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Steps to Transition Your Clinic to 100% Cash-Based

Hey there wellness entrepreneur! Welcome back! Today’s episode is a special form, a webinar I did for Embodia. Embodia graciously allowed me to share with you the content of the webinar here in this blog. This is the webinar called “Three Steps To Go A Hundred Percent Cash-Based.

So if you’re ready to go from low-income insurance payouts and time-sucking documentation to 100% cash-based practices with hell yes, patients willing to pay for out-of-pocket services, then this is the webinar for you!

And I want to give a big shout-out to Embodia for allowing me to repurpose that webinar here on the blog so you can give it a read. So I want to shout out Embodia which is an all-in-one platform for rehab pros and their patients. Emobidia does include an easy-to-use super bill feature as well as many automated features to have a more seamless and easy cash-based practice for clinicians who want to grow their practice and save time.

So if you haven’t yet already, you can go follow Embodia on Instagram or go head to their website and get subscribed to their newsletter because they give a ton of information. They’re always doing a ton of informational free webinars, they have a variety of different programs for the practitioner to boost your practitioner and your business skills as well as a whole bunch of options utilizing their platform where again, you can seamlessly integrate super billing and send out your HCP exercises to your patients all in one spot.

So go give them a follow and then we’re going to head right into this blog, so you can know the three steps to go have a hundred percent cash-based clinic and that is if you want to be in-person in your brick-and-mortar or online or have a hybrid.

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Maggie: Welcome everybody to this 60-minute webinar with Alison McLean, Go a Hundred Percent Cash-Based: Three Steps to Have a Hundred Percent Cash-Based clinic.

My name is Maggie Bergeron. I am a PT and one of the co-founders of Embodia.

So again, this is a 60-minute webinar. Before we jump into the webinar, I just wanted to show the Super Bill feature on Embodia. We get a lot of questions about this and recently, we built in a lot more automation of these features.

So Embodia does offer a Super Bill feature which is of course for USPT, it’s different for us in Canada and Just very quickly, to show you from the calendar, we can mark someone has arrived now. There’s a notion of invoices, which is how you get paid right? You can add your payment or if you’re collecting credit card payment and then there’s a super bill option which is automatically going to generate a super bill for you with all the information you need and you can add default so you can have all your diagnosis codes added as defaults as well as your procedure codes the price, and if you needed to, you could add, edit, or add more on there as well. Signature, all your state information, and then you can e-mail the Super Bill directly to your patient. So it makes it super easy and fast to use Super Bill on Embodia.

I’m going to hand it over to Alison who’s going to get into the meat of the webinar with you.

Alison: Awesome. Thank you so much. We will be talking about going a hundred percent cash-based in your rehab practice of sorts.

We’re going to go over a brief intro as to why you want to be a hundred percent cash-based and some of the methods that I will explain today will be completely relevant if you’re already a hundred percent cash-based. They’re going to help bring in more cash-based people.

So I’ll go with the three strategies required and within those strategies, we will talk about Super Bills. You know, some of, and this might surprise you, but some of your cash-based work might be online with wellness people anywhere in the world.

If you’re someone like Ariel who is on Instagram, has a big following in Yoga Journal, I’m sure she gets requests from people all over the world. I used to lead yoga teacher trainings all over the world and I would get requests from people I’ve worked with, people in Portugal and Brazil.

And so, when you’re cash-based, you want to think big. And how do you do that? If you’re only licensed in your state or for Canada, when you’re following the licensing for the Canada regulations, how does that work?

So we’ll talk about that. I’ll go over some case studies so you can know it’s not just me that has done this. Several of my clients have done it as well. And they come from different places. So you have some examples in your mind of what’s possible and then I have a special offer if you want to continue work with me and Q&A.

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Why 10K months Feel Really Overwhelming for Some

So if you’re wanting to hit 10k months, I know this is a very common number to work towards it is over 100k but sometimes, a year, it seems like a far stretch if you are taking insurance and you’re getting reimbursed anywhere from like 55 to 75 a session and you’re doing one-off sessions here or  there. Then 10k months can just feel really overwhelming because you’re like, “How will I do that with my schedule? Am I gonna have to see people at lunch? Am I gonna be treating people at all ends of the day?”

And then, “How do I get these people if I’m treating people all day, where do they come from? Where am I marketing?” A lot of people want to get out of the mill of doing one-off sessions, so a lot of evals and maybe one or two treatments after that, because again that $100 here or there, it takes a while to add up to 10k months. So they feel maxed out for time, they feel maxed out for revenue, but yet you want to help more people and you want to help people in a way that you have imagined.

Getting Dictated By Insurance

A lot of the wellness practitioners I work with have many different types of certifications. They’re very skilled at what they do. A lot of people even have large followings, very established in their communities, but yet they’re really dictated in their practice by insurance, by the number of visits that they can have, what they can code for, how long they might work with someone, even what they’re doing in the session is catered by making sure that it falls within the scope of the patient’s insurance or making sure that you get reimbursed for your time.

And to make sure that you get reimbursed for you time, often I find when I work with my clients that they’re spending a lot of time in documentation. And when they’re moving from an insurance-based practice to one that’s cash-based, and when we’re working with their time for example, if we’re trying to figure out their schedule so that they can hit 10k months and figure out how many patients a week that actually equates to, and we figure out a number, and they’re like, “Well, I don’t know how I can do that!”

