Here's a few clips from our private session. Now in today's episode, I talked to Ingrid Knight and she shares the pros and cons of accepting insurance as a registered dietitian. If you want to listen to the full video that we recorded live together, I invite you to join the library. That is our membership at dietitianboss.com
Where you have access to guests and content information and coaching from me and my team. So let's go ahead and listen to all the value that Ingrid provided. Ingrid Knight RD and LD is a registered and licensed dietitian and the owner and president of Ingrid Knight RD and Associates Inc, a group private practice located in Georgia with multiple locations and telehealth offerings.
Ingrid is a co founder of Nutrition Practice Network, NPN, an online membership site dedicated to all things nutrition private practice. Welcome today for today's guest guest conversation for our audience here. So I'm really happy to have you. Thanks. Thanks for having me. Yeah. Really, really excited.
And is there anything that you want to add to that bio to share with the listeners? No, no, I think that kind of covers it. I'm happy to be here on behalf talking about insurance. That's sort of my, my thing. So I think we can just jump right in. Yeah, I'm, I'm looking forward to it. So, I will say for our members and our academy membership who are listening, it is a fairly common question that I get from dietitians when it comes to setting up your business, how insurance works and if you should or shouldn't take insurance.
And since I am all things cash pay and all things online programming and consulting and all of that stuff that is not related to insurance. It only made sense to bring on an expert like you Ingrid, who, like you said, you're really well known in that space and you have a group practice. So you you're a total expert in this area.
So, can you 1st share what are the pros and cons of taking insurance? If a dietitian is thinking about it. Sure, well, I would say the biggest pro is that you're going to be able to reach more people. And, you know, most of us got into this. Profession to be able to help people and we recognize that, you know, cash pay can be limiting.
And so it's really going to expand the reach of the number of people that you can work with you know, the variety of people who can come and use your services. We still have a lot of people that are surprised that nutrition covers or insurance covers nutrition. So that's exciting. But it does that not only by covering the service, but once you're in network with a provider or with insurance, you're listed as an in network provider.
And so, when a patient is looking for someone to help them with nutrition, or as a dietitian, they will find you in their network listed on the roster. So that's a really big selling point in and of itself. Again, they may come to you thinking that it's not a covered service, or that might apply to deductible where they have to pay out of pocket.
And that's okay. At least you've got that conversation going by being listed as a network. On the same hand, if you are you know, we are considered healthcare providers and a lot of us get our referrals from other healthcare providers. And so, if those referral sources are accepting insurance, they're going to want.
You know, the, the people that they send their patients to, to accept the insurance to. So knowing what your referral, where your referral sources are, and if they're looking for that, that's going to be a big plus they're going to want to know what insurances you're enrolled with, you know, and that's covering a lot of their patients.
They'll be happy to hear that. Some of the other pros are the pay really. We can't talk about private contract rates, but we'll talk a little bit about public insurance and public insurance is Medicare and Medicaid. I'm not going to speak to Medicaid because that's state based. I'll just generally talk about Medicare.
Medicare rates are public, so you could look up what the rate is for a per unit. That's a 15 minute time frame that would be reimbursed to you. And, you know, for example, and in the Atlanta area, it's around 30 dollars a unit that's 120 dollars an hour. So, and usually you can build up to 2 hours, so we can see patients for a long time.
We can get paid for that time. And the reimbursement is there and so it's. You know, a win win all around some of the other sort of esoteric pros of it is that the more we build, the more data there is that shows that we're providing the services and that we are providing great outcomes. That's a huge plus to both the payers, which is the insurance companies and anybody looking at that data.
We all know data is huge. Right? So, if we can show, okay, dietitians are the 1 billing. They're the ones getting paid for the service, and they're creating all these great outcomes at what essentially is a lower cost to the healthcare system because. We're seen as valued providers, because honestly, our costs are lower than surgeons or physicians, or sometimes medications.
So, if we can make those behavioral changes, the data is going to be there and I think that covers a lot of the pros. I think we're probably going to touch on some more of those as we get into more of the questions. I mean, I could, I'm going to be always pushing lots of pros. Yeah. I appreciate that the pros are outside of just the reimbursement in terms of how much money you can make.
