Dragons roast revenue. They destroy documentation. They fry your finances, and generally, mess up a perfectly good day. These aren’t the dragons of mythology on HBO. These beasts are alive and romping around your office today

— dragging down your billing system. Left unchecked, they pick your pocket with inefficiency, confusion and error.

Slay these Seven Dragons of Billing and rescue the bottom line of your chiropractic kingdom:

Communication dragon

Today’s chiropractic marketplace is a hodge-podge of insurance coverage and pricing. Insufficient communication with patients about their fiscal responsibility creates friction, and leads to unpaid bills and unhappy customers who go elsewhere.

Slaying this dragon requires a well-trained team that efficiently communicates those important details. It means the doctor must understand it as well and communicate with the team.

Feedback dragon

This is close cousin of the communication dragon. When there are errors — and there will be — technicians need proper feedback so they can tighten systems and procedures. Otherwise it just keeps happening and the dragons keep raiding your treasure.

Sloppy dragon

Poorly-trained techs combined with loose or vague systems lead to sloppy work. This is a particularly insidious dragon as it shows up randomly. You lose money every time patient demographics are entered incorrectly, or insurance information is not entered at all. These are not complicated

tasks, but they are details. The sloppy dragon feeds on details, or lack thereof, and he likes money.

Technology dragon

Your billing is dependent on software. How well do you understand how it works? Probably not as well as you should, because who has time for that? The technology dragon keeps claims from going out because the settings aren’t right. It thwarts your tech’s proper input of information. It puts ghosts in the machine of your system.

Insurance dragon

The hated insurance dragon gets blamed for many things, and a lot of them are true. Changes and software updates including address or payer ID, billing guidelines such as codes and charges, third-party processors which can change the EOB/remittance information, requiring documentation

utilization reviews, and changing authorization requirements. While your head is spinning with rules and regulation, the insurance dragon slips away with more of your revenue.

Training dragon

The training dragon lives on the leftovers of his fire-breathing brethren. He shows up when teams aren’t trained on the standard operating procedures and when they don’t know what other members are doing or why. This leads to person-dependent procedures which are risky at best. The training dragon likes

Mary, who’s been doing your billing for 20 years. He lurks around complacency and loves outright theft. Training your team in multiple functions is the best defense against this horrible dragon.

Procedure dragon

Most dragons feed off mistakes and misunderstanding of the team members. The procedure dragon flaps around the head of the organization – the doctor. It’s a lack of standard operating procedures for financial techs, including collecting at every

appointment, verifying and inputting insurance benefits, sending out statements, and scanning and inputting all authorizations.

Without strictly enforced guidelines for techs, things are going to stray. And what dragon doesn’t love strays. Billing can be a vexing problem for chiropractors. It keeps you from doing the work you want, which is taking care of patients. It sucks time away from your family and community. And it gets more complicated every year.

About SIDECAR Chiropractic Billing Services

Our company was established by chiropractors, for chiropractors, and is still run by chiropractors. In short, we understand your challenges in the shifting sands of reimbursement. We are dragon slayers – a sharpened sword in a time of need. With a collective 75 years in experience, SIDECAR can offer proven methods for achieving a successful chiropractic practice.

When we say control the controllables – it is important to stay Expanded!   Think of trying to unfurl a sail when are knots in the rope. It cannot be done! 

Use every area of your life to make sure you are defending your Castle in every way you can think of. Stay strong using the three H’s – Heart, Humility and Hustle. 

Financial:  Look for ways to protect yourself, your family and your business. Trim the fat. Use the Crisis Survival Kit. 

Family: Protect them and keep them safe. Help them manage THEIR fears. Communicate to them.  Ask them questions and most of all love them. 

Spiritual:  Create or enhance your rituals, praying, meditating, and pay attention to you — breathe. Look for positives in your life daily (there is always a silver lining). Have unrelenting faith! 

Social:  Stay connected through social media, share jokes, use facetime, what’s app, send videos, listen to music, sing your heart out and dance like no one is watching. (Because they aren’t). 

