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Scripting for Successful Financial Strategies

Many different scenarios can arise when discussing payment obligations with patients. Use these scripts to help make your strategies successful.

Collecting Patient Portion Before Treatment

“I am happy to process your insurance for you and collect your portion for your treatment today. Completing this ahead of time will let you leave immediately after treatment without needing to stop and check out while you are numb.”

“We have estimated your insurance plan to pay $________, leaving you with a balance of $________. We can process this for you when you arrive for treatment on ___________. Then you can make a quick getaway following your treatment.”

 

Paying at the Time of Service

Transitioning patients to paying at the time of service rather than waiting for a statement:

“To keep our fees lower for patients, Dr. Smith asks us to collect the patient portion at the time of service. I know you are not used to this, so we can certainly send you a statement this time and incorporate the change at your next visit. This action helps us reduce overhead costs in mailing statements, making phone calls, etc., that we can pass on to you by keeping our fees lower.”

 

Quoting Fees to Shoppers

“I would be more than happy to answer that question for you. I want to give the most accurate information – may I ask a few questions? Have you had a diagnosis or treatment plan for this? Is it a front tooth or a back tooth? Has the tooth had endodontic treatment? Does it have a post? Is the tooth broken, or does it need a build-up? Is there any decay in the tooth? Are you asking for the fee on precious metal, semiprecious metal, porcelain fused to precious metal, porcelain fused to semiprecious metal, or a full ceramic crown?”

“To provide the most accurate information and fee, I would like to recommend you come in and meet Dr. Smith and allow us the opportunity to take a look at the tooth and discuss a plan with you.”

 

Initial Visit Estimate

“Mr. Cooper, for the exam and initial set of x-rays, the first visit will be approximately $206-$217.”

“Will we be billing dental insurance for you? For us to bill them, may I ask you some questions?”

 

Emergency Visit Estimate

“For the Doctor to take the necessary images and determine the appropriate treatment, the fee will be around $ (quote fee for an office visit). I see you and Susan discussed this yesterday when you called. Because of the nature of the emergency, the tooth may need immediate treatment. When Dr. Smith has an opportunity to determine the best options for you, we will review those estimates with you before starting any treatment. Do you have any questions about the treatment or the fees?”

“Good. Let’s go ahead and start treatment. How would you be taking care of that balance today – cash, check, or credit card?”

OR

“To allow you to be better prepared financially, let’s reschedule this appointment.”

 

Financial Arrangements

As a service and courtesy to your patients, financial discussions with patients should be in a private area. Extending this respect helps reinforce the quality of the patient experience. Additionally, statistics show a much higher case acceptance rate when the patient can ask questions without other people hearing the discussion. Every financial arrangement should be in writing and signed by the patient/guardian.

Financial Coordinator: “Mrs. Jones, I would like to invite you to our consultation area so we can have privacy while going over your treatment plan. I want to get any questions you have answered, and if needed, we can discuss financial arrangement options.”

Clinical Team Member: “For Anne to be able to answer your questions, let me show you to our private consultation area. Please have a seat. I will let her know you are ready.”

 

Asking for Estimated Co-Pays at the Time of the Visit

Financial Coordinator: “Mrs. Jones, your estimated co-pay for today is $148. Will you be paying with cash, check, or credit card?”

Patient: “Bill me, please.”

Financial Coordinator: “To keep our costs down, which helps us keep fees lower, we are asking for estimated co-pays at the time of service.”

Patient: “I can give you $50 today, but I will have to send a check for the rest.”

Financial Coordinator: “I understand you may not have been prepared to pay the total today. I will give you an envelope with the receipt showing the balance due. Can I expect that payment in the next day or two?”

OR

Financial Coordinator: “I understand you may not have been prepared to pay the total today. I’ll make it easier for you and save you postage. Do you have a credit card I can process for the balance in ____ days?”

Patient: “I’ll be able to put that in the mail on Thursday.”

Financial Coordinator: “Thank you so much. I’ll make a note on your chart so we’ll know when to expect it.”

 

Preparing the Patient for Co-Pay at Time of Service – RDH and DA

Dental Assistant/Hygienist: “Mrs. Jones, it’s been a pleasure. Let me walk you to the front and Anne can make your next appointment and assist with your payment today.”

 

When Recommended Procedures are Not Covered

“While dental insurance is an excellent means of helping you afford dental care, we recommend you dictate the quality of care you receive, not your insurance company. Dr. Smith recommends a gold onlay as the restorative procedure due to the long-lasting benefit. To avoid more expensive treatment in the future, we suggest taking care of this tooth now. We will be more than happy to work with you to set up comfortable financial arrangements.”

