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Mastering the Financial Report of Findings

Dr. Karen Sedore
in Documentation
By Karen Sedore DC CPCO

Mastering the Financial Report of Findings

Take a moment to think about how your office interacts with new patients. In most cases the doctor provides the patient with a polished Report of Findings explaining the diagnosis and treatment options that would work best for the patient’s condition. Does your office handle the patient’s financials with the same care and attention to detail? Providing your patients with a Financial Report of Findings (FROF) sets the tone for your payment expectations throughout their time under care.

Money is a major motivating factor in a patient’s determination of whether to seek treatment. Often, it is not about the actual cost of the services, but the perceived value of the services that your office provides. Clear, confident communication about the financial aspect of a patient’s treatment begins with your first contact with the patient and builds with each visit. When you discuss your fees and create a payment plan before treatment begins, you allow your patients to focus on their health and not their co-pays. Although you are discussing money, a very sensitive subject for many people, you are also a member of the patient’s healthcare team. The person your office selects to discuss finances with patients must be able to wear two hats simultaneously. That person must understand that the chiropractic profession is a business that must meet its financial goals to survive, and at the same time be a compassionate advocate for the patient’s well-being.

The Five P’s: Proper Planning Prevents Payment Problems

The first step any office should take is to have a solid financial policy in place. It often includes procedures for hardships, the collection of past due accounts, and missed appointment charges (if applicable). Review all marketing materials both written and online and address potential compliance issues. For example, avoid advertisements with discounts or offers of free services as an inducement to attract new patients. Be upfront about which insurance payers you are in-network with, if you participate with a Discount Medical Plan Organization (DMPO), or if financing options are available. Your marketing materials should attract patients who will benefit from what your chiropractic office has to offer and not by offering these inappropriate discounts.

Whether your initial contact with a potential patient is over the phone or in person, it is important to get as much information as possible and address all their questions. Collect their insurance information and verify their benefits prior to their initial visit. If the patient does not have insurance, this would be a great opportunity to briefly mention any DMPO’s that your office participates with and the potential savings they offer. Inevitably, you will be asked, “How much does your office charge?” While full transparency is ideal, it may be difficult to quote an exact price due to the wide range of services your practice offers. Do your best to give an estimate to avoid “sticker shock” and tell the patient about the forms of payment your office accepts.

The information gathering process continues when patients come in for their first visit. Now is the opportunity to make a copy of their insurance card and take note of anything they did not mention over the phone. Medicare patients should be made aware that many of the services they will receive on their first visit are not covered such as E/M services, x-rays, or passive modalities. This may be presented to the patient on a voluntary ABN form or a similar statement created by your office. Explain to the patient that you will discuss financial responsibility and payment options in greater detail during the next visit.

Day 1.5

“Day One-and-a-Half” is the day between the initial visit and the second visit. It’s where all the prep work happens. The treatment plan developed by the doctor will be used to determine what services will be provided to the patient, the number of visits they may need, and the patient’s diagnosis. Begin by completing any necessary pre-authorizations prior to the patient’s next visit and determine what the insurance will cover and what the patient pays out-of-pocket. If offering a payment plan as an option, do all the math ahead of time. Keep in mind that you will be asking the patient to make a financial commitment to your office. Present this information to the patient in a simple and professional manner.

Passing the Baton

The patient’s second visit begins with meeting the doctor for the Report of Findings where all the clinical aspects of the patient’s care will be discussed. The baton is then passed to you to do what you do best – deliver the patient’s financial responsibility.

New to Financial Report of Findings?

Here are some things to keep in mind:

  • Allow enough time for the conversation; conduct it in a private area.
  • Confirm the doctor’s treatment recommendations with the patient. Explain both the insurance coverage and the patient’s financial responsibility. Pause and allow the patient an opportunity to voice any concerns or to ask questions. Discussing money may be uncomfortable but avoid the temptation to keep talking to avoid awkward silences. It is important for patients to feel part of the decision-making process, and they are more likely to commit to care when they do.
  • No one in a non-physician role may alter a doctor’s treatment plan during a FROF to make care more affordable for the patient. The treatment plan is the equivalent to a prescription. The doctor strongly believes that all the elements of care need to be performed to maximize the patient’s outcome. Focus on the quality of the care, not the cost.
  • Both cash and insurance patients are more likely to follow their treatment plans if they pay the complete cost up front or are placed on a payment plan. It is easier to budget their chiropractic care as a monthly expense than it is to think about paying a set fee several times per week. Monthly payments that are under $100 are considered affordable by many patients. As a general rule of thumb, do not extend the payment plan out longer than the treatment plan.
  • Take this opportunity to schedule out the patient’s future appointments. This allows them to pick a set time to come in for every visit and establishes a routine.


While every chiropractic office has different procedures for new patients, many can customize the FROF to fit their practice needs. Implementing FROFs starts with training and role-playing to become comfortable with the different scenarios you may encounter. It is equally important to find the right person to fill this role and to be adequately prepared with an insurance verification process and a ready to go financial plan. Your patients will appreciate any attempt at demystifying the cost of their care, and you can enjoy increased collections with a lot less stress.

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Dr. Karen Sedore has over 10 years of experience working in the chiropractic profession. She began as a manager specializing in billing and medical necessity as well as taking on chiropractic assistant responsibilities so that she could be more involved with patient care. She also has experience with income tax preparation and has helped hundreds of families and small businesses with tax planning. In 2016, Dr. Sedore received her doctorate in Chiropractic from National University of Health Sciences. She joined KMC University in 2017 and assists doctors and their staff in her current role as an Membership Advisor.