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One Factor That Impacts A Therapist’s Schedule

And one of the number one factors that really impacts a therapist schedule is documentation. If you can agree with this then let me know in the chat. But when they go cash pay, you don’t have to spend all this annoying time and documentation.

You’re documenting yes, to see CYA, cover your behind, but also for you. Their notes for you. If you look behind me, I actually have a stack of files for my documentation for my cash-based patients. I do pen and paper still so it can actually be very simple and I document during my session. Very rarely will I spend time outside of a session documenting. So no time in my business really goes to documenting.

What Holds Back Practitioners from Going Cash-Based And How To Change This Mindset

So you want to hit six figures, you want to have time for a personal life, you want to have a consistent reliable way to bring in cash-paying patients and a reliable process to Hit those 10k months without working. We’re gonna go over all of that here and that’s especially what I do. I help clients create more freedom in their business by having reliable ways to 100k with having time for their own wellness practices and family life.

I actually just got back from Maui last week. It was a wonderful trip! So I can tell you that being more in-charge of your business not only allows you to treat patients the way that you vision, which often equates to giving them a better and higher quality of care, so they get better results, but also just makes your life so much more fulfilling!

And what often holds the practitioner back from going a hundred percent cash pay or going all in and believing that it will work for them is this one thought and that thought is, that people don’t want to pay high prices, they don’t want to spend a lot of money on high-ticket rehab or wellness or cash-based services and that thought will hold you back.

And so embedded in this whole presentation today is ways to negate this thought from your mind because the truth is when you hear a little bit about my story, people will pay a lot of money to get well when they know exactly what they will receive on the back end for that.

So it comes with a different mindset shift in terms of sometimes marketing and positioning of your cash-based services, but once you figure that out and we’re gonna go over that today as well, then it’s just rinsing and repeating because when you get visible and you get good at promoting your cash-based services, people will pay them and I’ve done that and that’s also why I’m providing my client case studies.

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The Problem: Firehosing During Evaluations

So the problem is, when you’re thinking that thought, you are accepting those one-off sessions here and there and you’re giving so much, you’re firehosing people on evaluations if you get that random person who does decide to pay cash, like let’s say you’re out of network with someone and they’re like, “Well I just know you maybe,” or they saw a workshop or they heard you on a podcast and they’re like, “No I need to work with you because you provide these in this and this services and that’s what I need, so I’m willing to pay out of pocket,” and you think you’ve struck gold with this rare random visual.

It’s not true, there’s many more out there, so they come for the evaluation and because you think they don’t want to pay for all these sessions afterwards following, you just firehose them with all this information about their diagnosis, about anatomy, about their myofascial, you give them a whole exercises and you send them home with all this information.

It doesn’t serve them because now they’re overwhelmed. Most likely they’re not gonna do all those exercises because I feel like it’s gonna take too much time or you gave so many exercises that they don’t remember the details for them. So they do them wrong or incorrectly or they just forget everything and they freeze and they block it and they think they got some benefit but they don’t end up following through and they’re not gonna get better that way, obviously, and it doesn’t serve you because now you’ve given a whole bunch of energy and your time and you exhaust yourself and you become this mill of evaluations and then letting them go you’re putting out all this energy into firehosing with people, with new information and you’re not seeing them through their plan of care again because you think that they’re not gonna pay for more services. But they will!

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You Need To Know Where to Market For Your Cash-Based Services

Also when it comes to cash-based practices, I find that people really feel overwhelmed with the marketing. They feel that they have to be on social media or that they’re gonna have to spend a lot of time on social media. They don’t know what to say. They don’t know where to show up. So then they end up at lunch and learns with doctors pitching their services, but it’s not a good match because those doctors have an insurance-based practice, so most of their patients that they see are in network, so you’re not getting any referrals for them anyways. Another waste of time.

So you need to know where to market for your cash-based services and the thing with insurance is what I said before, it’s going to limit what you can do not only the treatment sessions which impacts the results that your patients will get, but it’s limiting the potential that you have in your business because if you’re exhausted seeing two people in an hour or worst case, I worked in a mill over a decade ago, I had to work with two to five people because of the type of insurance that they took. I’d work with two to five people at once so then you’re exhausting yourself and not having the energy to build the practice the way that you really want to build it and when you get in kind of that stuck cycle business, feels hard and exhausting, and you don’t see how you can go from where you are to higher revenue months without working more and your brain’s a bit blown because you’re like, “Well, I don’t have any more to give.”

The Solution And How It’s Working For My Business

So the solution to all this is getting that reliable process and believing that people do want to pay the price and receive high ticket wellness services from you and again, that can be in-person, in your clinic, or online.

So you can see behind me I have that Mexican blanket. I have a table right behind me. So I have a hybrid practice. I’m mostly business coaching these days, which you’ll hear everything I do is a hundred percent business coaching. But I still have some cash-based physical therapy patients. I call them clients because they’re more on the wellness side now. Some of them have been with me over a decade, paying me consistently. Some of them come once a month. Some of them come twice a month.

I have a semi-professional golfer. He comes twice a month. I had a grand prix horse jump rider. He came twice a week. So really, people will pay a premium dollar if you’re gonna show them a specific result and here’s the thing: you don’t need a big fancy clinic to do that. I’m working as you can see in a she-shed and people pay me over $300 an hour and I’ll show you how I built that and the reason why I could let these people go, my business coaching practice is pretty much booked out. I don’t need the revenue from those services, but I love working with those people, so for now I keep them.

