SAMPLE DENTAL OFFICE
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WHAT WE CONVEY TO THE
We need to convey to
the patient that our policies are flexible and that we want them to have
the care that they need. We want to make it easy for them to obtain a
payment plan that will allow them to fit their dental care into their
budget. Privately, however, and tactfully, we will do our homework to
assure that we will be paid for our work.
1. We deserve to be
paid in full for our work, and we will not schedule work if there are
any doubts about getting paid. All questions about payment must be
answered before treatment is scheduled. The ONLY exception to this is new
patient examination appointments which are accepted without prior
when we have insurance that will pay 80%, there may be some hardship cases
where we are willing to forgive the patient's 20% copay. We are still
insisting on payment but are requiring a payment of 80%.
2. We will not
extend any credit beyond the new patient examination without researching
the client's credit history and a signed credit plan. Extending credit
means that we grant the patient any leeway to pay at any other time than
at or before the actual appointment. "I'll pay you tomorrow," is a credit
arrangement. "Send the bill to my dad or my ex-husband, etc." is a credit
All new patients
desiring credit must complete a credit application. Also, old patients
with any questions in their credit history must complete an application.
Extended credit plans and maybe some shorter ones will then probably be
sold to an outside company, but not necessarily. The final decision on
whether to sell it or not will be made after receiving the application,
and will depend on our cash flow and the soundness of the application, as
well as our relationship with the patient.
3. All payment plans
must be signed, and must be approved by one responsible person in the
office. In many cases this will be the doctor or owner of the practice..
4. A patient may pay
by post-dated checks without another written agreement. The signed checks
constitute the signed written agreement. Credit history needs to be
checked for these accounts - either the history in our office or, for
relatively new patients, run a credit report. The owner or other
responsible person needs to approve these plans also.
5. We will only
pursue insurance payments for two months. After that, if insurance
hasn't paid, the patient must pay the entire bill. We will continue to
assist them in receiving reimbursement from the insurance company,
6. If there is any
doubt about insurance coverage, the patient must pay and the insurance
will then reimburse the patient. We only accept assignment of insurance
benefits when the insurance coverage can be positively confirmed.
7. For large
cosmetic cases involving lab work (anterior bridges, porcelain veneers,
multiple anterior crowns), a down payment of 1/2 the fee is made BEFORE
the prep appointment is scheduled. The balance is dues after a successful
try-in, BEFORE the seating appointment is scheduled.
For full and
partial dentures, 1/2 the fee is due as a down payment when the
preliminary impressions are taken. The balance is due on delivery of the
make credit arrangements is good business for us -- it brings in "big
ticket" cases that people couldn't afford outright. And, when a patient
asks if they can get credit, we need to convey an attitude of "Yes, we
want to help you anyway we can," not and attitude of aloofness. Still, we
need to do our homework to assure that we will be paid. All credit
questions must be settled in advance--otherwise the patients must pay as
Often, a patient's
response after finding out that they need a credit application to obtain
credit is that they may be uncertain that they want credit. If this is
the case, tell them that you will place them on a pay-as-you-go basis.
Tell them that you need a couple of days advance notice to process the
credit application, if they decide that they do want a credit plan. Do
not accept any fuzzy "maybe credit, maybe cash" payment commitments.
Again, the ironclad policy is "Don't schedule the work until ALL QUESTIONS
about payment are answered."
scheduling an appointment is a commitment on our part to provide the
service. Do not put an appointment in the computer until the credit
arrangements are finalized -- agreed to and signed.
In all cases,
emergency patients should pay at the time of service, assuming the patient
is not one of our regular patients. It is sad but true that the patient
that has no regular dentist and puts off coming in until it hurts is very
often a collection problem. They should be made aware of this policy over
the phone when the appointment is scheduled. We have found that this has
never been an insurmountable obstacle for anyone who needed treatment, as
the fees involved are not that great. After the first appointment, credit
can be arranged for future appointments, if necessary.
examinations and x-rays are a different matter. For this procedure, we
make an exception to our policy of answering all questions about payment
before scheduling treatment. If there end up being payment problems, we
will write off the cost of the exam and x-rays. As an example of how this
might work, let's say a patient came in as an emergency. They needed
endodontic treatment and post and core today. We quoted the fees to the
patient before starting. Insurance pays 50% of these procedures, after a
deductible. The patient, because of what was told to her on the phone, is
prepared to pay only $45 today, but will owe $130 more than that. Since
it's an emergency, since we otherwise have wasted time slots in the
schedule, and since it is much more efficient for us to do this in one
appointment rather than two, we do not demand payment or an approved
credit application today. At the end of the appointment, we suggest an
examination and complete set of x-rays. Since it is a new patient
examination, we schedule that before all payment questions have been
answered. We will be prepared, if there are problems, to write off the
cost of the examination appointment. However, it will need to be paid for
before any further work is scheduled., as well as the emergency
appointment. Either that, or suitable credit arrangements will have to be
approved and signed. Note that in this example, we have followed all of
our rules. We had payment arrangements for a $45 appointment discussed
over the phone and settled--the patient would pay that today. We scheduled
a $45 appointment. The fact that it unexpectedly turned into a $300
appointment chairside doesn't break that rule. We would not block off
$300 worth of time on the schedule without payment arrangements being made
in advance. But that's not what happened in this case. We can also
schedule the exam and x-rays for a new patient without payment
arrangements. But we can't go beyond that until all of these financial
matters are settled.
Be aware that having
loose financial arrangements leads to legal complications for us. If
payment arrangements are not "signed and sealed" before treatment is
performed, our experience is that a few people will later take advantage
of that and make up complaints about the treatment or threaten legal
action to try to distract us from collecting the money. This causes a lot
of stress and injures our reputation. Having the work financed outside of
the office eliminates these problems.
If a patient's
financial situation makes payment impossible, arrangements could still be
made for treatment. The doctor earmarks certain money for a "goodwill
fund" that can be applied to a patient's account. This will only be done
for patient's who are "willing, but not able". We do not want to do this
for patients who are "able, but not willing". If the patient does not
place enough value on his dental health to make some financial sacrifice,
treatment will generally be declined.
other absent parties
a child patient is getting treatment and the parent says, "Oh, my
ex-husband will pay for that. Just bill him." That is a credit
arrangement, and credit rules need to be followed - credit application,
etc. We need to be more strict in this situation because we haven't
even met the person who is getting the credit, plus we've never spoken to
this person to find out if the credit arrangement is okay. The same goes
for any third party who is going to be billed. We don't "bill" absent
parties. Have them send the check for the work and then we'll talk to the
patient about scheduling once the check is in hand.
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