Best Practices To Ensure Success During Active Care

Posted on August 22, 2022 by Holly Jensen

As Chiropractic Assistants, we are trained in handling calls for new patients. We understand that some people call the office shopping around so we do our best to nurture them and make a great first impression in an effort to schedule them for a new patient appointment. 

When the new patient arrives at the office for the first time, we welcome them with open arms. Once the consultation and the exam have been completed, we collect money for the visit and schedule their report of findings (ROF). 

The ROF is one of the most important visits the patient will ever have, as this is where they will make a decision that could impact their overall health and wellness. When they arrive at this visit, we’re hopeful that the doctor can help them achieve the results that will be outlined for them. Once the patient has said yes to the treatment plan that’s been outlined by the doctor, we’re thrilled to add another member to the practice.  We handle the patient’s financials and set up their future appointments.

The patient comes in and gets care. They never miss appointments, they pay on time and they get the big idea of chiropractic. It’s that easy, right?


We all have had patients start care, then drop-out later because “the pain went away” or because their “insurance benefits were exhausted”. It’s painful when these types of excuses come up and the patient discontinues care because they leave the practice and don’t get to experience the true miracles of chiropractic. They don’t get to achieve the results that were outlined by the doctor in the ROF because they failed to follow through.

As soon as patients start a program of active care, we need to focus on ensuring that they stick to the treatment plan in order for them to get the full benefits of chiropractic and so that they are more likely to transition to wellness care. So what can you do to make sure that the active care phase is a success?

There are four key things that are crucial for the CA to ensure take place in order to have a successful active care phase that sets the patient up for success.

Active Care Must Be Forecasted
To have a successful active phase of care, we must begin with the end in mind. Care needs to be clearly outlined right from the beginning. List out all services and products that will be needed during a clearly specified time frame. You’ll also want to include the costs involved right up front so there are no hidden surprises.

There are many benefits to the practice and to the patient when active care is forecasted: 

  1. Patients appreciate knowing the game plan right from the start. 
  2. Better treatment plan compliance because they understand what is taking place and the expected timeframe.
  3. Streamlines the flow at the front desk.
  4. No confusion over patient finances.
  5. More time to focus on patient care and education.
  6. Increased patient retention.

Imagine having all phases of active care already planned out and agreed upon by the patient. It takes any guesswork out and streamlines the patient’s journey! Forecasting care alone will greatly reduce patient dropout during the active care phase. 

Create a Frictionless Payment Experience
Once you have successfully forecasted care for the patient, the next step is to automate the way you collect their payments. We want to make the process of paying as frictionless as possible by securely storing their billing information on file. The best practice for this would be automatically charging their card-on-file as a recurring monthly payment throughout the treatment period. 

Why automated recurring monthly payments compared to pay-per-visit or pre-pays?  

  1. It streamlines the flow at the front desk.
  2. No awkward financial conversations.
  3. Increased cash collections.
  4. Monthly payments help to establish a habit, thus making it easier for the patient to smoothly transition to the next phase of care.
  5. Most people pay their bills monthly, so having them pay monthly is normal for them.
  6. Monthly payments are more affordable than other payment options.
  7. Automation removes the thought of money and allows the patient to focus on their care when they’re in the office.

Monthly payments streamline a lot of what you are doing at the front desk. The patient doesn’t have to stop at the front desk every visit to make a payment and they aren’t constantly reminded about money. Moving away from pay-per-visit to monthly payments will have a huge impact on retention during active care alone. 

We prefer monthly payments to prepays because this establishes care into the patient’s monthly budget so when it’s time to transition from active care to wellness, there’s not a new purchase decision for them to make…their monthly payment simply gets lowered. We still offer the option to prepay because some people choose that, but we don’t push it as the only option. 

Creating a frictionless payment experience during the active phase (and all phases) of care will ensure the patient is set up for success and make your job at the front desk easier. 

Staying on Top of Their Scheduled Appointments
During active care, we need to ensure that we are keeping the patient on the recommended treatment plan. There are situations where patients may call to cancel their appointment because they are feeling under the weather. We need to make sure to let our patients know that getting adjusted when they’re not feeling well can boost their immune system. Now, of course, in light of current times, be sure to take necessary precautions and follow guidelines. 

If a patient does miss an appointment for whatever reason, we want to make sure they aren’t just simply skipping the appointment, but that it gets made up within the same week it was missed. This is how we ensure that we stick to the plan and things don’t get out of sync and fall behind. 

Another situation you may encounter is the patient calls in and says something to the effect of “I’m feeling much better, do I really need to still come in two times a week?” or “I feel good, I don’t think I’m going to come in today and  I will see you at next week’s appointment”. Now, it could be that it really is time for them to drop down to less frequent care, but only the doctor can make that decision based on what the patient clinically needs. 

So how do we handle a patient wanting to come in less? “Susie, I’m not authorized to make changes to your treatment plan. Let’s set aside some extra time with you and the doctor at your next appointment and he can determine if you are ready to come in less frequently”. We have the patient keep the scheduled appointment and make sure it’s a clinical decision that changes the frequency of treatment. 

Make Sure Re-Exams or Progress Checks Are Taking Place
When we get a new patient, one of the first things we ask is if they have seen a chiropractor before and if they have, we ask why they no longer go to that one anymore. One of the most common things we hear is “I never knew how I was doing over there”. Patients need feedback as to how they are progressing towards the goal of active care or they will assume when the pain goes away, they’re done. 

Providing patients with feedback helps them to know that they are making improvements and it allows the doctor to communicate that with the patient. One of the most powerful things that this does, if done properly, is it also shows the patient a clinical reason why they should continue care even though their symptoms are gone. 

So if re-exams are this important, then it’s crucial to make sure they are taking place at the proper times. It’s so easy to let those fall through the cracks. It is the role of the CA to keep an eye on this and audit patient accounts and notify the doctor when the patient is due for a re-exam. 

Applying these outlined best practices to ensure success during active care is sure to help the patient achieve better clinical outcomes. And when we nurture each and every patient this way we help to cultivate patient retention. 

By setting our patients up for success during this active care phase, we will be able to smoothly transition them to wellness, ultimately creating lifetime practice members. 

About the Author

Holly Jensen has served the chiropractic profession since 2002 as a CA and Office Manager where she oversaw the operations of Dr. Miles Bodzin’s Chiropractic Wellness Center in San Diego, CA. For more than a decade she has continued to serve the chiropractic community as a Professional Speaker and the Chief Operations Officer for Cash Practice® Systems, the software & training company founded by Dr. Bodzin. To date, she has trained thousands of DC’s and CA’s on how to successfully attract, enroll and retain more patients while skyrocketing cash collections.  Holly may be booked for interviews and speaking engagements at or reached directly at Her inspiring story can be watched at

About the Author

Holly Jensen, the esteemed Chief Operations Officer of Cash Practice Systems, oversees a pioneering platform highly regarded in the chiropractic community for its unparalleled ability to boost revenue and retention rates. At its core are innovative tools like The Wellness Score, Care Plan Calculator, Auto-Debit, and Drip-Education Systems, meticulously crafted to aid doctors in enhancing patient retention and revenue. With unwavering commitment, Holly has been instrumental in solidifying Cash Practice Systems as the premier choice for chiropractors seeking practice optimization. Prior to her COO role, Holly collaborated with Dr. Miles Bodzin, CEO of Cash Practice Systems, in leading a highly successful wellness practice in San Diego, showcasing dedication to patient care. Together, they've dedicated over two decades to advancing chiropractic care, inspiring practitioners worldwide. Explore for transformative tools.

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