he was giving away services that he should be paid for.

PLAN
The ACOM consultant analyzed Dr. Nohava's operations on-site and trained him in ways to improve them: how to code for all treatment performed; and how to dictate accurate and concise SOAP notes; and how to present documentation and reports that support prompt payment of claims. He also learned to take a business position: that he is entitled to charge for what he does and that to be successful, he must have goals and ways to meet them.

FINAL REPORT
The doctor is in, full-time and in growth mode, with no more thought of changing his field of profession.

• The practice is growing by 20-50 patient visits per month
• Patient composition is now 80-20 insurance and workers comp vs. cash
• He knows what to charge for; and what he treats, he bills for

Changing the direction of his practice enabled Dr. Nohava to increase average billing per patient visit from $20.00 per visit to $40.00. The practice is profitable, the doctor follows a constantly updated to-do regimen, and he maintains ongoing dialog with his consultant to keep the practice on its successful new track.

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