How to present finances for SIMPLE cases

ONE SENTENCE SUMMARY

Helping patients get the treatment they want by presenting clear finances and payment options.

BEST CASE SCENARIO IF WE ARE ALL 100% CONFIDENT

It's easy for patients to get the treatment they want because we make their options clear. They feel like we are here to help them get what they want, not to try to convince them to do something they don't want to do. They are treated with respect and they tell all their friends about how we do things differently than other dental offices that are constantly upselling and lecturing.

WORST CASE SCENARIO IF SOME OF US ARE NOT

Patients feel confused and overwhelmed. They don't get the treatment they want because nobody showed them ways to make it more affordable. They feel like they are being pushed and pressured into doing something they don’t want, don’t need, or don’t care about.

WHAT DOES 100% CONFIDENT MEAN?

Everyone goes through the live "General FA" training at least 5 times per year.

HOW DOES IT WORK?

1. Presenting the finances

1. This is how much it costs

2. This is how you should pay for it

3. Schedule the next visit

2. What to do if the patient declines our preferred payment option?

2. Documentation

3. What If?

1. PRESENTING THE FINANCES

4 tips for a great financial presentation:

1. Don't leave dead space that the patient will feel like they should fill with more questions. Instead, take control of the conversation. Guide the patient towards the conclusion that YOU want - booking the next visit.

2. Don't ASK the patient what they want to do. Instead, TELL the patient what you want them to do.

3. Use SIMPLE words. Would a 12 year old understand what you are saying?

4. Don't make a big deal about cost, payment options, or insurance. Instead, keep it simple and stick to the plan: "This is how much it costs, this is how you pay for it, and this is when we will see you again."

When do we require an initial payment (or deposit)?

1. Treatment that requires us to do some homework, order some parts, or pay for lab fees BEFORE the next visit.

2. When we are scheduling NEW PATIENTS (or patients without much history with us, or with a bad history of no shows) back for more than 1 hr of doctor time.

The deposit is a sign of commitment, so that we don't do that homework, order those parts, or order that lab work and then the patient changes their mind.

Example: Crowns, nightguard, whitening, Invisalign

How much deposit do we require?

The simplest way to break down the deposit is to ask for 50% of the total fee today, and the remaining balance when the treatment is completed.

What if we don't need an initial payment?

If no initial payment is required, then our preferred payment method is "pay as you go" aka "DOS" or "Day of service". The patient will pay for each visit on that day.

Here are some examples below.

EXAMPLE #1 (tx plan is a mouth full of fillings)

BAD way:

"Let's get your next visit scheduled" - and then no discussion about fees or payment and the patient assumes everything is covered by their insurance

GOOD way:

“I know Dr. Schneider talked to you about the cavities we found. There are 12 of them throughout your mouth. A few of them are quite large, and the others are medium size. It’s great that you came in today because you were able to catch these cavities while they’re still fixable. What we worry about is if you wait too long, the cavities get bigger and bigger every day and eventually reach the nerve. When this happens, not only is it a lot more painful, but it’s also more stressful and complicated and expensive to fix. This is when people need a mouth full of root canals and crowns, which can cost thousands of dollars and multiple visits per tooth.

The good news is that you are NOT at that stage yet, and our goal is to help you avoid that situation in the future.

The total fee to fix your 12 cavities is $4,200, and it will probably take 3 or 4 visits. We will let you know the fee for each section as we work through them. Dr. Schneider says that the top right is the priority, so let’s go ahead and get that scheduled. That section will cost $1,500, and you can pay for that on the day of your appointment. We can see you Wed of Thurs next week - which works better for you?”

In this example, BLUE = how much it costs using anchor, YELLOW = how they will pay for it, GREEN = schedule the next visit.

EXAMPLE #2 (tx plan is 46 endo/core/crown)

BAD way:

"So.... are you ready to do that root canal?"

GOOD way:

"Looks like we found a solution to that toothache that's been keeping you up at night. A lot of times when we see big infections like this, the tooth can't be fixed. We don't have a choice. The tooth needs to be removed. And since this is a really important chewing tooth, you'd probably want to replace it with a new tooth, which can take months of treatment and cost anywhere from five to seven thousand dollars for an implant. And even if we do the world's best implant, it's still not as good as the tooth you have right now.

The good news is that Dr. Bennett has found a way for you to FIX this tooth so you can keep it.

The total treatment fee is $2,500. Half that amount will be due at your next visit, and then the other half when we finish in a few weeks. I know Dr. Bennett wants you to get started right away. So which works better for you - Wed at 9 or Thurs at 2?"

