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How to meet patients' new financial needs

Aug. 1, 2011
It's a different time in dentistry. Doctors who, two years ago, booked out two months in advance now have openings in their schedule just two days away.

by Dianne Glasscoe Watterson, MBA

For more on this topic, go to and search using the following key words: patient financing, financial conversation, preferences, Dianne Glasscoe Watterson.

It’s a different time in dentistry. Doctors who, two years ago, booked out two months in advance now have openings in their schedule just two days away. Although there seem to be signs of an economic recovery, it looks like it will be a slow process. According to a recent article on, the “… economy has turned a corner. Although the pace still isn’t what it should be, a healthy mix of consumer spending, increased exports, and business spending is evident.

Regardless of the economic climate, patients still need dental care, a way to pay for that care, and the convenience and opportunities that various payment options offer to help patients meet their new financial needs and preferences.

That was then, this is now

Let’s take a trip back in time to 1972. Cash was king, and paying for dentistry with a credit card was unheard of. Dental insurance was a novel idea that both patients and dentists embraced. Dentists loved insurance because their schedules were full. Patients loved insurance because it enabled them to get care without directly paying for most of their dentistry. And for those patients without insurance benefits, dentists worked out a payment schedule, unfortunately with no guarantee of payment.

Since there were no consequences for delayed payments or nonpayment, high accounts receivable was the natural result. Frustrated dental teams spent a lot of time and money requesting payments from patients.

Then, dental practices began to accept credit cards such as Visa and MasterCard. Most teams were happy with that financial arrangement, because, for a small fee, they received payment immediately and patients could make payments after receiving the care they needed.

In 1987, another patient payment option emerged — CareCredit. This health-care credit card was a great addition for practices because many patients wanted implants and more extensive dentistry, but they did not have enough credit on their Visa or MasterCard for treatment that cost more than $300 to $500.

Fast forward to the present time, 2011. The economy is impacting patients in two significant ways. First, many companies are looking to save money and may reduce or eliminate dental insurance, leaving patients with little or no dental benefits. Paying for most or all of their dental care is a new reality for many. Second, some patients are financially fearful, hesitant to use their household credit cards or tap into savings to pay for dental care.

An effective financial conversation

Today, patients appreciate having more payment options and need to understand their choices as soon as possible. Patients are delaying appointments and hesitating to accept needed care. By communicating your practice’s payment options upfront, more patients can see that their dental care can fit into their financial situation. We all know practices don’t want to treat a patient without having a conversation about — and agreement on — how the patient is going to pay for care. Patients don’t like surprises, especially when it comes to their mouth or pocketbook.

That’s why it’s important not only to establish a firm, written financial policy, but also communicate it to patients in a way that gives them clear expectations. Your financial policy needs to include payment options that reflect the needs of your patients, including cash, major credit cards, and a monthly payment option such as CareCredit.

Ideally, the financial conversation begins well before the clinical examination. Patients who do not have a history with the practice should receive a new-patient packet that includes not only their registration form and medical histories, but also a financial policy that specifies the various payment options available.

This will clearly communicate to patients that the practice cares about their oral health and provides financial solutions. Then, when patients arrive at the practice, the financial policy should be provided as a reminder of the payment solutions the doctor offers.

“Mrs. Jones, it is nice to see you again. The doctor is running on time and will be with you shortly. While you’re waiting, is there any information we need to update on your health history? Great. If I may, I would like to give you another copy of our financial options. We’ve made a few changes and want you to be aware of them. As you know, payment for services is due at time of treatment. To make it easier for all of our patients to make comfortable monthly payments, Dr. Smith is making available several payment options. Here’s some information for you to review and let’s discuss which one works best for you after the doctor has completed his examination. As I mentioned, Dr. Smith is running on time and will be ready to see you in just a few minutes.”

After the clinical examination and treatment presentation, the financial conversation continues as the doctor hands off the patient to the team member, who then discusses the cost of treatment and payment options.

I recommend using a document that starts by identifying whether the patient has dental benefits, and if so, what amount is not covered and thus will be an out-of-pocket expense.

Next, discuss all payment options including any courtesies offered for cash payment in full. It can be especially helpful to estimate the patient’s monthly payment if he or she prefers to pay over time with a health-care credit card that offers extended payment plans.

Using a written financial policy and other visual aids such as an estimated payment chart can help ensure the patient clearly understands the payment options and won’t be surprised by his or her payment responsibilities and/or options.

As the economic pendulum continues to slowly swing back to a more healthy economy, it’s important that dentists continue to keep abreast of the changing financial needs of their patients. Although it may seem easier to “just bill patients,” it can be very risky to carry accounts receivable, especially in these financial times. Instead, set expectations, clearly communicate your financial policy, and give patients options that can enable them to move forward with care instead of moving you backward in time.

Dianne Glasscoe Watterson offers practical, on-site consulting for good dental practices that want to be better. She also presents seminars of interest to dental professionals. Visit her website at Contact Dianne at [email protected] or call (301) 874-5240.

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