Paul Gough

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“I Raised My Rates To Give My Patients The Service They Deserve”

Ellen Tomsic – Tomsic Physical Therapy – Durango, CO

Ellen Tomsic is one of the newer members of the Planet Paul community. Already she is seeing a huge shift in outlook as new processes are being implemented.  

She is shifting from insurance-based appointments to a cash-pay clinic and her eyes have been opened to what she can really get from the business.

In a two-part interview, Ellen, of Tomsic Physical Therapy, Durango, CO, this month tells us how her mindset is changing for the better. 

About Her Private Practice Clinic

I have been in Private Practice since 2004. Originally I was with a partner who retired in 2014. I own 1 clinic and employ 3 additional PTs, no PTAs.

We have been a traditional in-network clinic since the beginning, working on 30 min appointments with tech support.

Our only cash program was a continuation of care at a significantly discounted price when someone ran out of insurance and still needed care for their injury recovery.

I have grown very tired of insurance and the hoops they want us to jump through to see their patients.

I have one insurance contract that has not increased their rates since 2004. I contacted them and they are unwilling to negotiate. They are the 1st insurance contract I will drop. 

I participated in PPP near the beginning of 2021/Covid. I began the PT Accelerator program in January and joined the 4% Club in March. 

Her Prices Before Hiring Paul’s Team

All but 1 of the clinics in my area are insurance-based. My limited cash-pay program was near the top of what the other clinics were charging.

Compared to the only cash-pay clinic, my prices were below. My profits are low, as I lose money on every visit from my lowest 2 contracts. 

I live in a small rural community and felt a sense of obligation to keep this contract as one of our area’s largest employers uses this insurance company.

Regarding changing my prices, well I was just ignorant of the possibilities.  

What Her Prices Are Like Now

We have created a new self-pay wellness program. My prices are now the highest in my area. Although compared to other Paul Gough folks, still low.

This is a brand-new program, 4 weeks in, and our cash flow has improved as people are converting to packages and paying the full amount upfront.  

The jump to cash pay feels great! I am so ready to not have my front office staff spend up to 2 hours to verify insurance that will only approve 3 visits.  

The strategies used to implement these changes?   

I spent a lot of time listening to Accelerator and PG webinars to learn and get brave enough to do it. I spoke a lot with Lisa and Simon who taught me my new favorite phrase, ‘I have been providing champagne services for lemonade prices.’  

They also put me in touch with other therapists who had done this. I learned from their experiences. I hoped things would change, but really nothing was going to change and it was only going to get worse.  

I just had to bite the bullet and do it. I began by talking with my staff, who were all on board. I created the new programs and price structure. We have begun by educating all of our existing self-pay patients about the new programs. We allowed a 3-month grace on their old rate. Most changed to the new 60 min premium package and paid the full package price upfront.  

One of the biggest challenges has been the logistics of finding treatment times as they are changing from 30 to 60-minute appointments. What a great problem to have!!! What we have already learned is converting our existing 30-min self-pay patients to our new premium services has not been very difficult as they are already bought into the program.  


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