Dentistry is perhaps the last business environment where payment obligations are treated in a casual manner. Historically, most dental offices did not have any payment policies. They did the dentistry, sent out bills, and hoped that patients would pay! This casual approach may have worked at one time, but certainly does not work in today`s demanding business climate. If this sounds like the way your office still handles payment obligations, take heart because you are not alone. My observations, from visiting hundreds of dental offices and speaking with thousands of dentists in all parts of the country, is that most dental offices today remain loose and casual when it comes to payment policies. The result has been rising accounts receivable and inconsistent cash flow.
Let`s Learn From Other Businesses
It`s time things change! Most other businesses have gone through the process of creating crystal-clear payment expectations and installed systems to control accounts receivable, with good results. For example, consider the grocery industry. Many of us remember a time in the not-so-distant past when you could go into the corner grocery store, load up your shopping basket, sign an order ticket and walk out without paying. I personally remember doing just that with my grandfather, at the Hungarian grocery store in our neighborhood when I was growing up. The proprietor would keep a "tab" of our purchases and, about once a month, we would go down to the grocery store and settle our bill. While it is nostalgic to reflect back on this arrangement, the reality is that these days are long gone. Today, you cannot walk out of the grocery store without paying.
Just as other businesses have installed proven payment systems, the profession of dentistry can do the same. The purpose of this column will be to share techniques and recommendations that will help your office get paid, not serve as a bank, yet do so in a manner that the patient will feel good about paying. Our goal will be to become more businesslike, yet do so in a patient-friendly manner.
Creating Positive Payment Expectations
These excuses are a vivid reminder of the challenges you face in getting patients to settle their financial obligations with the dental office. Whether you routinely hear excuses like the creative ones listed above or, perhaps, the more pedestrian, "I forgot my checkbook," it is high time we as a profession developed the self-esteem and confidence to require payment at the time of service. As long as it is possible for the patient to walk out of the dental office and not pay, then we will forever have an accounts-receivable problem. The solution is to develop the expectation of payment at the time of service.
While it will not happen overnight, the good news is your office can succeed at making the transition from loose and casual to professional and businesslike regarding payment obligations. Even better news is that you can do this without offending patients. Stay tuned; I`ll cover how to do so in future columns, filled with many practical tips to help you succeed financially with your patients.
The author is a noted authority and frequent speaker on payment issues in dentistry. He may be reached at (602) 951-1652.
The Top 10 List of Excuses
Although this is a serious topic, we`ll have some fun along the way. A couple of years ago, I wrote a column titled, "Top 10 List of Feeble Excuses," that was a parody on David Letterman`s top 10 list. In this column, I cited my top 10 list of feeble excuses that I have heard patients use to avoid paying at the dental office. At the request of many readers, it is time to update this list. Below is my new top 10 list of actual excuses I have heard patients use to avoid paying:
10) "I don`t pay. I have insurance."
9) "I would like to pay, but we just bought a new truck."
8) "My word, if I would have known it was so expensive, I would have had the doctor just pull the tooth!"
7) "You better just check your adding machine, because I had a crown back in `62 and it only cost $55."
6) "Why, I can`t pay all that today. Do you think I`m made of money?"
5) "I`ll pay you when the corn comes in." (Overheard in Iowa)
4) "Send the bill to my mother." (Overheard from a 30-year-old male patient)
3) "I`m waiting for my bonus."
2) "I can`t pay today. We`re going on vacation next week."
And the new No. 1 excuse . . . (I heard this one when the front-desk person asked the patient why she had not been responding to the billing statements sent each month from the office):
1) "Oh honey, I wish you would quit sending me those. I get one every month and I don`t understand it at all; so, I just throw it away."