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  07.15.05 Issue #175

Create Payment Expectations for Patients and Staff

Sally McKenzie, CEO
The McKenzie Company

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Consumers appear to be having a love affair with credit these days as consumer debt is at an all time high. Have it now, pay for it later … well maybe. Many of those individuals love to buy but hate to pay, and some of them are your patients. They may adore you as their dentist and are fully willing and interested in pursuing your treatment plans, but a percentage of them will be more apt to wish you pennies from heaven than provide you with payment from their own pockets. That is unless you make it clear that this doctor/patient relationship is based on a few fundamental expectations.

Expectation #1 – Patients and staff (including the doctor) should be expected to follow the practice financial policy. Establish a standard operating procedure that spells out how patient financial arrangements will be handled. Every practice, no matter how small, how rural, how this, or how that must institute and follow a clear financial policy. It is in no one's interest to give free money to patients.

Expectation #2 - Patients should expect to clearly understand the fee for treatment. This is best handled by a staff member – not the doctor – who will provide information on the available payment options . Practices that provide care with no mention of the patient's financial obligation can find themselves in a financial tug of war that can become very expensive and very ugly, very quickly.

Expectation #3 – Staff should be expected to request payment according to a well-prepared, well-rehearsed script . For example, the financial coordinator tells the patient that the cost of the crown is $800. She goes on to give the patient two options designed to benefit both the doctor and the practice. “If you would like, you can pay for the cost of the crown today or at the next appointment when we start the procedure.” If the patient asks to make smaller payments over several months, the front desk person responds, “Mrs. Jones, we could take the cost of the crown and divide it into two payments: $400 today or when we start the process and the remainder when we insert the crown in your mouth.”

Expectation #4 – The practice should be expected to provide additional payment options that encourage patients to pursue treatment and enable them to manage the financial demands associated with pursuing your care. For example, if the patient says “I can make payments of $100 per month.” The front desk person says, “Mrs. Jones, we would be unable to accept $100 monthly payments because it would take eight months to pay for your crown. Being a small business, we are unable to extend interest free loans to our patients for that time. However, we do have a relationship with CareCredit which will provide an interest free loan for this period of time. It's just a matter of providing me with a little more information.”

This option gives both the practice and the patient a reasonable and cost effective alternative . Offering payment options for patients not only allows the dentist to collect what they produce, but production also will go up if patients have a means to pay for procedures that can be quite costly to most people.

Expectation #5 – Employees discussing payment options should be expected to understand the patient financing process. Few things will kill a treatment plan quicker than the employee who is poorly educated on patient financing options. Too often the staff member will halfheartedly mention the availability of a dental credit card. When the patient seeks additional information, such as the interest rate on the card, the staff member either doesn't have it or fills in with a comment such as, “It's kind of high.” Kiss that treatment plan goodbye.

Dentists who choose not to use a finance company but still want to allow patients to make payments should consider having the patient make the installments before the procedure begins . When the procedure is paid for, begin the treatment.

If you plan to change long-established procedures do so slowly and inform existing patients individually. Avoid mass mailings, which often come across as impersonal. Rather, talk to each patient individually when they come in for their regularly scheduled appointment. The vast majority of patients understand and respect the fact that their dentist is running a business and must operate it according to sound business practices.

If you have any question or comments, please email Sally McKenzie at

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