Physical: Get outside, work out, practice self-love, eat right, limit your sugar, smile and if all else fails — as Dr. Frank used to say – do naked jumping jacks. 

Intellectual:  Program your brain. Write three things you are grateful for every morning. Stop whining and blaming. Read something to reinforce a growth mindset.  Speak with like-minded people. OWN why what I do matters. Be mindful of your words! Adjust them accordingly (I want to vs. I have to). 

Career: Stay connected, study, increase your commitment level, train every day Stay creative together. Share ideas! CALL THE HOTLINE! 

Pray like it all depends on GOD! 

Work like it all depends on YOU! 

Your Sidecar Team. 

Set sail. 

There is nothing more beautiful than a sailboat on the open water.  As the wind catches the sail, the boat moves effortlessly across the water. As long as wind fills the sail, forward momentum continues.    

No wind, no sail, no progress. 

The boat also needs a sailor to maneuver the sail, catch the wind and head in the right direction. 

We can use the boat as a metaphor for our lives.  We need to fill our sails with wind and not get entangled with things that don’t create momentum.    

We need wind that includes people who make us better. It includes the books we read, the training we do, and a mindset that expands for more opportunities.    

Our sails get entangled by a contracted mindset, toxic relationships, bad attitudes, lack of action, and not accepting accountability for our decisions.    

We are the sailors of our own lives!   

Guide your boat toward the life we desire, one of  affluence filled with rich relationships, a reputation to be proud of, a vocation we love, a vision that ignites our days, and the resources to experience life on our terms.   

Set sail. 

Open or closed.  

That’s the decision for chiropractors and most small business owners across the country as we prepare for – and worry about – the coronavirus. 

The virus, the disruption, the political wrangling and social media blathering – seem complicated, and they be. 

But this decision is black and white – open or closed. 

That’s the issue I hear the most right now from chiropractorsWe are all struggling with the same question. The truth is, there is no wrong answer. Each of us deals with unique circumstances.  

We live in different states, even different countries where governments take varying levels of actions depending on the conditions on the ground. Some places have mandatory closing of all businesses, including affiliated health care clinics such as ours.  

In those cases, the choice is made for you. 

The rest of us struggle with the decision, balancing service to patients with obligations to public health and our staff and our families.   

Do we turn away an elderly patient who wants and needs an adjustment? 

Do we limit contact between patients, spacing tables and waiting areas? 

Do we require phone screening before a visit to identify potentially risky patients? 

None of these are unrealistic ideas.  

My message is to take prudent steps. Get the best information you can from reputable and trusted sources. Pay attention to updates from the National Institutes of Health, the Food and Drug Administration and the Centers for Disease Control. 

Listen to your local and state officials for guidance. 

Don’t go it alone.  

Talk to your staff, your family, your colleagues. What is best for them? 

Don’t be afraid to address the fear and anxiety we are all feeling, because it’s there. It manifests in all kinds of ways, through anger and outbursts, an underlying sense of discomfort or dread, or even gallows humor.  

Dr. Shahana Alibhai was a guest on a webinar we broadcast recently. (You can watch it here.) Dr. Shahana is an M.D. in British Columbia and expert on dealing with anxiety. She’s also married to a chiropractor 

She told a wonderful story of a discussion they had about what to do.  

Dr. Shahana told her husband to ask himself “why” seven times.  

What are you feeling? 

Stress about whether to close. 


Because I don’t want to let down my patients. 


Because it’s bad for them, and bad for me and bad for business. 

Why is that important right now? 

Because then I can’t provide for my family. 

And there’s the heart of the decision for Dr. Shahana’s husband. He feels the weight of responsibility to take care of his wife and young children. That’s a perfectly normal experience and one many of us share. 

As Dr. Shahana points out, the decision of whether to close is not a measure of our worth as parents, spouses and community leaders. Quite the contrary.  

That may be the best decision for our children, spouse and community.   

There’s no blanket stance that will fit all of us. I’ve heard calls on either end of the spectrum, from nobody can tell me to close my clinic, to everybody should shut down for the good of society. That’s unfortunate because it ignores that what’s right for you may not be right for me.  