And so it is possible to have an in-person cash based services as well as online and when you do that, you get to combine all the money that you’ve invested in all your trainings, in your degrees, in your certifications. When you have a cash-based practice, you get to utilize them all finally!

I remember when I was working for that mill, I was a massage therapist ten years prior to going to physical therapy school. So I went to physical therapy school late and my story is a little similar to Aaron Brower’s. How? Because people are paying me cash as a massage therapist with a BS and no doctorate and they’re paying me over a hundred dollars for my hands at that time and they were coming off the street with no prescription for help with their back pain and their neck pain and their headaches and all the stuff and I would say I’m not a Physical therapist. I’m a massage therapist and they’re like, “Massage is what I need.”

I knew when I graduated from physical therapy school I’m like, “Hey if I can book out my massage practice then for sure without a doctorate in physical therapy for sure I can build a cash-based practice.” So when I finally opened my own physical therapy practice, I never took insurance ever. I was always a hundred percent cash-based and in fact, I was on more of the wellness side. I never had physical therapy in my name. I called my business Ignite Ur Wellness because I knew I wanted to work with people online and in-person because I was leading yoga teacher trainings and I was getting requests for people all over the world. So my mindset went into physical therapy practice different than the traditional physical therapist that graduates from school or starts and works in an insurance-based model and that is trying.

That is the information that I want to pass on to you today is a lot of it is just a different mindset shift because the super bills, the legalities of contracts and all that kind of stuff, that all can be done in one hour and I’ll go over that here.

Some of the Things You Need To Do And To Have To Succeed Going From Insurance to Cash-Based

But the most important thing is believing that people actually want these services and when I first started my clinic, I went to physical therapy school because I was booked out with massages. I thought the way but I hadn’t hit six figures yet, and I was 25 years old and I thought to myself, “Well, if I haven’t hit six figures but I’m maxed out in the number of massages that I can do in a day, the number of massages I can do in a week, I have my own practice. Like the way to get ahead in business is to learn more. If I learn more, then I’ll figure out how to actually grow my practice to six figures and bring home more profit.”

Because I was working a lot back then. And so that’s how I ended up in physical therapy schools. I wanted to learn more about the body, which is good. I think we need to continue learning which a lot of healthcare providers have no problem with going to con-ed trainings.

And as you can see, I went on to many more trainings. I did a lot of massage therapist hours. I’m a yoga teacher. I’m also a yoga therapist. I did two tracks at the same time. I did my physical therapy schooling and I did a ton of yoga therapy trainings. I’m also a life coach, certified, so I thought in the beginning, the answer to getting ahead in business was more practitioner skills knowledge. That will get you so far in getting your patients result, getting your clients results, making sure that they’re getting what they paid for.

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So it’s a need to keep doing that. But the skill, that’s also really needed. That got me to where I am now: business skills. And that’s what I’m gonna teach you today. And so I had to invest a lot of money in business skills because when I first started my business, I thought it was the old mentality. Both of my parents were entrepreneurs and I rarely saw them because they were working seven days a week all hours, and I thought that’s what you had to do in business. I thought that’s how you got by.

So I was leading yoga classes at 7 a.m. In the morning 7 p.m. at night. I was squeezing in patient sessions in between those. I was leading yoga teacher trainings on the weekend. I was traveling. I was leading workshops. And a couple things happen at the same time. I got a scary health diagnosis and my daughter who you can see there in the picture came up to me one Sunday after getting home from my yoga teacher training and she said, “Mom I missed you,” at the time she was in preschool, “And now I have to go to school tomorrow and I don’t get to play with you,” because she was going to bed.

And getting the health diagnosis and hearing that from my daughter at the same time, and I was starting to get into the coaching world at the time, I knew that I had to do my cash-based practice a different way, that this old method of just working more, working harder, squeezing patients in, thinking that people didn’t want to pay cash-based, that mindset wasn’t working anymore. I had to learn a new way and when I learned this new way now as I said, I charge over $300 an hour for my physical therapy services. I charge 3k packages, 6k packages. I sell those consistently. I also, as I mentioned, have a hybrid online services and brick-and-mortar services, which I just love because I can take, well last week when I went to Maui, we actually did a vacation, so I can take completely off.

But last year, I took six weeks off. It was personal as someone in my family passed away. So I took ample time off to care for them and my business kept going. I was able to do that.

So I’ve grown two six figures businesses and if I can do it, I’m an introvert, I’m not a special snowflake, what I teach you today, you can too! And it gives you not only control of what you’re doing in your sessions, but how you run your business because you’re not waiting to get paid by insurance. 

Now you’re getting money ahead of treatments, ahead of sessions. There’s that saying of Cash is King. Once you have that money in the bank, then you can better strategize        and make more decisions plus it gets you out of that scarcity mindset thinking of like, “Well, I’m off money to pay the expenses.” Maybe you’ll say no to some things that you used to say yes to in the past just to try to bring in revenue, things like that. So when you start thinking like a CEO and believing that people will happily pay for cash, that’s when you start hitting those bigger revenue months.

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Three Steps To Go A Hundred Percent Cash-Based

Okay! So here are the three steps. We’re gonna go over on how to hit a 100K cash-based only and again, this can be online a hundred percent. It can be in-person a hundred percent. I’m gonna show you examples of both and it can be a hybrid like myself and some of my clients as well. I help them run some hybrid businesses because that gives you flexibility to travel and anywhere in the world and you’re not relying on your body.