 

Collecting the Patient Portion for a Hygiene Visit

“Based on the information we have regarding your insurance benefits, your carrier will contribute up to approximately 80% of your visit, which will leave you with an estimated co-pay of about $40. Would you like to take care of this with cash, check, or credit card?”

 

The Out-of-Town Student

“If your parents have agreed to be financially responsible for your account, I can send an estimate to them, or I can call? When we have received the payment, we’ll be happy to schedule your appointment.”

 

Making Financial Arrangements for Children

If the child is old enough to come without a guardian or if someone other than the responsible party (grandparent/babysitter) will be bringing the child to their appointment:
*Please note the parent who signs the New Patient Registration Form is financially responsible.

Financial Coordinator: “Let’s make financial arrangements for the treatment in advance. Then you will not need to accompany your child to each visit. We can fill out a form authorizing us to put the estimated co-pays on a debit or credit card each visit. We will call to let you know what the amount is for your records. Would you like a copy of the receipt sent to you?”

Parent: “Johnny’s father will take care of this. Since our divorce, he is responsible for all of Johnny’s dental treatment.”

Financial Coordinator: “Thank you for letting me know. I’ll make a note. So we can provide treatment for Johnny as soon as possible, we can give you a copy of the treatment plan so you can receive reimbursement from Johnny’s father as quickly as possible. If you want to wait for payment from Johnny’s father first, please let us when you receive it, and we will make an appointment to start treatment.”

 

Presenting the Total Cost or an Investment for a Recommended Treatment

Financial Coordinator: “The total for your treatment is $4,250. We estimate your insurance should contribute up to $1,500. This will leave a balance of approximately $2,750.”

Be quiet, wait for a response.

If a patient wants payments:

Financial Coordinator: “Generally, I find most of our patients have an idea of what their family budget is. Would you be willing to share this with me? I’d like to help.”

Patient: “Well, I can give you $25 this week and $25 per month.”

Financial Coordinator: “Mr. Cooper, can we look for some other options?”

OR

Financial Coordinator: “After your initial payment, I can take the balance of $1,000 and break that into 3 monthly payments of $334. Is this more comfortable for you?”

Patient: “I just can’t pay for it in that amount of time.”

 

Phasing Treatment

Financial Coordinator: “Mr. Cooper, to avoid delaying treatment due to finances, let’s make arrangements on the initial portion of your treatment. When that is complete, you and I can sit down again and make arrangements to continue your care. How does that sound?”

 

Minor Financial Arrangements
Scenario A

Financial Coordinator: “Mr. Cooper, I see Dr. Smith indicates you need a filling on the upper right side of your mouth. The fee for this restoration will be about $165. Today’s visit was $75. May I make out a receipt today for the total amount of $240? Then you won’t have to worry about bringing your checkbook to the next visit.”

Scenario B

Financial Coordinator: “Most of our patients like to eliminate the extra paperwork by making one payment today. May I make out a receipt for you for $240 for cash, check, or credit card?”

Patient: “You want me to pay all of that today?”

Financial Coordinator: “If you can, we would appreciate it.”

Patient: “I don’t want to pay for a filling I haven’t received yet. Let me take care of the exam and x-ray today, and I’ll pay for the filling at the next visit.”

Financial Coordinator: “That’s fine, Mr. Cooper. Let me make out a receipt for $75 for today’s visit, and I’ll make a note you’ll pay for the filling next time.”

Scenario C

Financial Coordinator: “Mr. Cooper, today’s visit is $195 for the exam, x-rays, and cleaning.”

Patient: “Wow, that’s more than I expected. I’m afraid I don’t have enough cash and I’ve forgotten my checkbook.”

Financial Coordinator: “Do you have your credit card? I would be happy to charge it for you.”

Patient: “I don’t have any credit cards with me either. Can’t you bill me?”

Financial Coordinator: “I understand you may not be prepared to pay the total today. To keep costs down and pass the savings on to you, we collect estimated co-pays at the time of your visit. Let me give you an envelope with the receipt from today showing the balance due. Can you put that in the mail in the next couple of days?”

Patient: “I’ll be able to put that in the mail on Thursday.”

Financial Coordinator: “Thank you so much. I’ll make a note on your chart, so we’ll know when to expect it.”

 

Changes in the Treatment Plan

Please sit the patient upright in the chair, remove the rubber dam and protective glasses before beginning the discussion.

Scenario A

Doctor: “Mr. Cooper, originally we thought this tooth would require a two-surface filling. Now that I have removed all of the decay, it needs an additional surface restored, which means there will be an additional fee.”

Scenario B

Financial Coordinator: “Mr. Cooper, I see Dr. Smith performed a larger restoration on the premolar than he diagnosed. This changes our estimated total fee for treatment. There will be an increase of $90. Your estimated co-pay for today is $275.”

