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Collections- It’s Not Just About the Money…It’s About the Plan

Posted November 28, 2016

Lois Banta

One of the many challenges a dental practice
faces today is in collections.  It should be simple…dental treatment is completed, the fee is charged, and payment is collected.  However, what usually happens is, dental treatment is completed, the fee is charged and NO payment is collected.  Why is that?  Where is on earth is this acceptable?  We go to the grocery store and payment is expected, we buy an airline ticket and payment in full is expected and we have work done on our vehicles and payment is expected in full or they keep our car.  There are many reasons for this phenomenon in dentistry:

  • Guilt for charging a fee for the service
  • Pre-judging the patient’s pocketbook
  • Lack of training
  • Poor communication skills

We have, in fact, done this to ourselves.  But, there is good news…WE can FIX it!   We just need a plan.  This article will outline some simple systems to improve collections.

First, quoting fees has, at times, felt awkward.  Many times, when the fee isn’t quoted prior to treatment, the patient becomes confused and angry and they sometimes object to the procedure.  Never surprise the patient…ever. When you charge what you are worth, you will be worth what you charge.  This profession is a wonderful profession.  We have the opportunity to create beautiful smiles which raises self esteem and confidence.  Take into consideration when establishing fees: lab fees, operating expenses and quality of care.  This will make it easier to quote the fee for quality care.

Second, never ever pre-judge the patient’s ability or willingness to pay for their dental service.  You know the old saying…”never judge a book by its cover”.  It’s so true.  As soon as it occurs to you that your patient may not want to pay, it will occur to them!   Make sure the entire team is well versed in the fee and payment guidelines in the practice.  Once a month, during your team meeting, organize an each one-teach one session.  Each team member trains another team member on some area of practice management.  This can include but not be limited to quoting fees, handling objections, reviewing payment choices and gaining treatment acceptance.

Third, make sure thorough training is provided to the dental team that is responsible for collecting payment.  Written guidelines are crucial.  50% of patients listen with their ears & 50% listen with their eyes.  Lack of proper training reduces the confidence of the team member in asking for payment at the time of service.

Fourth, effective communication will tie it all together.  No system will be effective without proper communication.  How we say what we say will make all the difference.  All the training in the world won’t help if you don’t know how to say it.

Treatment that is completed without proper financial arrangements is a recipe for disaster.  Always inform before you perform.  Even when treatment changes unexpectedly, discuss with the patient what questions they may have about how this treatment will fit in their budget.  Additionally, make sure there are written guidelines in place for collection follow-up.  Patients are looking to us for guidance, especially when it comes to presenting and collecting the fee.  If we don’t communicate with clear guidelines in place, the patient could interpret their own version.  All team members must have knowledge and understanding of the collection options in the office so they can build a bridge in communication to the expert in the office.

Knowing that no system is fool proof, a back-up plan must be in place for collection after that statement goes out.  Again, written guidelines and protocols will help to keep things on track and in check.  Have well established and documented guidelines on collection procedures.  I believe in the 4 statement rule.  Send a current statement then, the 30 day “gentle reminder”.  The next reminder is the 60 day notice, more firmly worded with a phone call follow-up.  The last and final statement is the reply letter.  Remember, “The Fair Debt Collections Practices Act” (FDCPA) requires that only one final notice be sent otherwise, it can be considered as harassment.  Also, you cannot leave a message about a patient’s past due balance on a recorder.  Someone other than the intended person could hear the message and therefore, it could be considered harassment.  The FDCPA has many guidelines to assist a dental practice in following collection protocols accurately.

Just remember, your collection systems are only as effective as you are.  Communication is crucial in preventing collections from becoming the beast.


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