02/17/2026
Before I finalize my exit from the chiropractic profession in pursuit of one of the other employment opportunities I have applied for, I felt it necessary to address the considerable blow-back, among other adjectives I could use, we have received over our decision to close our Ridgway location as well as our exit from accepting insurance.
As I am sure you are all aware, the economy over the last few years hasnât been the greatest and it has affected us all in different ways. That being said, our experience was a dramatic decrease in business in both of our office locations, which, given the cost of gas, milk and bread these days is understandable. Instead of making a rash, uneducated decision, we held out for as long as we could to see if the issue was greater in one location or another. After approximately 18 months we found that our attrition rate was equal in both office locations and therefore our decision came down to a matter of math. Our overhead in Ridgway was far greater (gas, electric, internet/phone, and then add to that travel expense and office supplies) and therefore our decision was based on the financial bleeding our business was experiencing given our operating costs. This was a life choice ALL FAMILIES that run a small business make in their day-to-day operations and unfortunately after 10 years, our Ridgway location had to go. The attrition from this decision just didnât make sense to us since the travel distance and time from Ridgway to our office in Kane is only 11 miles and 9.1 minutes more than a trip to the Walmart in St. Marys (via the most expedient route on Google maps) that most make on a weekly basis without a second thought.
As for our insurance decision, it was also one that wasnât made lightly, but given that all insurance companies stopped paying for many of our services as well as the fact that many of the co-pays for chiropractic care became more than our self-pay rate, that action was based on the affordability of cost to the patient for care. In fact, many of our UPMC patients went to self-pay even prior to our insurance exit because that co-pay was $10 more than our cash rate for care.
Not only that, many people, due to the overall cost per available insurance policies, have been forced to take high deducible plans which means that until your insurance deductible has been met the patient is forced to pay the full rate that we bill to the insurance company which turned out to be, in many cases, $30 more than our self-pay rate for just a standard established patient follow-up visit (it was $40 - $60 more for an initial visit). We were forced, by our contract with the various insurance companies, to charge patients this rate, to do otherwise would be insurance fraud. SO, it was our decision to TAKE A CONSIDERABLE PAY CUT PER VISIT in order to make the cost for care in our office MORE AFFORDABLE, tell me how many businesses would do that for their customers?
On top of that, we were incurring costs due to this change because every week we would have to spend 3-4 hours processing insurance claims that we werenât being paid for since the patient had already paid that claim up front and therefore we were showing no return on investment because it was left up to one of us, every Thursday, to stop seeing patients so that these claims could be filled out and then submitted to their respective insurance company which meant that one of us WASNâT GENERATING ANY INCOME for the business in order to supply the insurance company with data so they could deduct the money - ALREADY PAID - from the patientâs insurance deductible. Which meant, at our cash rate, we were losing $300 - $400 PER WEEK in generated income!!
BOTTOM LINE â we took a substantial pay cut in order to make treatment more affordable FOR EVERYONE! Could we charge more, YES, and many offices in this area do from what weâve been told from patients who have decided to go elsewhere only to return to care in our office due to price as well as the level of excellence in hands-on care we provide our patients.
We are still allowed to accept HSA and FSA cards because that money is set aside on those accounts for healthcare related expenses. We even on some occasions, will provide the patient an itemized health insurance claim form for patients whose card companies give them a hard time about this expenditure even though our supplied receipt clearly states what type of business made such a charge on their account.
So, what is the cost in our office â well for an initial new patient visit, which is a 45 minute to one hour appointment based on the severity of the case, is $100. When we were accepting insurance, depending on the level of care we would provide in different cases this cost was, on average, $140 to $160. A follow-up visit, which is a 20â30-minute appointment in our office, is $50. When we were accepting insurance, most co-pays, even with Blue Cross, had become $60 and if you had a high-deductible plan, on average, the cost to the patient was at minimum $79. Again, we took a substantial pay cut so that the musculoskeletal care we provide was more affordable!
I thank you for your time in reading my diatribe but I felt I owed it to myself after 15 years of practice to get that off my chest and explain in detail to all those who have been considerably upset over our business decisions. Not sure where my next move will be but I want to thank everyone who has supported us over the last decade in this area and may you all have a blessed day.
Respectfully,
Sean P. Konrad, DC