So the three steps we’re gonna go over is a reliable six-figure lead generation process utilizing workshops. I know maybe some of you have taught workshops. I’m gonna teach you in a way where you’re not just teaching the workshop to make money from the workshop. It actually converts to those cash-based clients consultations and having that ethical high-ticket wellness or cash-based offer and within the high-ticket wellness offer, we’ll go over some of the strategies of like, “Okay if I want to work with someone online and they’re out of state, how does that work? How does super bills pay into the equation,” and any other questions you may have of that type of.

You know nuts and bolts and admin because right here, one two three, that is how you’re gonna bring in cash-based people and that is really how your business is gonna stay afloat and that is how you’re gonna hit a 100K months. All the contracts and all the admin stuff, you can do in an hour. I know because how I actually started my business working for my mentor for a number of years almost decade and she sold her practice and when she sold her practice, I was operating and running a satellite office. They wanted to close that office so they let me go.

So in the time of them letting me go, in one week, I started my cash-based practice and had six people in the books. So I know it can be done, all the nuts and bolts of whatever admin work you need for your cash-based practice can be done in one day, can be done in one or two hours, and if you get stuck there, then it’s a mindset issue. It’s not crossing the T’s and dotting the I’s. It doesn’t take that long. This is actually the more once you have yourself covered in terms of legalities and contracts and you know what to do for super bills.

Here’s the thing too: once I send my people the super bill receipt which Maggie showed you which was so easy, takes less than five minutes, I had them submit it for reimbursement. It was off my hands and people still paid me a lot of money for that. Now if you have an admin, you can always have your admin help out with that process. But you don’t have to so keep it simple for yourself.

So workshops! How I hit over six figures with my cash-based practice was primarily through workshops. A good percent and percentage of my patients came from partnering and collaborating with studios in the area. So I’m a yoga teacher as well and I taught classes in some of the studios. So it was a natural extension to start doing workshops.

Now, I’m an introvert so you can do them even if you don’t like public speaking. I didn’t like public speaking. I didn’t like being in the limelight, but I learned and what I see with a lot of professionals that do teach workshops is they don’t have a clear workshop process that leads to conversions on the back-end of the workshops. They’re just teaching workshops and they’re again fire hosing people with a ton of information and all those patients leave attendees, leave the workshop thinking that they got everything they need to heal their bodies and there’s no talk about future sessions and so yes, they may have made a few hundred dollars.

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Sometimes when I had a sold-out room, I would make over a thousand dollars in a workshop but if you don’t have a clear process, it’s not going to convert to the high-ticket wellness clients, but that’s most important because if you’re making a thousand dollars in a workshop, for example on a good day versus signing three of those attendees if you have a $2,000 cash-based package. That’s a difference of $1,000 or $6,000. That’s a big difference per month.

Question from a Participant: Can you briefly talk about CPT codes?

CPT codes, there’s not a standard price for each code. What you’re gonna put in the price line for your CPT code is whatever you’re charging. So for example, I primarily used to see two or three CPT codes. Manual therapy, 140, exercise 110, and neuro 112, and depending on what I did in a session if I charged two hundred dollars, for example, I would break it up that way. So you have to break up your CPT codes based upon the price that you’re charging again, this is a mindset shift. You are the CEO. You’re dictating those prices. Someone out there in the world is not dictating the prices for you. You own your own business. So you dictate the prices. Does that make sense?

Back to the Topic On Workshops

Okay, so when you’re teaching, a lot of the times what I see with the workshops are they’re not done really well. Attendees are given a lot of information. Often too much information, but there’s no way to convert them at the end.

So you can substitute workshops. I’m going to teach you my process here in just a moment but think of like this process can be used for podcast guesting. This process can be used if you do teach classes. Some of the philosophies can be taught in fitness classes. I have a client and she partnered with CrossFit gyms. You can partner with Pilates studios. You’re only limited by the creativity in your mind so it just becomes a mindset switch of now, instead of booking lunch and learn lunches with doctors who have insurance-based patients who want to stay in networks, so you’re not likely to get referrals or if you do get referrals, you’re gonna get a lot of questions on the phone or in that discovery visit being like do you take my insurance? Right there and then, you’re having that battle all the time.

Versus if you just go out into the community and partner with facilities where people are ready, used to paying for out-of-pocket services, you’re gonna reach a demographic, a different demographic of people who are already used to paying for cash-based services, so then they’ll have a higher bridge to paying for your expertise. Because now you hold masters and specific knowledge in the body in a way that a lot of the fitness professionals don’t, that they will be more likely to pay a higher price and pay for a private.

But then it’s just educating them in the consult which we’ll get to later. But the seeding of that work is done out in the community in workshops. So the process for workshops that I teach is this right here. And this is how I filled a lot of rooms. I taught workshops anywhere from one to two a month for over a decade for ten years or more and I still teach workshops and webinars. As you can see, this is a little meta I’m doing it right here to this day and it doesn’t matter if you have an in-person workshop. You can still have an in-person workshop, but sell online services.

So for example, I did a workshop for our Chamber of Commerce here in my local town and I was for the wellness entrepreneur and I pitched my online services of coaching and I had several people take me up on that offer. So you can do workshops online or in-person and it doesn’t matter if you offer your cash-based services that are online or in-person because at the end of the day, what the person in the workshop really cares about is their back pain and as if you can help solve their back pain problem.