Note: The tx plan 46 endo/core/crown will require 2 visits. We ask for 50% deposit at visit 1 because there is lab work involved. And then balance can be paid at visit 2.

BLUE = how much it costs using anchor, YELLOW = how they will pay for it, GREEN = schedule the next visit.

EXAMPLE #3 (tx plan is 2 crowns)

BAD way:

"Dr. Mattina wants me to talk to you about 36 and 46 crowns. Is that ok?"

GOOD way:

"Looks like we found some molars with really big fillings on them today. Teeth like that with such large fillings and under so much biting force are high risk to break. If they break, these kinds of teeth usually crack right in half, and then they need to be removed. Since they are your major chewing teeth, you will probably want to replace them which can take months of treatment and cost five to seven thousand dollars each with a bridge or implant, and sometimes trips to the specialist office. And even if we do the world's best bridge or implant, it's still not quite as good as the tooth you have in your mouth right now.

The good news is that Dr. Mattina has found a way to help you strengthen those teeth now so they don't break in the future.

The cost to do that is $2,500. Half that amount is paid at your next visit, and then the balance 2-3 weeks later when we finish. Dr. Mattina has time Monday morning or Tues afternoon - which works better for you?"

BLUE = how much it costs using anchor, YELLOW = how they will pay for it, GREEN = schedule the next visit.

2. WHAT TO DO IF THE PATIENT DECLINES OUR PREFERRED PAYMENT METHOD

The patient might say something like:

• "That's a lot of money"

• "I don't know if I can handle that"

• "Let me think about it"

BAD response:

"Ok, we'll follow up if we don't hear from you in a couple weeks."

GOOD response:

"Not a problem. Just so I know, are you ok with the plan Dr. Schneider came up with? Are you having second thoughts about your options? Or is it the finances that's holding you up?"

If the patient is having second thoughts about their options, answer their questions as best as you can, or book them back for a second consult with the doctor.

Almost always, the holdup is finances. The money issue isn't going to disappear if the patient goes home to "think about it". So let's get it out in the open and deal with it right now.

What to do if the patient is concerned about finances

Use 3 steps, in this order:

1. Payment plan

2. Stage the treatment

3. Change the treatment

How to present a payment plan

BAD response:

"Yeah that's really expensive. You can just take that tooth out instead and it will only cost $250."

GOOD response:

"I completely understand. I know Dr. Schneider thinks this is important for you, and I'd like to help you find that balance between what you want, what you need, and what you can afford.

Would it make it easier for you if we could break this up into smaller monthly payments?"

If the patient says NO, then it might be time to STAGE or CHANGE the treatment plan (more later)

If the patient says YES, they would be interested in a payment plan...

Think about what payment plan WE would like to offer first.

2 plans that almost always work for us:

1. Half now, and half in 1 month

2. 3 monthly payments

BAD response:

"Ok we can do a payment plan. What did you have in mind? How many months do you want to pay over?"

GOOD response:

"Ok that's great. Instead of having to swipe your credit card for the full amount all at once, we can help you by splitting the payments into 2. So the first payment would be taken today, and then a month later. Does that work for you?"

If the patient still doesn't like your proposed payment plan... ask THEM to indicate how much of a deposit they are comfortable with.

BAD response:

"Ok... if you can't do it over 2 months, how many months did you want to do?"

or

"Ok... can you do a down payment? How much do you want to spend per month?"

GOOD response:

YOU: "Ok that's no problem. Let's keep playing with the numbers and we will figure something out that works for you. The way this usually works is you start with a downpayment and then make monthly payments on the rest. So Mrs. Patient, what kind of downpayment would you be comfortable with?

(And then give them MULTIPLE CHOICE - don't leave it open ended)

(For this example, let's assume it's a $6,000 treatment plan.)

Could you do half? Or $2,500? $2,000? What do you think you can handle?"

PATIENT: "I can probably do $1,500"

(As long as the downpayment is 20% or higher, we are good to go.)

YOU: "Ok great, we can work with that. So $1,500 to start leaves $4,500 remaining. Let's divide that into 3 monthly payments, so you will basically have $1,500 to start, and then 3 months at $1,500. Does that work for you?"

PATIENT: "No.... I'm still not sure I can do that."

YOU: "Ok let's keep playing with the numbers because I really want to help you make this work. You said you can do $1,500 to start, so it sounds like the $1,500 per month is too high for you? So where would you like to end up for your monthly payments?

(And then give them MULTIPLE CHOICE - don't leave it open ended)

Could you do $1,200? $1,000?"

