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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 financial arrangements.

     Realize that 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 arrangement.

     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, however.

 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 denture.


 Letting patients 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 they go.

 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."

 Remember that 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.

 New patient 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.

Ex-spouses and other absent parties

Let's say 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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