So when we think of it from that lens, how to get people in the room for your workshops, is you first want to pick a popular topic. So I had my first workshops where I’ve done those collaborations with the studios. I had about five different workshops I would choose from and they were all based upon like the requests that I would hear in my office, like how do you heal my back pain? I have neck pain and neck and shoulder pain. I did de-stress and migraine, one was another core strengthening workshop.

So it’s learning a handful of topics that you know will resonate with your crowd, that people are requesting help for maybe their shoulder. If you work with a lot of tennis individuals, if you work with a lot of skiers, maybe it’s a knee workshop, so thinking of the person that you work with the individual. If you have a niche or if you’re more general, you can kind of cycle through the body? I mostly specialized in spine because as you can see behind me I utilize the yoga wall where we can get a lot of traction.

And that was step number two was showing them in the workshop uncommon strategies. So for example when an individual came to my workshop, a lot of them thought that I for example, my two most common popular workshops was the low back one and sciatica one and they all thought that they needed more core strengthening and so I would meet them where there was where they were at.

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I would yes, give them some core strengthening, but then I would blow their mind and show them some uncommon strategies that they haven’t seen before and with step number three. I would sequence in it in a way that combined all my certifications. So then the common exercises of Bird dog and cat and camel. Yes, I might do some of those but they were from a different perspective.

Because now I explained it all based upon my experience, my own life experience and my expertise of all my certifications. So I’m gonna break that down in a very practical way and show you exactly what I mean.

So because I’m a yoga teacher, because I’m a massage therapist, I work for 20 years now, I prime a lot with the nervous system. This was like a decade ago before the nervous system was as hyped up as it was used to be. So as it is right now, so a lot of people when they would come to me I worked with a lot of ambitious types, professionals, busy people with back pain, and they thought they needed core strengthening. They thought they needed to get stronger and their hamstrings were tight for example.

And I would say yes, I’m gonna show you all that and I would show them but first I talked about the nervous system and I talked about how if even if I’m going to show them a hamstring stretch or ways to relax their neck, if they’re not having tools and techniques in their day-to-day to release and calm their stress, then that tension is just gonna come back. And I explained how underlying tension, and always in the sympathetic response most of the time, in a triggered nervous system state fuels cortisol which fuels the inflammatory system and all that type of stuff.

Also Read: Integrating Yoga, the Nervous System & Physical Therapy for Pain Reduction

They would have never been bought into the nervous system. So part of my workshop was utilizing on my past experience of being a massage therapist, of being a yoga teacher, of being a coach and working with mindset. I brought that into my workshops and I would layer all that in so they left feeling a completely different person. I wouldn’t fire hose them with a lot of exercises. I took my time in explaining the exercises in a way where they understood the benefit in the power of everything that they were doing and it left them wanting more they learned maybe one breathwork technique, they learned maybe one restorative pose.

I also did a lot of traction work with straps which they’d never seen before. That was like a hamstring stretch in a way that they’ve never done before with two straps to provide space in the hip joint, in the spine, so they left feeling like a new person.

And as I said before, I was an introvert at the time and I didn’t pitch well, I didn’t at all. I would close my workshops and it would just be like, “If you have any questions, talk to me.” I got better at the end and I would say, “If you want, I do offer private sessions, if you want to work with me then come talk with me,” and I’d actually book consultations at the end.

But when I first started my workshops, because I was showing them these uncommon strategies and sequencing them in a way that no one else could do because only someone like me had my specific expertise, had my specific life experience, because I have a history of sciatica and I have scoliosis and I have two herniated discs and tears in my discs, they were bought into me so they were willing to pay out of pocket to come to see me and they would approach me after workshops and say, “Alison I think I need to work with you. Can I work with you?” And so that is how my practice started and it was just utilizing this process here.

Question From A Participant: How Do You Market Your Practice?

This is how I market my practice, Georgia. We’re in it right now, workshops primarily. I’m also on social media But I’ll tell you social media becomes your billboard. You don’t have to do post after post after post. I would just do a post and people in from my workshop might follow me and it would just reinforce the work that I did in workshops back then.

Now I sign clients off of Instagram all the time but back then, when I had my brick-and-mortar practice, I built to over a hundred thousand plus from workshops. So when you have this process dialed in, your clients realize your expertise. They know, like, and trust because they’re in a room with you for two hours. They get to know your story, they get to know your specialty, where you differ from other practitioners doing similar work than you.

When they understand that, that is why they’re willing to say, “Okay I’m gonna commit to 12 sessions working with you versus doing one-off sessions,” or saying, “I’m gonna go to the practitioner across the road who takes my insurance.” This is why I have people with me for over a decade and they tell me, they’re like, “Alison if you stop seeing me I don’t know what I’m gonna do because no one else has this combination of utilizing the yoga wall in your magic hands and calming my nervous system the way that you do. Like, every time I come to you, I leave feeling like I work with other physical therapists and such. She’s like no one else! I won’t let anyone else touch my neck except you!”

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I always leave with my head on straight because people I work with, some complex patients, and they’re willing, I’ve raised my prices on them several times over the years. Not in a mean way but because that’s where my business was going and they’re willing to stay with me for that long because I’m in San Diego. There are practitioners, wellness practitioners, physical therapists like right across the street from me like everywhere in San Diego. There are so many practitioners doing similar work that I do. Yeah! They can’t do it the way that I do because I’m a specialist.