 

Fee Increase

A fee increase should be a non-event in your practice. Just as other industries increase fees, dental fees cannot stay stagnant. We recommend you honor the estimate associated with previously diagnosed treatment six months following the diagnosis. This allows patients the opportunity to complete treatment on estimated fees.

“Like most industries, we have routine fee increases to cover additional costs we incur each year. Our goal is to provide the highest level of care with the best products and technology available to you. We can provide several financial resources. Would you like me to review your options?”

OR

“We are committed to maintaining the highest level of care possible. We have the most competent staff, and we treat every patient as an important individual. We did have a minimal increase in our fees to compensate for the rising costs of maintaining our practice.”

OR

“Yes, we had a fee analysis and realized that while our costs for salaries/utilities/supplies had risen, our fees had not.”

 

Reducing the Number of New Patients with a Particular Insurance Plan

It may be necessary to reduce the total patient base on a particular insurance plan when reimbursements are very low. Reducing the number of new patients on this plan may be a better option than dropping participation. In this way, you retain your existing patients without adding more.

“Thank you for calling and allowing us to provide your care. Before we find a time that works, I will need to gather some information.”

Gather name, address, phone, etc.

“Will we be processing insurance claims on your behalf?”

If yes, get insurance information.

If the insurance plan they are on is one you are trying to limit growth, simply let them know the next available appointment is several months out and provide a couple of options. This will generally limit new patient flow since many new patients will want an appointment sooner. Monitor the percentage of your patient base on each insurance plan quarterly.

 

Material Charges in States with Non-Covered Benefits Laws

Depending on the PPO contracted language, you may be able to let patients choose optional services or upgrades. These can be limited if you are in a state that has not passed non-covered benefit legislation. Optional services should be pre-determined before starting treatment, and the patient should sign an optional treatment waiver.

Check with your state laws regarding non-covered benefit regulations and check with your contracted plans to see how they handle optional upgrades. In some cases, the payer may choose to pay an alternative benefit (downgrade) while allowing the practice to bill the patient for the difference.

Optional upgrades may include:

  • Clear aligners
  • Porcelain crowns on posterior teeth
  • Acrylic clasps on partials
  • Laser therapy (LANAP)
  • Same-day crowns
  • Implants rather than bridges

Patients have a right to select optional treatment and pay out of pocket for the upgrade. Patients may also choose not to bill their insurance company for the optional treatment.

Upgraded crown material:

“We are estimating the dental benefit plan your employer negotiated will pay $____ towards your treatment. The plan you have does not cover the materials charge for enhanced esthetics for the type of crown Dr. ____________ will be placing for you. The total fee you can expect is $____________.”

If the materials charge is questioned, go into further detail at that time.

“This type of material is necessary in your case due to bruxism/history of grinding/added longevity/added esthetics/added strength/etc.”

Laser therapy, LANAP:

“We have an opportunity to use a laser-assisted therapy to treat your gum disease. It is a more conservative approach to traditional surgical options. Dr. ____________ believes you have a right to make healthcare choices regardless of restrictions your insurance plan may have. The plan your employer negotiated does not cover this service but does allow you to select it as an optional treatment. The fee is $________________.”

 

Discussion With Patient When Dropping their Contracted PPO Plan

We do not recommend writing letters to patients to let them know you are dropping your participation with their contracted plan. Sending letters tend to create the highest patient loss, no matter how well worded. Patients read the letter and assume they need to find a new Dentist. Instead, identify the patients on the plan and speak with them at their next dental visit.

“Mrs. Jones, Linda let me know you are on ___________ dental plan. I want to let you know we have changed our status to a non-restricted provider with that plan. We are still maintaining a close relationship with ___________ since we have many patients on that plan. We will continue to process claims for you and help you maximize your benefits, as we always have. There may or may not be an out-of-pocket expense for you, depending on the treatment needed. We will provide a written estimate before any treatment to avoid any surprises. Does that sound good?”

 

Divorce and/or legal separation.

Financial Coordinator: “To eliminate any confusion on your account or errors in billing the charges to your insurance company, we need to open a separate account with you as the responsible party.”

 

Confirming the patient understands and wants the treatment.

Financial Coordinator: “Before we get started, do you have any questions I can answer regarding the treatment Dr. Smith has recommended for you?”

 

The patient has gone through the process, however, isn’t committing to treatment.
Scenario A

Financial Coordinator: “I sense you may have a question or need clarification. What can I give you more information about?”

Scenario B

Financial Coordinator: “If we can figure out a way to make the financial investment work for you, is there any other reason you would not be ready to go forward with your treatment at this time?”

 

Collection Calls/Helping Patients Manage Their Account

First phone call following a missed payment.
Scenario A

Financial Coordinator: “Hello, Mr. Cooper, this is Susan from Dr. Smith’s office. I’ve been reviewing our records and see we haven’t received your payment. I’m calling to see if you have been receiving the statements? We could take care of the balance over the phone with a debit/credit card.”