And more broadly, is undercuts the reality that we are all in this together as a profession. Our individual threads form a common cloth of chiropractic — not based on technique or history — but as small business owners.  

That’s what we do as SIDECAR. We’re here to collaborate with you, to bring chiropractors together to share ideas and find solutions for our businesses.  

One of the principles we follow is relevant to the times. It’s called $even and it’s a personal and business financial management system created by one of our founders, Dr. Douglas Sea. This is the perfect time to bring discipline to your budgets and $even gives you practical tools to start today.  

We do this because we believe in our profession. We believe there is a place for chiropractors to contribute to the overall good of our communities, even in this time of crisis.  

SIDECAR truly is a resource to put you on a path to affluence. We want to help.  

Open or closed is a simple question but a difficult decision.  

My advice is, make it for the right reasons. Get to the heart of what’s best for you, your family and your business.  

Understand the why behind your decision – even if you have to ask it seven times.  

Daily life has been upended by the coronavirus pandemic.  

At SIDECAR we’ve been gathering all the information we can to help chiropractors through this crisis.  

What I keep coming back to is this singular message: Control the controllables.  

I’m sure you’ve probably seen or heard that phrase in other communication from us. But that’s not enough. This is the time to not only make sure you get through the pandemic – and it will end – but also prepare to grow your business when the stress eases.  

We changed the focus of this month’s Fuel Tank to “Business Survival Kit: How to stay proactive during a crisis.” That session is Thursday at noon central. You can still sign up here.  

It’s also available in replay afterward. Watch for that link soon.  

Our guests on the webinar are Dr. Ray Foxworth, Bill Esteb and Dr. Shahana Alibhai.

Dr. Foxworth’s participation, and other efforts by CHUSA, was highlighted this week by Chiropractic Economics on their website, chiroeco.com. Read that here.

We’ve also created the Coronavirus Business Survival Kit for download. You can get that here.   

The kit includes: 

  • Ten activities you and your staff can do now to not only survive but prepare to grow. 
  • A two-week email campaign to stay connected to send to your patients.  
  • Images that match the emails to use on social media. 
  • A Power Point presentation you can use to educate patients or other groups.  

These are two resources we hope you’ll take advantage of in the near term. The SIDECAR crew is committed to serving you during difficult times as well as good.  

We will ride alongside you through coronavirus… and beyond. 


There’s an old saying, “You don’t know what you don’t know. 

It’s more than a clever turn of a phrase. There are real world applications when it comes to the billing system in your chiropractic business.  

That’s one of the things we’ll be talking about during the next SIDECAR Fuel Tank at noon central time on Thursday, March 19. 

The session is called the “Slay the Dragons of Billing to Rescue Your Bottom Line.” Register now to save your spot in this informative – and potentially money saving – webinar.  

Going back to what we don’t know. That’s the rub isn’t it?  

The world of reimbursements grows more complex each year. Do you feel like you are keeping up? Or have you turned your financial future over to one staff member, charged with tracking all the rules and regulations? 

As well-meaning as that financial staffer may be, they may not be able to decipher insurance regulations and obligations either.  

Or, and isn’t this possible, your trusted employee also doesn’t know what they don’t know. 

In preparation for our discussion on March 19, we’ve prepared a one-pager: “Six questions to find Out if your billing system is leaking money.” Download it here. 

We hope that it helps you at least get an idea of what you don’t know and put you on a firmer footing when it comes to billing and, ultimately, your business.  

Then we’ll dive deeper in the Fuel Tank on March 19.  

Remember, even if you have a conflict and can’t make the live version, sign up anyway. That way you’ll get links to watch the replay when you’ve got more time. 

Finding and hiring good people. 

How many times have you heard that? It’s one of the main pain points for chiropractors and business in general. Historically low unemployment – and changing career goals – have made it more difficult than ever to assemble a world-class team.  

You can’t use that as an excuse, however. You need that team to create the patient experience that will lead to referrals and patient retention.  

Not to mention the significant cost of hiring a new team member. 

