Here is a view concerning insurance practices and “cash” practices that is different from what you might traditionally hear.

You might not agree at first, but at least read it and think about it before getting mad. Don’t be defensive.

1. Insurance isn’t what it used to be.Gone are the days of $250 deductibles. The only ones who have insurance like that are people in large unions or government-funded employees like teachers. Most of us are in small businesses with $5,000 deductibles, which means most patients are cash patients anyway. They know they have to pay cash for everything until they pay $5,000.

Secondly, over half of these employees with high deductibles have health savings accounts. This is a great way for them to pay their high deductible and they are happy to pay. They have to spend it on healthcare and it is pre-tax dollars. You are already more cash than you think!

2. Your staff can bill insurance and collect it.They are smart. Give them credit. Besides, billing insurance isn’t as hard as you think. There is work to billing and collecting, but you are paying them to work, and it’s called work for a reason.

There are two reasons why your staff may gripe and wear you down with insurance war stories: They are trying to increase their value in your eyes or they are trying to excuse not getting the money. Don’t get involved with that.

Your billing person doesn’t need a “university” or 10 years experience in insurance to do this job. Expect them to be able to collect 95 percent of net services. They can do it, and if they don’t, you get somebody else. Unemployment is currently over 10 percent — there is a long line of people out there willing to do the job.

Many of you say you want to go all cash because you are tired of the insurance hassle, but you shouldn’t be involved. You are paying somebody to do that for you. If they were collecting like they were supposed to you wouldn’t be frustrated.

The degree of difficulty in collecting goes up in direct proportion to the trick billing and coding you are trying to get away with. Don’t try to get paid for something you are not supposed to be paid for. Don’t try to get paid more than you are supposed to. Don’t justify dishonest billing. The more outside the scope of an adjustment and therapy you bill, the harder it is to collect.

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