And thanks for sharing in terms of that. Some of those rates are private versus public. But I, I am aware that taking insurance can help you become a higher earner dietitian because the top. paid dietitians do own a business. I'm assuming that data is from private practice from the Academy of Nutrition and Dietetics.
They don't specifically say what type of business, but there is data from the Academy that says the higher earners, highest earners in our field are business owners. And I, I like that you also added that. We're advocating for the field by showing more. I really appreciate that as well. Like the more data we have about seeing patients the more that we're able to advocate for the profession, which we all know we need to do, right?
If we want to be seen as an expert, the more we can show that data, the better. So I hadn't really heard too much in terms of that perspective. I've heard more about the reimbursement piece. So appreciate you giving a well rounded pros list as to why insurance is helpful. So I thought a good part about insurance is that and you can correct me if I'm wrong here.
Maybe this is a myth, but there's a, when you have systems set up, whether it's with another provider or however, you're, you're getting leads, you're getting potential patients to come work with you. It would be a different, let's say funnel or process than cash pay. Can you speak on that? Like, I don't want to say, I don't want to say it's easier, but can you speak to that?
Because that's what I see dietitians love about insurance. Sure, I get what you're saying and something that I wanted to touch on anyway is the fact that it diversifies your business. I'm sure you have talked many times about how people have multiple streams of income and private practice. So you can say, yeah, I own my own business, or I have a private practice.
But what does that mean? Yep. Just to back up and give you some background about how we ended up starting nutrition practice network. We were all in a mastermind together and our organizer actually kind of require that. We all take insurance. So that was something that was a unique experience. But when you get the 7 of us together, our businesses are so different.
Yes, the insurance piece keeps us the same, but 3 of us started nutrition practice network because we realized there weren't enough. Resources for private practice dietitians from the beginning to the end to the growth to having a group practice. So I'm the insurance expert. Christy does more corporate wellness.
Anna does programs, but that's my point. Is that we are all we all take insurance, but our businesses look very different. So, by diversifying your business by taking insurance, it's just another. Stream of income that doesn't mean that you can only take insurance or that you can't have people pay cash for other services.
There's a lot of things that insurance doesn't cover. Like, maybe creating meal plans, or I'm going to go do menu consulting for a nursing home or a senior center. You know, we're going to have lots of different incomes and cash pay. Things or different types of testing and labs, all of that can, the patient can still pay for that.
I mean, I can walk into some of my doctor's offices and they're selling supplements and other testing and, you know, the hormone shots and things that insurance doesn't cover. We can do the same. Yeah, diversify your business. I think that's where you're touching on. I'm huge on diversification. I, I gotta be honest with you.
Ingrid is only in the last 6 months have I come around to being more open with insurance and I've posted YouTube videos about it and I've. You know, I've been on it, honest with my community. I thought that the paperwork, and this is my own bias. I'm going to be honest about that. And I've said this publicly.
I have been intimidated by the paperwork and filing the claims. And I know that all business has paperwork, even if you're cash pay. Is that something that you see? I know we haven't gotten to the cons yet. This might be a good segue. Is that something that you see dieticians struggle with, or it's just like anything, it's a system you have to overcome.
So I tend to have an allergic reaction to paperwork. I just like my, I cannot. I, I'll do it, but it's so hard for me. I have to do like 12 affirmations before I can sit down and get some administration work done. It's, it's a little bit of both. It is a, it can definitely be a con, but it's also, like you said, it's just something you have to get through.
You know, we offer kind of. You know, the step by step to getting started, like, what do you all need? We have that in our document library at NPN. So you can get started with that on your own. And it's just like anything else. You got to break it down. Okay. You know, say you want a new job. Where do you go?
Find it? What application do you have to fill out? Do you fix your LinkedIn profile? Do you need an indeed profile like. All of those things are kind of the same steps. Like, we can do this. It's fine. Someone said it wasn't me. You know, if we can calculate TPN, then we can file, you know, to be an insurance provider.
And I can't even do TPN, so don't ask. Yeah, that's, that's not, yeah, that's a nice way of looking at it. So you can do the applications. Yes, it's a hassle. Once you're in, you've got to understand how it works. And we, like I said, we also offer, you know, billing and that sort of thing, training. Once, but it is a system once you get it down, you file a claim, you know, it's pretty much all in your the way it works.