PATIENT: "I was thinking like $800."

(As long as the monthly payment is $250 or more, we are good to go.)

YOU: "Great we can do that. So the total is $6,000, and if you can do $1,500 to start, that leaves $4,500 remaining. If you want to do $800 per month, then that will take about 6 months. Does that work for you?"

3 general rules about payment plans:

1.Downpayment should be 20% of the total or higher.

2. Monthly payments should be $250 or higher.

3. If the payment plan is 6 months or longer, you should use the Google Sheet because the math gets trickier, and there is interest applied.

These are just general rules. They are not written in stone. You should use your experience and judgment. Know the rules so you also know when to break the rules.

For example, you might decide to break the rules if...

1. You want to do the patient a favour

2. Your payment plan is "close enough" - 18% downpayment instead of 20%, or $240 per month instead of $250

How to Use the FA Google Sheet

To make it easier to present payment plans 6 months or longer, use the FA Google Sheet.

Note: Even though these Google Sheets are online, it is much more effective to print the sheet and then use the paper version to show the patient. The paper version feels much more personal. Plus we need the patient to sign it anyways.

IMPORTANT! Do this before using any of the Google Sheets:

2 reasons to make a copy of the G Sheet before you edit it:

1. You don't want to accidentally make changes to the master copy, and then it's messed up for the next person who wants to use it.

2. FD can search for these FA forms if you save them in the right folder with the right filename. Set your teammates up to be successful!

How to use the FA General Sheet

How to STAGE the treatment if you can't find a payment plan that works

If you can't get agreement on the entire treatment, plan, book SOMETHING.

• Is there an area that is most important to the patient?

• Is there a part of the treatment plan where there isn't any decision that needs to be made?

• Is there something simple you can start with?

• Can you at least book hygiene?

EXAMPLE #1 (tx plan is mouth full of fillings)

BAD way:

"Ok if that's too expensive and you don't want a payment plan, then let's just take those teeth out instead."

GOOD way:

"Not a problem. I completely understand that we have to work within your budget. Here's what I think we should do: Dr. Schneider says the most important area is your top right. So let's start there, and then we can do the other areas as you're comfortable.

We can get started Monday morning or Wednesday afternoon - which works better for you?"

EXAMPLE #2 (tx plan is endo/core/crown)

BAD WAY:

"Ok if that's too expensive and you don't want a payment plan, then let's just take those teeth out instead."

GOOD way:

"Not a problem. I completely understand that we have to work within your budget. If you can't afford doing everything all at once, then let's prioritize. The most important thing is to get rid of the infection, so let's start with that first. It would be great if you could do the crown as well, but if you can't afford it, then we can leave it for now. That means your tooth is higher risk to have problems later, but that's still better than having no tooth at all.

We can get started Monday morning or Wednesday afternoon - which works better for you?"

How to CHANGE the treatment

If the patient declines a payment plan, and still can't afford the treatment after you've suggested phasing it, then it's time to CHANGE the treatment plan.

You should know the backup plan from the doctor or from the chart.

For example, endo might turn into exo.

3. Documentation

See training here for how to document the FA:

https://www.smilingdentallearninglibrary.ca/post/treatment-planning-in-od

IMPORTANT!!!!

If you give the patient anything to take home - a treatment plan in writing, FA sheet, proposed FA options, ANYTHING - you MUST make a copy to keep in the patient's chart.

4. WHAT IF?

"Do you offer payment plans?"

2 ways to handle this question, depending on if you are going to be the one dealing with the payment plan or if you are going to transfer to someone else later:

Option 1:

YOU: Yes we absolutely do! Many patients like to split their treatment into smaller, more manageable chunks. The way this usually works is you start with a downpayment and then split the remainder up into monthly payments. So if your total cost is $5,000, what do you think you could do for a downpayment? Could you do half? or $2,000? $1,500?

Option 2:

YOU: Yes we absolutely do! Many patients like to split their treatment into smaller, more manageable chunks. When we finish up here I'm going to ask Stacey to go over how that works with you. She's really good at making it affordable for you.

"Can you send a predetermination?", or "How much is covered by my insurance?"

CLICK HERE for more training on handling insurance questions.

You start discussing finances but then get out of your comfort zone

If at any point you start to feel like you are getting in over your head, feel free to transfer to someone else. "That's great Mrs. Patient. To be honest, this is not my area of expertise but I'm going to pass along this info to Stacey because she's really good at figuring out the final details." - And then do a really good NOTE and VERBAL transfer to set the next person up to be successful.

How do you use the anchor principle?

CLICK HERE for more training on anchoring.