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The time to talk about finances is now

April 1, 2009
Most dental professionals like discussing fees and financing with patients as much as Paris Hilton enjoys crossword puzzles.

by Nate Booth, DDS

For more on this topic, go to and search using the following key words: discussing finances with patients, offering financing, Checkbook Chills, Dr. Nate Booth, The “Yes” System, comprehensive care, internal/external marketing.

Most dental professionals like discussing fees and financing with patients as much as Paris Hilton enjoys crossword puzzles. So they put off the painful moment by repeating, “Our financial coordinator will explain all the financial information to you at the end of your visit today.”

As a result, the discussion of fees and financing is often delayed until after the comprehensive case presentation. This is the worst time to have a money conversation for two reasons:

1 Patients are excited about completing the proposed care. That is, until the financial coordinator whacks them over the head with the “fee-to-do-your-dental-care-is-$12,000” baseball bat. Now they feel 3-D — dazed, disappointed, and discouraged. So they compose themselves by saying, “I need to think about it,” and walking out the door. Sometimes the office never sees them again.2 I believe that comprehensive case acceptance is a series of conversations with people, not just one big “lay-it-all-on-the-line” case presentation. This series of case conversations allows patients to take several small steps to receive comprehensive dentistry. It also allows your team and you to discuss money and financing before you have to. If your case acceptance system dictates that you have the money conversation only after care has been presented, you won't have these smaller conversations and patients will be forced to accept care in one big leap.

Have a variety of ways and times to discuss fees and financing

The discussion of fees and financing is more of an art than a science. Your success depends on your comprehensive case acceptance system, and the personalities of the people in your office. It's important that your entire team believes in the principles of comprehensive dentistry and patient financing. If you have nonbelievers, they should receive career adjustments.

Also, your team should be coming from the right place in their hearts. They should not be takers who press the money issue. They should be givers who provide options that allow patients to receive the best dental care as soon as possible.

Here are 16 times and places you can communicate information on fees and financing. Do not use all 16 with every patient.

That would be way too much information to discuss way too frequently. Just pull out the best method at the best time from your handy-dandy fees and financing toolbox. Also make sure that each method matches your practice's image.

1 In your internal and external marketing, mention that “no-interest financing options are available.” I spoke with Barry Trexler, senior VP, sales and marketing, for ChaseHealthAdvance, recently. She told me that 85% of patients they finance choose the no-interest option, and a high percentage of people choose the 24-month plan.2 Provide a link from your Web site to your finance partner's Web site application page. Do not link it to their homepage because there is probably a “search for a dentist” link on it with names and addresses of other dentists in your area.3 On your Web site, create a page that reviews your payment options. Make this a separate page by following the “one idea per page” Web site guideline.4 During the first phone call, if a patient brings up a money issue, or inquires about financing, briefly explain your no-interest payment plans and invite him or her to the office. Many first phone call “price shoppers” are often people who are prime candidates for financing.5 Between the first phone call and the first visit, as part of your new patient packet, mail or e-mail new patients a “Welcome to the Practice” letter that briefly reviews your payment options.6 At the first visit, as part of your new patient information material, give patients a “Welcome to the Practice” letter that briefly reviews your payment and financing options. “Patient financing today is more than a rate and a fee. It involves having resources available for the dental team and people in the field that can refer business and solve problems,” said Bete Johnson, CareCredit's Director of Business Development.7 Anytime during the first visit when patients ask about fees or financing, say, “I appreciate your bringing that up. If you want, we can get you preapproved with a financing partner ahead of time. That way, we will have a plan in place where you can spread out the investment in your dentistry if you choose to.” 8 As part of the conversation at the beginning of the exam, ask, “Is there anything that would stand in your way of getting the dentistry you need?” If they mention that money could be a problem, immediately explain your payment methods and financing options. With their permission, get preapproval.9 In his Productive Dentist Academy training program, Dr. Bruce Baird teaches dentists to say this to patients after the exam is completed: “You probably know this, but you have around $7,000 worth of dental care that needs to be done. The good news is it doesn't matter if it takes us four months or four years to complete. We can go at the pace you choose. Does that make sense? Great. Tonia will explain all your options in a minute. We'll see you again soon.”10 For patients who need comprehensive care and plan to return in a few days for a treatment conference, have a short conversation about possible care and fee ranges. Don't talk specifics. That will come later. Always show them how they can spread out their investment over time.11 When you quote fees for comprehensive care at the case presentation, follow what their monthly payments would be with one of your financing plans. An example: “Maria, the investment to complete the dentistry we just discussed is $9,000, which is $378 a month if you want to spread it out over time with our no-interest financing option.” 12 After patients choose a treatment option, use a printed dental care agreement to discuss their payment options. If they choose a no-interest payment plan or extended pay plan, apply for the financing now. You can find a sample dental care agreement at If patients are declined for financing, encourage them to reapply with a cosigner.
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14 After hearing comprehensive care a patient says, “I need to think about it,” or “I need to talk with my spouse,” follow up with a phone call. If appropriate, offer to help with financing.15 If you're new to no-interest financing, send a letter to patients who have been presented care in the past year, but didn't schedule treatment visits. Statistics show that 60% didn't schedule because of financial considerations.16 At recare visits, offer your financing options to patients who have uncompleted or newly identified care.

Discuss fees and financing with confidence

It's vital that the people who quote your comprehensive fees and explain financing are comfortable doing so. If they aren't, all the right words may be said, but their voice quality and body language will say, “I don't feel comfortable doing this.” Or worse, it may say, “I don't really think you should spend this much money on dentistry.”

At your team meetings, frequently tell stories of patients who delayed their comprehensive care for years, and then finally had it completed. How often do they say, “I wish I hadn't done this?” Practically never. They almost always say, “I wish I had done this sooner.” Don't be afraid to diagnose and present comprehensive care. You're doing everyone a favor.


If your patients are thinking, “Wow, that's way more than I thought it would be!” after you quote your comprehensive care fees, this means you're not having the appropriate fee and financing conversations with them earlier in your relationship. If you follow the advice offered here, most of your patients will think, “That's about what I thought it would be.” And when they think that, they're much more likely to say yes to the comprehensive care they deserve.

Dr. Nate Booth is a speaker, consultant, and author who provides dentists with the information and systems they need to thrive in their dental practices. He teaches at the South Beach Dental Institute, and is a practice management advisor for ChaseHealthAdvance. Dr. Booth is the creator of the in-office, DVD-based program, The “Yes” System: How to Make It Easy for People to Accept Comprehensive Dentistry. For more information, go to or call (800) 917-0008.

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