9.30.11 Issue #499 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

The Patient Wants a Discount?
By Sally McKenzie, CEO

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It's a disconcerting sign of the times. I recently had a doctor contact me because a patient was insisting on a 10% discount. More troubling is the fact that a portion of this patient's procedure was covered by insurance. If the doctor were to grant such a discount, he would be in violation of state insurance regulations. It is a reminder that since 2008, when the world's financial troubles began affecting many dental practices, doctors have felt pressured to make concessions on treatment recommendations, hold the line on fees, abandon established financial policies, and cut corners wherever they could.

Yes, things are slowly improving, but we are seeing too many practices that are routinely disregarding their financial policies. While I understand that practices need a certain measure of flexibility, and the policy should be reviewed annually, it is critical that every member of the team respect and uphold the policy. Moreover, all new patients should be given a copy of the policy along with other office procedures and information, and existing patients should receive a copy periodically - particularly if changes are made.

So now the question is: what should be included? It goes without saying that a financial policy should reflect your practice philosophy, but remember, yours is a small business and you simply cannot afford to give no-interest loans or other financial breaks.

I recommend that you consider the following options:

  • Offer a 5% discount if the case is over $250, paid in full, and will not be submitted to insurance.
  • Divide fees for more involved cases over a specific number of appointments.
  • Ask patients to pay 50% at the start and 50% when treatment concludes.
  • Establish a relationship with a treatment financing company.
  • Allow patients to build a balance on their account before beginning major treatment.
  • Make arrangements to bill the patient's credit card on a recurring basis until the dental work has been paid in full. This is ideal for larger cases. Orthodontic practices often do this routinely. This system streamlines payment and posting while eliminating billing for your practice.
  • Accept cash, check, and charge.

Remember that if you accept checks, you cannot accept post-dated checks. This is a practice that had been all but eliminated, only to be revived during the recession.

In addition, spell out what you expect of your patients. For example, if a patient's insurance will cover 50% of the cost of a crown and the patient's portion is to be paid in full upfront, they need to know this. Make your financial policy clear. Don't assume that displaying the policy on the wall or showcased in your brochure is enough. It is critical that the financial coordinator review the terms of the financial arrangements with each patient for each procedure or treatment plan.

Verifying that everybody's on the same page will go a long way toward improving your practice's collection success. Which brings me to my next point in a practice's overall financial policy, and that is collections.

Practice collections should yield 98% for treatment currently being performed. I do not disregard the fact that you must be sensitive to your local economy. Just understand that each time you make concessions and exceptions, you chisel away at your financial policy and further risk the fiscal solvency of the practice. The exceptions and concessions add up much more quickly than you realize.

Business staff must know the fees for each procedure, and at no time should a business employee say to a patient, “Did doctor tell you the fee for this procedure?” S/he simply states, “The fee for the crown is $xxx. Our financial options for payment include the following

Financial policies are only as effective as the person in charge of collections is at upholding them. Certain people just cannot bring themselves to ask for payment from patients, no matter how low the fee. They simply are not cut out for the position. Effective collections require someone who is assertive, tactful, confident, and goal oriented. “Stacy” may be a wonderful member of the team, but entirely too pliable when it comes to collections. If Stacy is your only option, train her. If “Meredith” is better suited for the position, assign the responsibility to Meredith and train her.

Next week, patients aren't paying, now what?!

Want more of me? Click here to visit my blog, The Lighter Side, for more Dental Practice Management info.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com. Interested in having Sally speak to your dental society or study club? Click here.

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