So you hear all the time like you don’t need a whole bunch of certifications and stuff. The thing is I know you’re gonna go out and get the certifications anyways. So keep learning but utilize them, utilize those certifications and training to set yourself apart from anyone else doing your work and people will want to come to you because they’ll realize they can’t get the work done anywhere else and you’ll be talking with them not a doctor in a lunch and learn who again is just gonna hand that patient a script with your name on it.

There’s no connection there and so that is why often the first question out of their mouth on the phone call when they call you is because they have nothing else to go from, like they have no information to compare you from the other physical therapist across the street who does take their insurance. So this is a way to set yourself apart.

Question From A Participant: How do you get people to attend your workshops?

Oh! Filling the workshops. Okay. Let me get into filling the workshops. That’s a great question Georgia. I don’t know if I read your question earlier and I realize I have to read them for the people that are watching on the replay Georgia’s question before is how do you market your practice? So marketing the practice is yes through workshops.

Question From A Participant: Is it all word of mouth?

I did get word of mouth. I do have word of mouth, but you don’t want to rely a hundred percent on word of mouth because it puts a lot of pressure on your patients. So I always love word of mouth and whenever I did get referrals, I worked with whole families like sisters, a mom, and a dad. I work with many couples to this day where they actually treat me like family because I worked with them so long. Friends of friends all that I did take but I felt in control of always bringing people into my business at my own pace. Like if I knew I had one to two workshops a month, I knew I was gonna sign more clients versus word of mouth and referrals.

You never know when they’re gonna come. That leaves your business a little risky because you’re not in control of that. So yes, it’s one spoke of your marketing wheel.

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Marketing Workshops

So to market workshops, it can be through utilizing your current connections whether that’s your e-mail list. So I personally would market my workshops through my e-mail list on social media. I would market my workshops as well as collaborations.

This was key for me because when I first started obviously, I didn’t have an e-mail list. I had to grow my e-mail list from zero just like everyone else but I would partner with yoga studios as you see in these pictures. I’m in different yoga studios, I had about five to ten yoga studios here in San Diego with my handful of workshops and throughout the year I would just go and teach workshops at those studios and I would cycle through the topics and when I held a workshop at a yoga studio primarily, it was commission based meaning I would receive anywhere from 50 to 70 percent of the commission from that workshop because the studio would market my workshop to their list and usually a studio’s list are thousands long.

So that is how I grew my e-mail list, through workshops, just 20 to 30 people at a time. And teaching yoga classes around town. People would come up and inquire about my services after classes person by person. I grew my list to over thousands. So collaborations are really helpful. Now this studio that I’m teaching at here actually, I read so you can see that’s a full room and I sold out this workshop and I rented the space meaning that this studio didn’t help me promote this workshop at all. It was all through my own promotion of my new e-mail list and social media. That’s primarily how I did it but that was after doing workshops for a couple years so you can get to the point where you run out of studio space.

The reason why I did this was because I was getting requests from students at that particular studio to do a workshop as well as some of my current yoga studio is at a different studio that I taught at and I wanted to use the yoga wall as well as my current patients that were in a part of San Diego. They didn’t want to drive down south where I usually taught the yoga wall so I run it out the space at this studio that was closer to their home and I was able to fill it because by that time people got to know me in my community.

Okay, let me see if there’s another question, but keep the questions coming. I love them! So yes workshops are primarily how I built my practice and the thing about it is it’s simple because it’s a rinse and repeat process. Once you start it, you get better at marketing it so your rooms fill.

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When I first started marketing workshops with maybe three to five people, I think my very first workshop had three people in it. Not very large. And then they filled to five to eight and then into double digits ten to twelve and then twenty to thirty and then I was selling out and then I started getting requests from workshops in the nation like if I was traveling I could travel to New York and see my family and I would teach a workshop there and I was able to fill it.

So once you have your process dialed in, then you can have travel right off your travel expenses because now you’re teaching workshops anywhere and if you’re working online, then you can sell some of those clients into your high-ticket wellness offer.

A Client’s Story

So let me move along here. So Christina came to me. She only had two patients. She was a mobile therapist and she was extremely stressed out. She didn’t know her marketing plan and how she was gonna bring in revenue and she was working with a lot of insurance-based people and Medicare was slow to reimburse her and we work together and she is a go-getter.

She just reached out to a lot of studios and CrossFit gyms because she really specialized that. She got a bunch of workshops in the book and she got fully booked within three months. She got so busy and her revenue jumped so high that she was able to leave from being a mobile therapist driving around San Diego in town to now working.

She opened her own office and then she started. We made a plan to let go of Medicare and then next step was to let go of Tricare because now she was getting more cash-based people through her workshops. So that is just one example.

So how do I take people from workshops then to the ethical high-ticket wellness offer?

That in-between steps is Consultations. So a mistake I see with consultations is people are winging them. They’re doing them on the phone as a discovery visit or it’s like a quick 15 to 20-minute thing but when your people are investing thousands of dollars with you, they need to understand what they’re gonna get. They need to understand you now. Sometimes it can be quick off a workshop, someone can be really bought in if they loved your material and you really spoke to what they were needing and they felt great after the workshop and they wanted more.

