Our Blog

Choosing the Right Model for Your Practice: In-Network, Out-of-Network or Cash-Based

September 18, 2017 | 11:23 am
Published by | Krunal Popat

For your chiropractic and physical therapy billing, there are three popular types of payment models you can use to collect money from your patients or insurance. You can use in-network, out-of-network, or cash-based as your primary means of getting payments. You can combine this with one another so that you can create the most efficient revenue cycle management for your practice.

Cash Based

Here, the entire payment is collected from the patients and they are provided with what is called a Superbill so the patient can submit it to the insurance company for reimbursement. One advantage is that your practice does not need to go through a contracting or credential process thanks to the payment system used. This makes it easier to get established and start your practice on the right foot. Plus, your cash flow is maximized since you collect directly from the patient who gets reimbursed by their insurance.

However, the downside is that your patients will need to have the cash-on-hand to pay you for your services and that may rule out many potential patients from your practice. Admittedly, it does keep things simple even if you eliminate many potential patients.


This is one of the most common models used by practices to collect their revenue. Healthcare providers that are in-network get negotiated [i.e. discounted] rates from insurance companies while receiving advertising to help expand their practice. This means that you get a built-in referral source that is combined with your work inside the network. Most patients prefer in-network practices because they pay lower co-pays, deductibles, and coinsurances.

However, you will have to go through a contracting and credential process to join a network which can be time-consuming. If you are prepared and you have done the research to know this is the method you want, then it is well worth the effort. Plus, you get plenty of support that can help your practice grow while spending less money on marketing. It’s little wonder that so many practices use in-network payment method given the advantages it provides.

Outside the Network

Working outside the network offers several advantages, starting with not having to go through a contracting process like in-network providers, but there is still credentialing. The main advantage is the flexibility that operating outside a network offers. The rules are different and you can choose the type of payment method that works best for your needs.

  • Collect entire payment, submit a claim to the insurance, requesting reimbursement on behalf the patient
  • Collect entire payment, provide patient with bill so they can request reimbursement
  • You collect part of the patient’s payment, submit claim to the insurance for reimbursement

The chiropractic and physical therapy billing services you use will complement the type of payment you accept. Whether you are cash-based, in-network or outside the network, professional medical billing company specialized for chiropractic and physical therapy will work for you so your practice runs as efficient as possible from a financial perspective. You’ll want to do your research first so that you can find the one that works best for your needs.