“I feel as if my team is well-versed in patient payment arrangements, but I know we could do better. Sometimes, patients aren’t clear about how they can pay for dental services and that they have options available to them that may help them move ahead with needed treatment without creating a financial burden. What would you suggest to make sure we are ensuring a high case acceptance rate and getting paid for services?”

Great question; and of course a timely inquiry in these economic times. Patients are looking carefully at the value they receive for their dollars spent; in any place – dental office, clothing store, auto dealership, etc.

In my experiences recently while working with dental offices, the issue about patient payment for services continues to be a relevant topic. Most dental team members understand the fundamentals of a good patient payment system, and in most cases they do a fine job of getting patients to pay.

Once in a while, I come across an office that boasts excellent statistics on patient payment; but something’s wrong. The office isn’t growing, patients are not accepting treatment, and the doctor and team are frustrated. This occurred recently in a client’s office where the office was solid, but case acceptance was down, production was down, and cash flow was thin. Looking deeper into the situation, I found a payment system that had done okay, but was missing a few key elements. Once in place, case acceptance picked up, the practice was productive once more, and cash flow was beginning to roll all over again.

So what was the deal? The office had become too strict on payment arrangements, they were not using a written financial policy that once was in place and had served the practice well, and the team had lost the edge with their verbal skills.

Back to the drawing board? Maybe not.

Throw the baby out with the bath water? Not yet.

Get back to basics? Yes, now we’re talking!

If it hasn’t been done recently, re-visit the patient payment process in your practice. The key here is to make sure all the resources you have available are being used with great communication skills so that patients will say “Yes!” to treatment and money doesn’t get in the way.

Dental patients across the country are service savvy. They want to be sure their investment in healthcare provides them with the benefits of good oral health: looking good, feeling good, having strong teeth and gums, and enjoying their natural teeth for a lifetime.

Imagine for a moment how many hours of continuing education was logged during 2008 that covered clinical care, treatment methods, and materials? Now, how many hours were recorded on business related courses regarding communication skills and systems development for patient payment arrangements?

Often overlooked is the need to keep up with the changing marketplace regarding payment. It’s not a surprise to me that, on occasion, some offices lose the edge and their mainstay systems such as patient payment arrangements may begin to hinder practice growth.

Studies conducted in practices recently show a similar pattern than in years past: dental consumers continue to pay for approximately one half of all dental treatment out of their own pockets.

In today’s economic climate, unless patients know their options to pay for services, they may choose not to go ahead with treatment. In fact, sensible payment options and good communication skills will help the patient make informed decisions that will lead to enhanced case acceptance. Moreover, if you haven’t re-visited your payment options during the last year, your payment systems may not be sensible in these days and times.

Back to Basics!
Three simple ground rules will help your practice cope with these changing times. Follow, or re-visit if the case may be, these rules diligently; make them the foundation upon which you build your payment systems. In this way, you can experience payment success in your practice.
Ground Rule #1: “Discuss Fees Prior to Treatment.” Patients should be informed of all fees, and specific arrangements should be made for payment before any treatment begins.

Ground Rule #2: “Don’t be a bank.” When patients are allowed to pay for their care over an extended period of time, you are actually loaning them money! And, you run the risk of alienating a patient; they may not return to the office knowing they owe money and haven’t been diligent about paying.

Ground Rule #3: “We will provide a variety of payment options.” “Not paying” is not one of them!. It is a reality that, while people generally want the best possible care, they often need some form of financing. The best way to solve this problem, without breaking Ground Rule #2, is to provide a variety of payment options for your patients.

What kinds of payment methods are available? Of course it’s preferred to have payment in full for services rendered. But for those hard to manage situations, here are some back-up methods.

Offer a cash courtesy for treatment paid for in advance. This is a great way for patients to save money, and a way for the practice to secure payment. An added benefit to the practice is patients tend to keep appointments for which they have already paid! Be mindful however, of insurance contracts that require proper documentation of discounts or courtesies.

Make better use of major credit cards as a payment option. One approach, which could be used more, is the process of spreading payments out over time using a signature on file for credit cards. There are forms available that provide structure to this system. But exceptional presentation skills must be used with this payment option. Consider this type of language when presenting credit card debiting:

“We have a great way for you to handle payment for your treatment. So that you don’t have to pay for the services all at once, you can make payments over time, interest free. All we need is your permission to debit your credit card once a month for an amount we agree upon and only for the amount of services provided. That way, you can have the dental treatment needed to get well, and you can make payments over time. Which credit card would work better for you, MasterCard, VISA, American Express, or Discover?”

Offer this to patients who have established themselves in the practice and have a track record of timely payment and attendance; that is, people who regularly pay well and keep their appointments.

In all cases, it is important to make sure your patients know you accept payment by credit card, and they can make payments over time with their credit card. Tell them! Don’t rely on a sign at the front desk or a note on the billing statement. Use good old face-to-face communication.

Use a dedicated healthcare financing company for patients in need of financing. Here, you receive payment up front, and the patient can make low monthly payments. A definite win-win for the patient and the practice. Again, make sure the verbal communication skills are at the forefront. Please, use words that highlight the benefits the patient will receive when using an outside finance company; such as:

“We have a wonderful way for you to handle payment for your dental care. The good news is, you don’t have to pay for your treatment all at once, you can make payments over time, and it’s interest free!”

It’s strongly advised, in either of the case of credit card debiting or using an outside finance company, to inform the patient of what their monthly payment will be. For example,

“We can split that up into four payments of $750 each. Which credit card would work for you, MasterCard, VISA, American Express, or Discover?”


“If you use the six-month interest free option, your monthly payment will be $250 per month. When would you like to get started with your treatment?”

Here’s where a simple, straightforward, one page written financial policy which explains the various payment methods you have elected to accept in the practice comes in to play. With this tool, describe the various payment methods in a positive manner, and be sure to describe the benefit the patient receive under each option:

“We’re very excited about helping you get well and become as dentally healthy as possible. We have a variety of payment options to choose from, let’s go over them and you can decide which would be best for you.

You may handle payment by pre-paying for services; we offer a pre-payment courtesy of 5% when payment is made before treatment begins; your savings would be $500.

Or, you may choose to use a major credit card, we accept MasterCard, VISA, American Express, or Discover.

For our patients, upon approved credit, may be able to make payments over time, interest free, for up to six, 12, even 24 months.

Which of these payment options would work best for you?”

Use these recommendations (and the Written Financial Policy I have included) to build payment systems that work for your patients. Work on the verbal communication skills mentioned here as times have changed. Dental offices must re-visit systems in the practice regularly to make sure the system is serving the practice; especially during changing economic times. In the final analysis, patients deserve the very best care you can deliver, and you deserve to be paid!