Sometimes you can do it in that 20 minutes but sometimes especially if you want to sell that, your $2,000-$3,000 dollar package, people need a little bit more time because especially if you’re a stranger, and that’s just normal right? It’s human psychology is that people want to learn information they want to feel safe with buying and when you have a consultation process that you know you can lead them through to help them feel secure, that they’re making a good decision for themselves, then you’re gonna start to get less of those questions of, “Will you take my insurance,” or “I might try Insurance first and see if it works for me,” to “I need to work with you because I know that you have the services that I need because of your expertise,” and people are willing to pay and more importantly, when you’re getting more yeses on your consultations, that is gonna take you out of the burnout cycle of trying to bring in a lot of money through insurance-based or low ticket offers or one-off sessions or just doing discovery visits on the fly and getting a lot of no’s or spending a lot of time and energy on the phone with someone trying to convince them that your services are worth it.

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When you have a process, you get out of this exhausting cycle and you’re able to have a reliable structure where the consultation is actually focused on the client. You’re gonna listen to their specific needs and the plan that you’re gonna offer them is not a cookie-cutter.

It’s yes, you can have a framework in your process. We’ll get into that in the ethical high-ticket offer but what you’re saying on the consultation is completely catered to them and their worries and their symptoms and their desires of what they want in life and when you’re able to do that, then you’re able to confidently say, “Okay, so to heal your back pain, to work with your scoliosis so that you can get on the golf course every week and play nine holes,” or “I have a patient who plays 36 holes without pain then you really need to work with me at least once a week for 12 sessions and the cost of that is $2700,” as succinctly as that.

And then you can talk with the person when you have that structure and most likely that’s where the conversation starts. Someone may say, “Oh, well, that’s not what I was thinking,” and you have an answer prepared for that or they say, “Oh, okay. Well, I have to think about that.” Okay. You have an answer prepared for that and so you’re not surprised when someone is coming up with objections because that’s normal. Because when someone’s gonna spend that much money to care for themselves, they’re gonna want to think about it.

Yet as a professional who knows what they need in their body, you have to help them through that process and not be skimish or a weirdo because you think it might be slimy, right? So that is the whole trick in converting with cash-based practice. It’s for their benefit. It’s for the clients. It’s not for you. Because not everyone is gonna say yes. You are speaking to and trying to attract those clients that do want to work with you because they know that you specifically can help them and that also reduces the shopping around and the price comparing.

So when you have that process dialed in, you’re able to tell your price and why they need those services. It doesn’t feel slimy because you know that working with you for 12 sessions for example versus one session, which is just the evaluation and a couple exercises. They’re gonna get so much better one or three versus twelve and with that confidence and when you start getting more and more people results, that’s how you’re able to charge higher prices and that’s what’s gonna fill those 10k months.

And then you get into a different cycle, which is more energy fueling of the sign clients because now you’re making more money, you’re seeing your people get better because they’re with you longer. They get to know you, they refer you more people, you’re utilizing your certifications, you’re treating people the way that you want to treat. You’re not spending all your time documenting, you’re working with people all over the world.

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If you add in an online component, it’s a whole different mindset and feeling in your business versus the burnout cycle. So if you’ve ever been in the burnout cycle, you just need to get out of it as quick as possible. Not only for you and your own health, but for sake of keeping the doors open to your business.

So my client Lynn when she first came to me really disliked consultations. She disliked selling. She felt really slimy. She was selling mostly one-off sessions. Maybe a package of three and we really worked on but she’s a specialist. She’s a physical therapist for runners. She really has a great niche in her area. There aren’t other people doing what she does, she’s the expert. And so we worked on her consultations and she went from selling those one-off sessions and packages of three to getting really confident of selling mostly packages of three then two packages of six. She got really good at that and now she’s selling packages of 12 and last year she hit her 100k year.

So just like that! And she uses the workshop process. However, she calls them running form clinics. So again there, it’s the structure you can call them whatever they want, whatever you want. That’s again based upon your clientele and it’s a just a rinse and repeat process to get you to 100k. So she does monthly running form clinics where she gets people to come and get their running form assess and then she pitches the consultation at the end, gets people on the consultation and then converts them into packages of 12 and that’s how she hit 100k.

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And so that package of 12 that is your high-ticket wellness offer. So you’re not just selling one-off sessions. You’re not waiting for insurance to pay you. You’re not stuck at one-off sessions. People are actually committing and seeing working with you through their plan of care and for me personally, I think 12 is even a low number but that’s because I have people that stay with me for months and months and months because I’m also on the wellness side. I can provide a lot of wellness services in combination with my physical therapy brain and I’m always learning.

So the knowledge is never-ending. I’m always finding new ways to tweak and up a golf game or make retired life more enjoyable. I don’t just work with professional athletes. I do work with retired individuals who can use Medicare so that’s what I’ll talk about here because that’s awesome.

The two most common questions I get when it comes to cash based our Medicare and If I’m gonna work online, how do I protect myself?

So we’ll get into that in just a moment but when you when again when you don’t have a package that you feel confident in or you don’t know how to sell that package that gives you into that burnout cycle of feeling overwhelmed, exhausted, stressed, inadequate to charge high price, so then you’re backing down when your mind, you say, “Oh, I’m gonna charge $150 for this service.” Then someone comes in the door and the next thing, you’re like, “It’s $80 for an hour.” You’re saying these random prices and then you have people paying all sorts of money, which again is not a sustainable way to run a business and it’s not gonna lead you to that 100k year.

