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Scripts for Practice Financial Policy

April 20, 2023 329

Explaining the Practice’s Financial Consent Form to the Patient.

“We find that communicating all of our financial options and protocols to patients in advance of treatment works best and helps avoid any miscommunication down the road. We ask that you read over our financial consent form and provide your signature. Please let me know if you have any questions.”

Informing a Patient of the Practice’s Fee/Deposit After a Missed Appointment.

“We are happy to reserve the doctor’s time for your treatment. To do this after a missed appointment, we do need a deposit to hold the appointment. We can take your credit card information down or you can bring cash or a check to the office.”

Requesting Payment in Full at Time of Service.

“Many of our patients like to take advantage of our 5 percent courtesy when payment is received in full before or at the time of service. This also allows us to reserve the doctor’s time for larger procedures and assures you of your reservation. We accept cash, check or credit card for this payment option.”

Requesting a Deposit Before or at Time of Service.

“To help break up the payments for large procedures, we do offer our patients the option of submitting a 50 percent deposit before treatment, with the remaining balance due at the last appointment. This option allows us to reserve the doctor’s time for larger procedures and assures you of your reservation. We accept cash, check or credit card for this payment option.”

Introducing Third-Party Financing. We are happy to offer patients, upon application approval, a monthly payment plan through (enter name of third-party financing company). There are several interest-free payment plans to choose from and some extended payment plans with small interest rates offered as well. Would you like to complete the application to see if this would be a good option for you?”

Response for When Patient’s Third-Party Financing Application Is Declined.

“Unfortunately, the financing you have requested was not approved. Would it be possible for you to pay a portion of the fee with cash, check or credit card and we can see if a lesser dollar amount can be financed through our third-party vendor? Another option would be for you to submit three payments to our office over the next couple of months and once we reach the 50 percent deposit amount, we can schedule you for your first appointment. Which option do you prefer?”

Requesting a Patient’s Copayment at Time of Service.

“I have good news — the estimate I have received from your dental benefit plan indicates that the plan covers approximately 70 percent of the treatment fee. That is great coverage. As a participating provider, it is necessary by contract for us to collect the patient’s portion at the time of service, otherwise known as your copayment. Following completion of the procedure, we will file a claim to your dental benefit plan to receive payment for the remaining balance. We accept cash, check or credit card for your portion.”

Explaining to a Patient That the Dental Benefit Plan Coverage Is an Estimate.

“We contacted your dental benefit plan prior to your appointment and were able to get an estimate of your benefit for this treatment plan. This is an approximate figure — sometimes the plan pays more and sometimes they, unfortunately, pay less. We work very hard to maximize your dental benefits and will provide you with a refund if we receive more than the estimate. With that said, if there is an unpaid balance after receipt of payment from the dental benefit plan, the patient is responsible for the difference.”

Requesting a Credit Card Authorization for Automatic Charge (when dental benefit reimbursement does not cover the estimated amount).

“Should the dental benefit plan reimburse our practice for less than the estimate, would you like to complete our credit card authorization for us to charge your card for the remaining balance? This way you do not have to worry about receiving a billing statement from us and mailing us a check.”

Response When a Patient Requests to Be Billed for the Treatment.

“We request payment before or at the time of service and do not send billing statements following treatment. This is a benefit to our patients, as we can keep our practice costs down by not having the time and expense of billing and collections, and therefore we are able to keep our fees competitive for our patients. We accept credit cards if you do not have cash or a check with you.”

Requesting Payment from a Patient with an Overdue Account (31 or more days overdue).

“I’m calling regarding your recent treatment with our practice. We hope you are satisfied with the service you received. We do show an outstanding balance on your account that was due to our office last month. We can take down your credit card information or you can mail us a check for the amount.”

Notifying a Patient with a Delinquent Account of the Practice’s Collections Policy (91 or more days overdue).

As you are aware from our financial consent form, the practice’s policy is to send delinquent accounts, when 120 days overdue, to an outside collections agency. Our accountant requires me to forward all accounts at 120 days to his attention, and I would hate to put you in that situation. To avoid this, I can take your credit card information down or you can mail us a check for the amount.”


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