Presenting Financial Consults

Some offices have very specific front desk roles: insurance coordinator, financial coordinator, scheduling coordinator, etc. In other offices, there is one person who handles all of those roles. It is up to your practice to decide on those roles and the responsibilities within those roles.

For our purposes, we are going to assume that someone at the front desk will be responsible for discussing financial arrangements with patients. This is quite the topic that certainly deserves a lot of attention and study.

To Properly Discuss Financial Arrangements with Patients, THREE KEY ELEMENTS Must be Understood.

  • 1

    An Understanding of the Needed Dental Treatment

    If that team member cannot answer questions about the treatment (procedure details, reason for treatment, length of treatment, etc.) then the patient may not feel confident in the practice. We’ve included an entire section (WHAT PROCEDURES DOES THIS PRACTICE PERFORM) for learning about this practice’s specific treatment options. Please work through that BEFORE discussing treatment with patients. Patients are looking at THE PRACTICE to be the expert in dentistry for them.

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    DETAILS OF THE PATIENT’S DENTAL BENEFITS

    Whether we like it or not, patients look to the dental practice for guidance regarding their plans. Caution patients that benefit estimates made by the office are ESTIMATES only. The team member should familiarize him/herself with that patient’s updated rundown information. Check for any restrictions regarding age limitations, replacement clause, and missing tooth clause when presenting fees.

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    THE PRACTICE’S FINANCIAL FORMS AND PAYMENT OPTIONS

    What sorts of payment plans does the office offer to patients? Many offices offer Care Credit Financing, but not everyone who presents financials really understands how it works. Financing companies offer training materials to make presenting their payment option easy.

Six Major Components to Presenting Financial Consultations

  • 1

    Obtain Patient Benefits

    Many offices enter specific insurance plans right into specific patient accounts at the time benefits are obtained. It’s pretty sweet when planned treatment is added into the software and the program can estimate the patient co-pay. This can be incredibly helpful. However, we always like to remind people that the person presenting financials must be smarter than the computer! Practice management programs are not always able to take certain things, like missing tooth clause or replacement clause, into account. The dental team member should be astute enough to realize that just because the practice management software says the patient will owe an amount for a procedure, it doesn't mean it is correct!

  • 2

    Doctor Sees Patient and Diagnoses Patient

    The treatment is entered into the practice management software by a team member or the doctor.

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    Front Office Determines Financial Options

    Reminder! In order to determine benefits, please consider the following information:
    Has Deductible Been Met?
    How much is a patient given a year and how much has been used?
    Some procedures are not covered if the patient is too young or old.
    Some benefits may not be paid out to replace a tooth if it was extracted under a different plan.
    Some plans have time limits on covering a duplicate procedure on the same tooth.
    Some insurance companies will reduce payment for a procedure based on material.
    The length of time after purchasing a dental benefits plan that a patient must wait before coverage for certain procedures goes into effect.
    It is a GREAT idea to be able to mentally estimate patient co-pay and insurance portions independently of the practice management software. The list above include some things that the practice management software is not capable of taking into consideration.
    We will say it again: Be smarter than the software!
    Let’s get back to the logistics of this. A patient comes in and complains of some discomfort with a broken tooth and has noticed some black spots on two other teeth. The doctor reports to the patient that a crown and 2 fillings are needed. Typically that information would be added to planned treatment in that patient’s digital file. The front desk might receive an alert that the patient has treatment and must have a financial discussion. The front desk should review the patient’s benefits, including deductible, procedure payment percentages, and remaining max. In this case, the front desk must also find out if the fillings will be downgraded and if the crown is a replacement. Looking at the software, the front desk sees that the patient portion is $650. However, upon closer examination, she realizes that the crown is replacing one that was done 7 years ago and there is a 10–year replacement clause. She now knows that the insurance company will not cover the crown replacement for at least another 3 years. The patient will in fact owe $1300 for his treatment. What would have happened if she told the patient he only owed $650 when in fact he owed double that? It pays (literally and figuratively) to get financial info right the first time.

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    Present a Financial Consultation by BUILDING VALUE throughout the conversation

    Once the benefits have been obtained, the treatment has been determined and entered into the practice management software, and the financial form written up for the patient, it’s time to have the financial consultation. We recognize that a new employee might be nervous to discuss financials with patients. Here’s our advice about that.
    MASTER THE THREE KEY ELEMENTS OUTLINED ABOVE. The more knowledgeable you are, the more confident you will feel. That confidence will come across to the patients. They will be more likely to trust you and your practice if they FEEL as if you know what you are talking about.
    BE PROUD OF YOUR PRACTICE. If the doctor performs good dentistry, then you should be proud of your fees and the service your practice provides. Do you believe in his/her work? Do you think the practice can accomplish what the patient wants/ needs to be done? (If not, maybe find a new doctor to work for?)
    Ok, so we know we need to build value into the conversation. But how do we do that?
    Let’s say you were looking to buy a new car and went to a car lot. Would a sales person walk up to you and immediately point to cars and call out prices? No way! That sales person would attempt to find out what your needs were. He/she would then tell you ALL the great features about the car before telling you the cost. That sales person is trying to build value that will explain why the car costs what it does. Most likely the sales person would find out what your specific needs are and then repeat them back to you.
    For example, if you were to mention to the sales person that you wanted a bigger SUV to accommodate your growing family, the sales person would most likely use that information when looking at cars. “Take a look at this SUV. It has room for 7. Would that work for your growing family?” By restating the customer’s original objectives, the sales person is reassuring the customer that he has the solution the customer needs.
    Why would the sales person do that? To build value, of course!
    How can this same principle apply to dentistry? Let’s create an example where a patient is having some discomfort with a broken tooth and needs a crown. Imagine this scenario. The doctor tells the patient he needs treatment, and a front desk team member walks up to the patient and simply says, “That will be $1300!” What did that team member do to build value? Nothing! A more ideal situation would call for that team member doing the following:
    Team member asks the patient if he has any questions on the treatment that the doctor recommended. Often times, patients will feel more comfortable asking questions of other team members instead of the doctor. “Before we review your specific payment options, do you have any questions on the treatment that the doctor is recommending?”
    Team member reviews the treatment, even if the patient does not have any questions. While reviewing the treatment, the team member should be sure to respond by BUILDING VALUE into the conversation using the BEGINNING, the MIDDLE, and the END concept.
    Think of it this way.
    The patient’s concern before they came to your office is the BEGINNING.
    How the office can help is the MIDDLE (Use the Three Positive Response Rule here!
    The way the patient will be improved as a result of the dentistry is the END.
    We love the idea of restating the patient’s own words, reassuring them that we can take care of the problem, and then letting them know how well off they will be after treatment. We will break it down for you.
    Beginning: “I heard that that broken tooth is causing you some discomfort."
    Middle: "We can easily fix that tooth with a crown. In fact, we offer same day dentistry for crowns. Because we are a digital office, we do not have to take any messy impressions. You can actually watch the crown process, too. It’s pretty cool!"
    End: "By the end of today’s appointment, that broken tooth will be fixed. You will be able to chew like normal on that tooth again. No more discomfort!"

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    Patient accepts treatment, chooses financial option and SIGNS financial form.

    The financial form should include language that any information being presented is only an estimate and that the patient may be responsible for additional payment after benefits have been paid.
    Be sure to scan a copy into the patient's digital file and give the patient a copy of the form.

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    Doctor begins treatment

    Only after the treatment has been discussed and the financial agreement understood and signed should treatment be started.