Patient: “I’ve been meaning to take care of that, but our car broke down, and it’s been quite an expense.”

Financial Coordinator: “Sounds like you’ve had some unexpected expenses preventing you from honoring our original agreement. So your account with us doesn’t become more of a burden for you, let’s set up a new financial agreement that will work for both of us.”

Scenario B

Patient: “Gee, I completely forgot. I’ll put the check in the mail today.”

Financial Coordinator: “That’s fine, Mr. Cooper. I should receive the payment of $100 from you within the next three days. So I can flag your check for the bookkeeper and keep your account in good standing, please give me the number of the check you’ll be mailing. Another option to save time and a stamp is for us to take care of that over the phone with a debit/credit card today.”

Scenario C

The patient becomes very upset when the dental office calls regarding past-due payment. The patient is yelling at the Financial Coordinator over the phone.

Patient: “I’m sick and tired of being bothered by you people about a stupid $75. Dr. Smith is too expensive.”

Financial Coordinator: “Mr. Cooper, I hear you are upset.”

Patient: “You bet I am. What’s the big deal anyway?”

Financial Coordinator: “Please know I want to be part of the solution, not part of the problem. What can I do to help you take care of this obligation?”

Scenario D

The patient has not kept his financial commitment due to the death of a family member.

Financial Coordinator: “Mr. Cooper, this is Susan from Dr. Smith’s office. In reviewing our records, I see you have missed a scheduled payment of $200. I am calling to see what we can do to take care of this.”

Patient: “I’m sorry, but my wife passed away three weeks ago. I’m going to be moving to a smaller house, and I have been busy packing.”

Financial Coordinator: “Mr. Cooper, we are so sorry to hear that. She was a wonderful person. So you have time to get settled, I’ll give you a call again in about three weeks. Will your phone number remain the same? Please give our condolences to the family.”

Scenario E

The patient has recently lost his job.

Financial Coordinator: “Hello Mr. Cooper, this is Anna from Dr. Smith’s office. We haven’t received your scheduled investment of $100, and I’m calling to find out what can be done to take care of this balance.”

Patient: “Well, I’ve recently lost my job, and I’m looking for work right now.”

Financial Coordinator: “I’m very sorry to hear that – sounds like you’ve been pretty busy Mr. Cooper. Reviewing your account, I see you have always been a good patient and have previously kept your financial arrangements. To help you through this difficult time, let’s set up another more manageable arrangement for you until you’re employed again. I can email or mail you a new financial agreement document to sign. Which would you prefer?”

 

Second phone call following a missed payment.

Financial Coordinator: “Hello, Mr. Cooper, this is Susan, calling from Dr. Smith’s office. I spoke with you last Thursday regarding your past due investment of $925. So your account is not assessed a finance charge this month, I’d like to help you get back on schedule with your financial commitment.”

Patient: “I’ll write you a check, but I can’t send the whole payment.”

Financial Coordinator: “How much were you planning on sending?”

Patient: “I can write a check for $200.”

Financial Coordinator: “That leaves a balance of $729. When can we expect the balance?”

Patient: “Well, I could pay that over 3 months, at $240.00 a month, by the 15th of each month.”

Financial Coordinator: “That would be a payment plan of $240 a month, by the 15th of each month. That’s fine, Mr. Cooper. Let me make a note of this in your chart; so the doctor knows what to expect. I can email or mail you a financial agreement document to sign. Which would you prefer?”

 

Third phone call following a missed payment.

Financial Coordinator: “Hello, Mr. Cooper, this is Susan, calling from Dr. Smith’s office. I’m sure you know why I’m calling. This account is now very overdue, and we must get it taken care of immediately to avoid steps toward further collection. How can we help?”

Patients who insist on the predetermination of benefits.
Scenario A

Financial Coordinator: “I know you are interested in determining what your insurance may pay towards your treatment. So there will be only a minimal delay in starting your treatment, I can calculate your estimated co-pay with the information provided by your insurance company. We can make financial arrangements on the balance that will be investment, and then I’ll schedule you to begin treatment as the predetermination is being processed.”

Scenario B

Financial Coordinator: “Based on the information we have, it looks like your insurance may participate at 50% for this procedure. This leaves your estimated co-pay $450. Please know even a written predetermination from your insurance company is not a guarantee of payment. For you to remain fully informed, I’ll review this with you when your predetermination of benefits has been returned.”

 

Letting the patient know how long you will carry a balance.

Financial Coordinator: “We can carry the insurance-related balance for up to 60 days. Because I know we are both concerned about the finance charges that will be assessed on your account after 60 days, we will ask that you clear your account if the insurance delays payment beyond this time.”

 


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