And honestly, the way. The other thing, too, as I like to say, step back and say, just dietitian billing is not a different than any other health care billing. So, like, if you just wanted to know, what does a claim look like? What does what does a deductible mean? Things like that? That's all health care. So it's nothing unique to us.
It's universal information that could be located anywhere else. The other thing I want to say is there's nothing wrong with outsourcing. Whether that's hiring an admin and training them to do it. I personally believe it's a good idea to kind of understand at least what you're doing and have the systems in place, whether you're doing it yourself or someone's teaching you and setting up those systems, having what we call a playbook or a standard operating procedure.
All of these are just good business practices. You're going to do the same for having your insurance filing and your insurance plans. Sure, you can train somebody else to do that, or you can pay somebody else to do the billing. The thing that I find what most often happens is because we're trying to be dietitians, right?
We want to provide the service. That's great. But we're in business and the 1st. Priority of a business is to make money period. That's just the goal. Like, you can have missions and, and, you know, career statements and all that good stuff, but it's still a business still needs to make money. So we need to have the processes in place to make sure that we're getting paid for the services that we're doing.
And, you know, like I said, it's okay to, to not want to do it and to hire somebody else to do it. But, you know, how else do you get paid if you have what what happens if a cash pay pay client doesn't pay or their card gets like, you should have systems for that. I feel like it's sort of the same process.
Absolutely. And for for those of you watching who it's you're new in business. That is where the intimidation factor might come up where you're thinking, oh, gosh, maybe you're even insecure about providing the service at this point. Right? A lot of dietitians might feel intimidated. I know. I work with some clients that are still afraid about giving a great service to clients and it's just a matter of.
Creating that system, because that is part of business, you have to be able to have the processes in place. I don't believe you should delegate something until you know how to explain what you're delegating. Especially I mean, you're a group practice owner. So you would know, know that more than anyone and me having an employees and whatnot.
It's very important to have processes in business. So I can see where that feels intimidating to people. But it's also part of business. So thanks for reiterating that the number 1 goal is to make money. And so set in thinking that way and setting up the systems is just part of you delivering the service.
It just doesn't feel like that as dietitians because we, of course, we want to do the thing we're going to do. But in order to work for yourself, you have to have the other aspects together. Otherwise, you can't have can't create recurring revenue, right? It's just not possible. Something will break credit card.
Payment will go through. Somebody will be late or no show. And you're going to have to figure out what to do in that moment. So, and luckily there's support, right? It just feels it could feel uncomfortable for those who are either new or they're shifting to this They're shifting to offering a new revenue stream, especially if it's outside of 9 to 5, where you're being told what to do, and you're being told what the policies are versus creating your own.
Is there any other cons that you want to share before we move on to some of the other common questions that people ask about insurance? I can't think of anything across the board, but I'm sure we'll come up with some as we talk more about the questions. Yeah. So, when it comes to the billing and all of that, like, you're saying, it's just a process.
It's a matter of learning a new system, similar to, let's say, learning a new tool, like a social media platform. Once you learn it, and you have process in place, then then it becomes more natural. So, is that what I'm hearing in terms of taking that con and shifting it to something that you accept as a part of being a business owner?
Oh, for sure. For sure. And another point to make that a lot of people don't realize the reimbursement rate is actually calculated to consider the time that we spend. So, you only get paid for the face to face time with the patient, but the rate is higher such that it is considered all the time that we spent either charting maybe after or getting labs before and even some of the administrative time.
So, it's hard to think about. Okay. Am I spending all this time doing this administrative work outside of the face to face time? Yes, but that's. That's part of what the pay rate is, and it does get much more efficient as you go along. And then, you know, just to say something that we have is having those documents and forms and all the policies in place.
So they, your policies that you're handing to the patient back up your procedures. So we have all that in our document library. You don't have to reinvent the wheel, but you can at least see what a template looks like. I think that's where a lot of people get intimidated. Like, I wouldn't even know where to start.
If I was looking for a playbook of or a standard operating procedure for a just a general private practice, much less anybody. I don't care how you're getting paid. Yep. But just be able to have that access to, like, a library of all these documents where we have multiple options. Like I said, 7 of us in this mastermind group.
