Chapter 19: Getting Paid for Patient Cost
Except for routine dental treatments which may be covered by insurance at 100%, your office will need to collect payment for at least a portion of the cost of the dental treatments you offer. It is always best to collect this payment at the time of service. However, the patient is still responsible for the payment even if their insurance reduces or denies the claim. Therefore, if you accept assignment of benefits, you may be left with an unpaid balance that needs to be collected after the fact even though the patient has paid the expected fee at the time of their dental visit. In either case, you need to have a system in place that ensures patients pay their bill to you.
Offer Financing for the Patient Portion of Treatment
An effective way to make sure patients pay their part for treatment is to offer financing. You can work with a dental financing company to make this happen. At the time of treatment, you contact the financing company with the patient’s personal information and the cost of the treatment. You get an answer on approval within minutes. The financing pays you directly and immediately. The patient makes the agreed upon payment to the financing company each month. Then, if the patient does not make the payment, it is between them and the financing company. You have been paid and your involvement in the financing is over. This works either for the patient portion of the bill or for the total amount if you do not accept assignment of benefits.
Require a Down Payment at the Time of Treatment
If you are providing your patient with an extensive or costly procedure, you should always require a down payment from them unless you already have approval for financing. The down payment ensures that you do not lose money on the treatment. However, if the patient does not follow through with complete payment, you might not realize any income from your work.
When You Need to Collect After the Fact
When the patient does not pay at time of treatment for whatever reason, you run the risk of losing out on complete payment. In these cases, you need to impress upon your staff the importance of collecting for every treatment you supply.
Why Would a Patient Not Pay for Treatment As Agreed?
A patient’s failure to pay for dental work can be baffling. Why would an otherwise good person refuse to pay for valuable services they received? The most common reasons are:
- They forgot about the bill or wrote the check and forgot to mail it.
- They have had a change in life circumstances such as losing a job.
- They have experienced temporary financial setbacks.
- They do not understand that their insurance will not pay for the entire treatment.
- They are dissatisfied with the dental work.
Once you know why the patient is not paying, the solution is often obvious. If they simply forgot to pay, the call may be reminder enough. If they have had a change in their financial position, you might be able to offer financing options. A knowledgeable staff member can clear up any confusion about why the insurance company does not pay the entire amount. And, for patients who are dissatisfied with the outcomes of their dental procedures, the dentist can attempt to please them by doing further work.
Should You Continue to Treat After Nonpayment?
The decision to end the patient-dentist relationship when they have failed to pay for dental work they receive is a difficult one. It is a decision most other business have no trouble making. The main thing to remember is that, as a member of the dental profession, you are obligated to make sure that stopping after only partial treatments do not harm the patient. If the partial treatment was helpful without continuing treatment and will not cause problems in the future due to not being completed, you can feel justified in ending treatment. If it causes harm, though, you need to keep going with the treatment plan until you reach a point where no harm will occur.
Dental Management Software Can Help with Collections
If you purchased software designed especially for the dental practice, you have a range a collection features at your disposal. The software can create statements. It can also vary the message on statements based on how late the payment has become. You can also use the software to create personal letters individualized with the patient’s information and payment history. Personal letters tend to be more effective than standard statements in collecting from people who intend to pay.
Dealing with Delinquent Accounts
First of all, it is important to make sure your staff are keeping track of the age of accounts. The longer it takes to collect on an account, the less likely you are to ever collect that money. Phone calls work very well for many people. However, you do need to follow good collection practices. Do not allow your staff to make collection calls anywhere near your waiting room or treatment rooms. You do not want patients waiting for treatment to hear these calls.
Before calling, the staff member needs to check the patient’s balance to ensure that no payment has been made recently to clear up the overdue balance. It is important to be as polite as possible and show concern for the patient’s financial situation, especially if you ever want to provide this patient any services in the future. Be ready to offer the patient some type of solution if they say they do not have the resources to pay their bill. Remember that it is better to make an extended pay arrangement than to not collect anything at all. When the call is complete, leave on a positive note, expressing to the patient that their dental care is important to your clinic.
Using Outside Collection Agencies
The best possible scenario with an overdue account is that your staff is diligent in collecting it for you. Once you hand it over to a collection agency, you immediately lose the 33% to 50% that comprises the collection agency’s fees. If it is a small balance, the collection agency might not work on it at all. There is too little in it for them to be worth their time.
However, it is good to be connected with a collection agency. The hope is that you never have to call on them. Yet, it is good to have this tool for collection in your pocket. If nothing else, a threat of sending the account to them can prompt a hesitant patient to pay sooner. If you do make that threat, you must follow through once they do not meet the payment deadline you set. Anything else would be deceptive and even illegal.
Choosing a collection agency is an important decision. Check with other dentists in your area to find out who they use and whether they are satisfied with the service. Ask the agency for an explanation of how they handle collections from start to finish, including what they do with accounts they do not collect. Then, consider whether the agency’s tactics will reflect poorly on your dental practice. Finally, be sure they are legally permitted to operate in your area and whether they are bonded.