Patients' two greatest fears upon entering your dental office--and two of the barriers to accepting treatment--are the fear of pain involved with actual treatment and the fear of the cost of treatment. Your caring attitude and expertise in creating value and the need/want for treatment will minimize the first fear. Establishing a successful financial arrangements system will help overcome the second fear.

The "Why?" is now obvious, but knowing the "Who?, What?, When? and Where?" of financial arrangements is imperative to success:

"Who?" Choose a staff member who is comfortable talking about money and has the verbal skill and communication ability necessary to handle every situation. Give your staff titles such as Financial Coordinator or Financial Advisor for a more professional atmosphere.

"What?" The Financial Coordinator must know what treatment they are making the arrangements for prior to discussing it with the patient. It is imperative that the Doctor prepare three (3) treatment options for the Financial Coordinator. S/he should begin by presenting the full fee for optimal treatment, not individual fees. If that option is not accepted, the Financial Coordinator still has the alternatives of phased and minimal treatment to offer.

"When?" For large treatment cases, a separate appointment for the Doctor to present the case and for staff to discuss the finances is recommended. Whenever possible, have the patient return with the spouse or significant other who can help them make their financial decision. If treatment is minimal, the fees can be presented after Doctor has explained the options and completed the initial visit with the patient.

"Where?" Successful financial arrangements can only be made in a quiet, private area away from the front desk or reception area. If your facility does not have a separate consultation area, the treatment room or operatory works well.

"How?" The presentation of fees is crucial to successful financial arrangements. The following is a simple yet sophisticated way to present the fees for maximum patient acceptance.

Fees should always be presented as one case fee, not individual fees. This allows the patient to see the importance of the entire treatment plan and not pick and choose the procedures they want. When patients are given an itemized statement or estimate of the recommended services, they will choose the treatment to be rendered according to cost, and not necessity. This allows the patient to control the course of your recommended treatment plan and prolong completion of the case.

Once the case fee is presented, the first question you should ask is: "Will you be paying with cash, check or credit card today?" Then STOP AND WAIT for a response. Let the patient tell you what they can afford--you may receive more than anticipated. Do not pre-judge your patients' ability to make payment in full.

Here are some typical patient responses and answers for you to give in return:

QUESTION: "Can I make payments?"
ANSWER: "Yes, we accept Visa and MasterCard." Visa and MasterCard are payments to the bank. If the patient cannot use their own personal credit cards, offer a patient financing program. This allows the patient to make low monthly payments and begin treatment immediately. Always get a down payment by asking, "What is the largest deposit you can make today?" Never tell the patient what is needed to start--you may get more than expected!

QUESTION: "I have dental insurance, don't they cover this?"
ANSWER: "I verified your insurance for you. You have a $1000.00 of benefits available and they pay by percentages. I will be happy to assist you in completing your insurance forms for reimbursement." Then STOP AND WAIT for a response. Do not use words like maximum, allowance, or give individual percentages--this limits acceptance. Once again, if you give patients itemized accounts of the recommended treatment, they will choose what they want. Your goal is to get each patient to accept the recommended treatment, the "ideal" case, regardless of insurance benefits. You may want to offer patient financing again to assist with monthly payments.

If the "ideal" treatment plan is not feasible for your patient, then go to your second option or the "phased" treatment plan and start over with presenting the fee for each phase. This gives patients the opportunity to have the "ideal" treatment over 3 years, making it more affordable. Your last option is the "minimal" treatment plan. This is a carries control diagnosis and should only be presented after the first two options are declined.

If none of the three treatment options are accepted, or if the patient wishes to "think about it," you need to find out what is preventing the patient from accepting treatment. Many times they will mask other concerns during financial arrangements by saying "I cannot afford this." To determine their real objection(s), you may ask any or all of the following questions:

1. "If we can fit this comfortably in your budget, is this the type of treatment you would like?"
2. "Is this the office where you would like this type of treatment done?"
3. "Is this the Doctor you want to perform the services for you?"

If they answer "No" to any of these questions, the Doctor needs to return to discuss the value in his/her recommended treatment. If they answer "Yes" to these questions, schedule them for a small procedure immediately so that they become more committed to having the treatment plan completed. This may require additional creative financing such as post-dated checks or deposits toward future treatment (lay-a-way plan.)

In addition to an established system for "Who?, What?, When?, Where?", and "How?", it is crucial to have a written financial policy which details your office policies and payment options. If your practice does not have a written financial policy that helps guide your staff toward consistent financial arrangements, your patients are likely to make up their own as they go!