And, you know, 3 of us and NPN, we all have very different businesses. So we're all going to have different playbooks and setups and how things are going to flow. So, 1, 1 size does not fit all. But, you know, when you read about a lot of these questions, like the, what if, or the, what if that should all go back to your.
policies that you gave the patient and the policies that you have in your office. So I understand that, but I know that a new business owner feels, I know for a fact that feels overwhelming. Because even, even with the resources, which is why it's great that you have that support and it aligns with my values to, to recommend you because you've got that team approach.
And I absolutely, that's one of our values is teamwork. If you want to add contribution to the fields, you know, I love that you have. A variety of people who have practices and operate it differently. I think that gives great experience to your students, right? That people who are learning with you that's important.
So for those that are intimidated do you have any tips of advice, even though I agree with everything you're saying, but I know new practitioners, or maybe not even new, just people that are not. Process oriented are going to feel exhausted. What do you have to say to those people that are dietitians that are feeling overwhelmed?
A couple of things just, you know, break it down step by step, you know, recognizing that you're still going to be doing and you're still going to be providing the same great service that you do. Really? There's not a whole lot. That's It's just the way that a patient is going to pay is different. And so we need to just make sure that the systems are set up.
Also, I like to say, think about this. Like, most of us have lived in the health care system in 1 as a patient and as an employee, in some instances, so we kind of know, I mean, think you go to the doctor's office, they have a HIPAA policy. They have a financial policy. They have, you know, all these paperwork that you have to seems like a lot to sign, but there are some things that are required.
But honestly, most of that's just business practice. So it's the same. We're healthcare providers. We're still going to do the same. Our work is not unique in the sense of it's going to be any different. We still need to have those forms and policies in place. But in my mind, like you said, just as a business person, you know, if you've gotten to the point where you're like, I'm going to start a business and I want to do this right.
And I want to do it right. The 1st way you, you know, everybody needs some help. Let's get some resource together. Let's get something to start with. And. You know, I love us dietitians. We overthink everything. So I say, just jump in. I mean, I remember I had, I had a referral for a client. She was scheduled. I didn't even have an office.
I didn't have, you know, I think I had a phone and a fax and that was it. So, you know, it's like, oh, my gosh, I have a business. Right? So then I thought, well, I need some paperwork for them to fill out. And You know, that's evolved over the years, but that's what it was like. This is the document library that I wish I had when I started and we also have mastermind groups and we have 1 on 1 coaching.
So we know people learn in different settings. So being able to talk through that and say, you know what? We've all been there. We've all gotten through it. If you have your baseline business set up. You know, taking insurance is not going to be that much different. If you're ready to start, you know, look at what the checklist is say, you know, which insurances do you want to enroll with?
How do you do that? And then get started and learn about how it is, you know, understanding the billing because it is, you know, unique and complex. But if you've got all your system set up and, you know, you're going to go through some hurdles. Of course, there's going to be sometimes when a claim gets denied and you thought it would be covered or you know, something gets rejected in your system, but.
And the great thing is now we had so many resources, especially on social media, where people just pop in on Facebook groups, or, you know, ask questions or search up questions and find out how to fix it and learn as you go. For sure. Yeah, I think that the, what I, what I took away most from that is that having the willingness to learn as you go and approach something that is.
Maybe intimidating or overwhelming and you're absolutely right. The dietitians overthink things. That's a fact has to be something with our personality and it makes me wonder a little bit more about your stories, which I was going to ask. So I appreciate you sharing that you dove right in. You had an opportunity.
You started with just a couple tools, right? Maybe a fax machine and 1 other 1 other tool and you were able to build on it and then, you know, create a group practice. Right? So that's that's a great. A great story and role modeling for dietitians. So thank you for sharing that. Thank you for listening to today for the full session.
I want you to join the dietitian boss library available at dietitianboss. com where you can get access to our live guest recordings and you can submit your questions to be answered. Replays are also available. I also want you to check out Ingrid and her Nutrition Practice Network where she supports private practice dietitians specifically in a reimbursement and group setting and she helps showcase the visibility of a dietitian in our field with nutrition and insurance reimbursements.
Alright, I hope that you enjoyed today's episode.