Monday, April 8, 2013

Chiropractors Guide to making money with Orthotics by a Podiatrist

Chiropractors do lots and lots of orthotics.  As a chiropractor there is no need to tell you that the foot and the back are intimately related.  So, getting a patient into a pair of orthotics is usually a necessity to curing what is bothering the patient.  Whether you have diagnosed a limb length discrepancy, flatfeet or over pronation, many causes of back pain can be emanating from the feet.

Additionally, orthotics can be used as a revenue generator by a chiropractor, so at the same time you are helping patients, you can generate revenue for yourself.  Now there are two types of orthotics Chiropractors can use over the counter or custom.

Over the counter orthotics are similar to orthotics that can be purchased at Wal mart or any drug store.  The only thing unique to the orthotic is the size of the foot the orthotic will be placed on.  These can be ordered over the Internet and placed for sale in your office.  I do not believe personally it is wise to offer an orthotic for sale for any amount greater then thirty dollars.  Over the counter orthotics are not covered by insurance anywhere, so these are strictly an out of pocket expense.  Generally, it is best to have display that the patients can see, and a stock of enough of the most common sizes.  I would avoid using Dr. Scholls products as those are available in most pharmacies and Wal Mart.  I have listed a couple brands below.  Remember, most of these brands when you buy in quantity will lower their price.

Now Custom Orthotics are a whole different ball game then over the counter orthotics.  These can be covered by insurance but they also require a great deal more of work.  One of the keys to these orthotics is to make a mold of the patients foot.  This can be done one of three ways.

One way is to purchase a bio foam box.  The patient places their foot in the box, in subtalar neurtal position.  The chiropractor then mails the orthotic to the orthotic lab of their choice or have an orthotic created.  The biofoam boxes are fairly inexpensive and can be purchased many places.  I have placed two such places beneath these paragraphs.  You can generally charge between 200-300 dollars for these orthotics and your foam and lab fees should not exceed anything greater then seventy dollars

Another way, to cast the orthotic is via actual casting with plaster.  This is considered the most accurate way to cast orthotics.  However, the person doing the cast must know what they are doing, otherwise you will produce a bad orthotic.  The key to the cast is the subtalar joint must be kept in neutral position.  You can actually bill for the casting process of the procedure.  Like the biofoam process, the cast is sent to an orthotic lab for manufacture.  You can charge for casted orthotics as much as 300-400 dollars.  However, if you have no experience casting you need to practice and get experience with a practitioner that casts already, before attempting to cast for a patient.  Casting for an orthotic is very operator dependant.  Here are some places where you can purchase casting material.

The third way to create a orthotics is via a scanning method.  Their are multiple companies that have created gait scans to capture a patients pathology on their feet and biomechanical issues.   These scanning machines typical cost a couple hundred to thousand dollars depending on the model, the chiropractor chooses.  Generally, you have to use the company to fabricate your orthotics that you purchased the gait scan from.

Now billing for custom orthotics can be difficult, so I have provided some links for the chiropractor and billing for orthotics.
http://www.casd.us/Files/casd_orthotic_billing.pdf
http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=52105

3 comments:

  1. I am really happy with post because these days i am looking for podiatrist Malpractice and i found many information from this post.

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  2. I had a headache. Everyone suggested that maybe I’d put my neck out and recommended a chiropractor they’d all been using and were happy with. OK I said, I’ll give it a go. spinal alignment

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