So when you have your high-ticket wellness offer, it is a package. It’s just a package. It’s a fancy name for a package. But you’re positioning it in a way that tells them why they need 12 sessions. I never say 12 sessions. I just tell them, “Okay, when you work with me for this length of time for 12 weeks,” maybe I’ll say, “You come and visit me 12 times, we’re gonna work on this and this and this so that you can achieve this and this and this.”

I’m never highlighting that it’s $2,700 for example for 12 sessions. They’re paying for the result and how they get the result is through the high ticket wellness offer. It’s through the package. So it’s a very different mindset shift. But that is how you go from selling one-offs which I know you can only do and you know, you can only do so much and when you’re having that package, that’s how you combine all your certifications, all your life experience because you stream it through those 12 sessions.

So each session you’re working with someone. I can work with someone one week on core strength, another week on breathwork and visualization and meditation another week. I can get them on the wall. I can’t tell you the number of people who bought a yoga wall from me but then they still come and use my yoga wall because I teach them fancy poses and I upgrade their poses or I work on their biomechanics or they want to get on the table. So it’s endless all the work that you can do if you’re continuing your knowledge which I know you do. You just keep bringing it into your sessions and you layer it in and the work is never ending. And people will continue to work with you again and again and again.

And by that, you establish a reoccurring reliable revenue in your cash-based practice. So Medicare simple again, like I said, it’s an admin thing. There’s a lawyer out there or you can contact your own lawyer. You just need a Medicare opt-out form. Now I’m not a lawyer. So I don’t write these forms. But if you can get a Medicare opt-out form, I do work with people that currently, actually who are retired and they can go to a Medicare clinic.

The very first time that they see me in that discovery visit, I say, “I’m not a Medicare provider. I’m completely out of network. You cannot submit a super bill to Medicare. It’s a hundred percent cash-based and by law in California, I’m not allowed to work with you. If There’s a Medicare facility within driving distance to you which in San Diego there is.” So, I tell them legally, “I cannot treat you as a physical therapist because you need to go to a Medicare facility.”

I say, “However, I am a yoga teacher and a massage therapist. So if you would like to come see me for wellness then because that’s not covered by Medicare then you need to sign this form that says you’re opting out of Medicare and we’ll do wellness services.”

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So that’s how I work with people with wellness and when they’re online out of state, it’s a similar thing. I say, “As a physical therapist I cannot treat and work with you online, as a physical therapist I cannot do rehab online out of state as a physical therapist, but I’m a licensed yoga teacher and I’m a licensed coach so I can work with your mindset I can give you exercise and I have a contract that says this is not Rehab therapy. This is a wellness coaching practice.”

And so I have a lawyer you can look up and go ask your own lawyer. I have two lawyers. If you want to message me I can recommend that right contracts like that. I did pay I think it was $1,300 for my contracts, but I had my contracts written years ago and I just reuse them again and again and I know that I’m secure because a lawyer wrote my contracts and actually, I have a podcast episode and one of the lawyers is on it. I’ll tell you my podcast is Ignite Ur Wellness Business and the podcast episode where the lawyer is on, he actually touches on this point and made sure to ask this question.

It’s in one of the most recent episodes called Protect Your Wellness Business Episode 225 and it’s with Corey Sterling who’s a lawyer and he can give you all the details about protecting your practice so you can work with people online and I’ll tell you it’s really awesome to be able to work with people anywhere in the world and have flexibility with your practice to help people. When you get requests, I work with people in Portugal and Brazil in Finland in Swindon, I work with people all over the world.

And so here’s another example with the high-ticket wellness offer. My patient or my client Emily. She’s a physical therapist. She’s also a yoga teacher and a health coach. She moved to from California to Tucson and she opened her practice using this method. She got fully booked within three months and she also works with people online with health coaching. So she was able to have the same high-ticket wellness offer but depending it, they either worked with her for physical therapy services online in her brick-and-mortar or they paid her as a health coach and they did health coaching services and she just loves that because she has flexibility to utilize all her talents and all her certifications and she is now hitting 8k months.

Conclusion

So that is the process to being cash-based. Everything else is admins and nuts and bolts and really can be done in a short amount of time. The most important thing is marketing your practice and getting good at converting those consultations and selling the packages because that is what is going to fuel your 10k months. Getting you “yes” clients who give you a ton of referrals and keep coming back for years and for more and more and more as you evolve more and you have more control over your schedule and I can tell you I truly am living the life that I love to live, working with all kinds of amazing people, I get to travel, I’m spending so much more time now with my daughter than last year. I had my biggest revenue, I took off a ton of time, I don’t work in the evenings anymore, I don’t work weekends anymore.  And so, you can be in more control of your schedule.

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So I’m gonna check out the questions because I know we’re at time now. If you want to work with me, you can head to ingniteurwellnessbusiness.com. There’s a big consultation button if you want to talk with me and ask questions. You can just sign up for a consult today and I can take a look inside your business and see what needs to happen to allow you to hit 10k months. If you want to follow me on Instagram, I’m @igniteurwellnessbiz or you can listen to the podcast which is Ignite Ur Wellness Business and I like to have on lots of guests as well.

Actually right now I’m going through a workshop series where I’m breaking down that whole workshop process in more detail. So you can follow along with that as well.

Maggie: All right. Wonderful. Thank you so much Alison for joining us and for sharing such valuable information about running a cash-based practice and thanks everyone for joining. Perfect. Have a good rest of your day.

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Alison McLean

"I help the Entrepreneur reduce stress and live a more fulfilled and balanced life."
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