Dr. Tony Alessandra

It’s one of the points we’ll cover in our Fuel Tank this month with Dr. Tony Alessandra, an expert in behavior assessment and communication.  The session is Feb. 20. Sign up here.

I was going through some of Dr. Tony’s materials this week and ran across a one-sheet he put together on hiring and the importance of assessments in the hiring process. You can download that sheet here.  

Here are a few statistics I thought were interesting. 

  • Seventy-five percent of all hiring is due to turnover.  
  • Average churn rates have increased by more than 14 percent in the last decade and it’s going up. 
  • Eighty percent of all Fortune 500 companies rely on selection assessments in their hiring process.  
  • The average cost of a bad hire for a salaried position is $7,000. It goes up as the level of the position rises. Regardless of the job, it’s going to cost a significant amount of money when you make a bad hiring decision.  

There’s a lot more information in Dr. Tony’s one-sheet. And you can learn all about it at noon central time on Thursday, Feb. 20.  

It’s free. Just sign up here.  

We talk about communication all the time.  

How many times have you heard; we don’t communicate well as a company? Or my boss doesn’t listen to me. Or my wife. Or my husband. Or my kids. 

It’s over and over. 

The problem is that we don’t understand what that means. We don’t know why we can’t communicate, and it gets chalked up to “they’re just different kinds of people.” 

Which is exactly right, though slightly misstated. More specifically, people have different personality types. Understanding those broad classes of personality is the first step toward happier and more productive relationships. 

I’ve been thinking about this a lot lately because it’s the topic of the SIDECAR February Fuel Tank. My guest is Dr. Tony Alessandra, an expert in this field.  

You may recognize Dr. Tony if you are active in our training programs (and you should be). His courses offer practical approach to figuring out who you are, how to read others and how to use that information to connect with people.  

In my preparation, I ran across this information from Dr. Tony that I think sums it up pretty well.  

You can download a one-pager here to review later but I’ve included some of the information below.  

I hope it gets you excited for the Fuel Tank. I hope to see you there.  

Here are the seven areas where behavior assessments can be beneficial: 

1) Improve Hiring & Selection 

The right person in the right job is priceless. The wrong one is a nightmare waiting to happen. Accurately identify job applicants BEFORE the interview, make scientifically informed judgments and build an organization of A+ employees. 

2) Increase Sales  

Teach your sales team powerful behavior profiling skills. Empower them to identify— to your organization’s advantage— observable behaviors, then adapt their selling style to ft the customer’s buying style.  

3) Improve Customer Service  

Know in advance that your people believe in your organization and care about your customers. Better equip and train your customer support team with the invaluable communication and behavior profiling skills that pay countless dividends.  

4) Increase Productivity  

Identify with scientific accuracy the strengths and shortcomings of each employee. Create observable action plans, from the data, that maximizes your organization’s talent.  

5) Reduce Employee Turnover  

Ensure the best possible positional job “fit” for each new hire. Great fit means stronger retention rates, which lowers the costs associated with turnover.  

6) Customize Employee Training Model  

One size fits ONE, not all. Learn how each person learns best and get them back to productivity sooner. 

7) Team Building  

Know who fts with whom in advance. Create your teams based on compatible skills and traits, not just generic ideas of balance. Top-level teams are comprised of behaviorally compatible members with an optimal array of complimenting proficiencies. 

I was going back through “Chrome” the other day getting ready for our next SIDECAR Fuel Tank. 

The SIDECAR founders wrote Chrome a couple years ago to distill our principals on branding and marketing, which is the topic of the live Fuel Tank on Thursday, Jan. 23. You can get the details here. 

In reviewing the book, I had that flashback moment to the early days of my practice. It’s the experience I wrote about in the introduction. It’s always humbling and gratifying to rea

d it because it’s a reminder of how far we’ve come at SIDECAR and how fortunate I’ve been. 

At any rate, I wanted

 to share that experience with you from the introduction.  

Here you go: 

I wrote Chrome because I believe that your business can shine without advertising. Really shine. 

I know what you’re thinking: ‘That’s easy for you to say. You already have a successful practice.’ Trust me, it wasn

’t always that way. 

