I think it is a combination of things. But mostly I'm thinking it is the type of clients. First I think I've asked you this in the past if you were doing this through Practice Mate? If so, that is a big part of the problem. We did one account that way and had to give it up. It took 4 to 5 times longer to do anything through that system. I know it's free but trust me, it's costing you. If it is taking you 100 hours to bring in $1350 that's barely $13 an hour, which is not enough. In our experience the Optical is better than the chiropractic. No offense DCs! I know a lot of you and you are great, but the reimbursement per visit is low. We do have some DCs and they are ok, but not the easiest. I know you don't see how one person can produce $5000 - $7000 but if they don't we can't survive as a business. It's just that you haven't seen it yet. I believe the other main issue is efficiency. But if you are using Practice Mate then you will not be able to improve that much. If you spend 100 hours bringing in $1350 you will not be able to increase that much without quality of work suffering.
The DCs can be a great learning experience for you so it's not that they aren't good.As far as the MDs it is unfortunate that you lost them so quickly. I am going to try to answer without harping on PM. In our system when we start a new provider the set up of the system takes about 15 minutes. Then the initial claims take a bit longer than normal because we have to input some additional information such as insurance, CPT, ICD, etc. But still we are able (1 person) to get claims input and submitted within the first day. Usually can do about 15-20 claims an hour for the first day, then up to 30 - 45 claims an hour after most of the set up is established. If we take on a client with a backlog of claims we tell them we will do our best to get all claims out quickly but it is going to take us a bit to catch things up. That way they know what to expect. However, we do try to get claims in and submitted the first day so that they money starts flowing quickly. We submit the claims as we get them input, we don't wait for all claims to be entered before sending. But we also enroll to receive ERAs so that payments can be autoposted. This is a huge time saver and allows for payments to be input when received and quickly. The providers need to be able to see that the money is coming.I would not shy away from MDs but I would make sure that you are ready for the next one. Have a system that allows you to have as much as possible automated, like posting payments. Input needs to be able to be done quickly, smoothly, and efficiently. If you are wasting all of your time on things that can be done quicker you won't have time to do the things that will matter and that are important. You might want to consider finding someone who is looking for extra work, or part time work that could help you out in the beginning to get things rolling. Maybe a stay at home mom who has time while kids are in school? Or a retired person looking for something to do but doesn't need anything permanent? Having extra help getting things started might have saved you.We've never told a provider that they have to switch systems. We have told two providers in 25 years that we could not renew our contract because of the system they used. One was PM, and they chose to leave. The other immediately offered to switch to keep us. She knew her system was bad and was more than willing to switch. So you can't really insist that they switch. However, for new clients who do not have a system of their own, I would highly recommend using another system so that you can see the differences. It's hard for you to understand or even see until you've experienced using a system that is more efficient. Maybe you can try some demos of other systems?