I can still remember the internal struggle I felt trying to convince myself to get out of the shower in the mornings. Faced with the challenge of piecing back together the mess I had made in my business and the struggles it placed on my personal life. 

I remember lying in bed at night and not sleeping, for days. The constant dialogue going on between my ears as I tried to find solutions to all the daily problems. 

I remember having an office full of billing staff; not making any money and being constantly barraged with problems we created. 

I remember thinking that the answer was an influx of new patients, and trying everything to accomplish that: doing spinal screenings, hosting dinners with the doctor, and pedaling every community event trying to spread my business. And while those new patients made me work harder – a lot harder – things didn’t get any better. 

I’ll never forget my wake-up call. 

I was confronted by the person I had abdicated my financial operations to with alarming news. He alerted me to the fact that we weren’t going to make payroll that week. I looked at him, a little bewildered, and told him that we would be ok, just let the line of credit take care of the short fall for the week. 

He told me the line of credit was maxed. 

My $200,000 line of credit was maxed out! 

After all the hard work – all the hours I had put into my business – I was $200,000 in the wrong direction. 

I realized at that moment that I had to change. Nothing was going to get better until I got better. That defining moment led to where we are today. 

The concepts are simple but that doesn’t mean the process is easy! The steps to build your brand and a world-class patient experience are simple, but the time and the hustle it takes to accomplish it isn’t easy! 

The steps to improve your communication skills with patients is simple, but the process of changing your behavior, leaving your agenda at the door, and connecting on an individual basis isn’t easy! 

But what I discovered is that doing it on your own is impossible. Chrome contains everything I’ve learned about branding, marketing, and advertising a chiropractic business. It’s the road map I followed to pay off my student loans, climb out of debt, impact my community, and enterprise my business to include several office locations. In short, it’s how I resurrected my chiropractic dream. 

I know it can do the same for you. 



Guess what percentage of the population has a favorable opinion of chiropractors.  

Seventy-five? Eighty? 

It’s more like 50 percent, according to a recent poll by the Gallup organization.  

Which may lead you to think, “50 percent doesn’t like us!” What a disaster! 

But that’s not what the poll said.  

The question was whether they agreed with this statement: Most chiropractors are trustworthy. 

Only 9 percent said they disagreed with the statement. That’s pretty good. 

Fifty-two percent said they agreed with the statement. That’s not terrible, though we’d like it be better. 

But think about this: Thirty-nine percent of the people polled said they didn’t know or were neutral on the question.  

Almost four out of ten.  

That’s a huge opportunity for chiropractors.  

They need to hear our story. How we reach these people? Marketing. Branding. Advertising.  

Yes. But what works? You can throw money at the opportunity and never move the needle.  

We’re going to discuss that in the SIDECAR Fuel Tank at noon central time on Thursday, Jan. 23. If you’re discovering the live presentation, click here and you can watch it. 

We’ve distilled the foundational principles of marketing in our book, “Chrome.”  

“Chrome” is a concise guide to the basics of achieving affluence with your chiropractic practice by building a shiny brand. At the core are the twin pillars of the right marketing and designing a memorable patient experience. 

Let’s go back to the poll for a moment. 

These are the people who’ve never been to a chiropractor. They have no opinion on trustworthiness. But many of them have an impression. They are frightened or distrustful of anything new, or just don’t have the information. This is where we can shine. 

But we know this. You don’t start with spending a bunch of money on advertising.  

Radio, TV, print, online – they all have their place at the end of the process. Not the beginning. 

As we discuss in Chrome and reinforce in SIDECAR’s training, there a prescribed order to marketing.  

It starts with operations. The systems and procedures in your practice must be tight. Your teams must understand how they fit into the whole process. What are the expectations for them? What does that look like in your practice?  

That lays the foundation for designing memorable patient experiences. When you deliver on that promise, it leads to more and better referrals from your happy and enthusiastic patients. Those steps, properly executed, create your shiny brand.  

Only then is it time to use traditional advertising. Then you’re adding fuel to the fire.  

Without that shiny brand, you’re just burning money.