At this stage, you have the right financial coordinator hired, and you have prepared for the financial consultation by creating documentation and planning the system with your team. You and your financial coordinator are ready for the financial consultation. But, first, here are some tips to make the consultation seamless.

• Have one staff member be responsible for the practice’s financial consultations. The financial position in the practice should be held by one person — it usually results in poor management of the financial system if shared by two or more team members. It is perfectly acceptable if the staff member presenting finances serves a dual role. It is quite common for this team member to also be the treatment coordinator or be responsible for scheduling, billing and collections or managing dental benefits. Keep in mind that it is not essential for the financial “presenter” to also be responsible for billing and collections. These two responsibilities typically require very different personality traits and skills, therefore, may not complement each other in a dual role. Please note — if the financial coordinator does manage accounts receivables, the practice owner should have a mechanism for “spot checking” the financial system to protect against embezzlement.
• Conduct the consultation in private. Due to the sensitive nature of the topic, financial consultations should be held in private. For existing patients with smaller balances (or balances mostly covered by dental benefits) who are aware of their payment obligations, private consultation is not necessary. However, for all new patients and for existing patients with significant treatment plans and balances, private consultation is essential. Because the financial coordinator often holds a dual role in the front office (receptionist, scheduling coordinator), the consultation space is usually conveniently placed close to the front desk area. If the financial coordinator serves a dual role, time for consultations may need to be built into the schedule or the practice may need to plan for a “floating” dental assistant to serve as a backup to the front desk during financial consultations.
• Be friendly and ease the patient’s discomfort. The discussion of money can cause an automatic trigger of discomfort for many people. When people are uncomfortable, they tend to get defensive. This explains why many financial consultations head down a negative path and lead to the patient’s dissatisfaction with the customer experience. But this does not have to be the case and can be avoided if the financial coordinator approaches the consultation with confidence and addresses the patient’s hesitations by putting the patient at ease.
• Help patients plan for long-term health. This message should begin with the provider’s treatment plan consultation and be carried through to the financial discussion. The cost of extensive treatment plans can be overwhelming, but it is effective in helping patients accept the cost if they understand the treatment to be a long-term investment in their health rather than a “quick fix.”
• Educate patients on dental benefits. Whether you as the practice owner participate in a plan or not, file claims for patients or not, it is important for patients to understand their plans’ benefits and limitations. There is a misconception among most patients that the dental practice holds responsibility for their dental plans’ reimbursement percentage. The financial coordinator is responsible for educating patients on their benefits and explaining the dental practice’s role in helping the patient to maximize these benefits. Some practices believe that by having the patient pay the balance in full and receive reimbursement directly from the dental benefit plan, patients take more ownership and responsibility. Regardless of the degree to which the practice chooses to be involved in patients’ dental benefits, education about the benefits to the patient is paramount.
• Include third-party financing near the top of your list of options. Third-party financing should be a top-choice option, not a last resort when a patient prefers to pay overtime. In many offices, it is often the last option offered to a patient for no reason. Third-party financing can offer benefits to both the patient and practice over credit card financing or the practice carrying the account itself. When making third-party financing arrangements, be certain the patient understands the nature of the financing program and the patient’s rights and responsibilities.

Dental practices are required by law to have patients sign a “Credit for Dental Services Notice” (a sample notice is available on cda.org/practicesupport) when choosing to utilize third-party financing for dental treatment. CDA recommends practices do not offer credit products to patients while the patient is under the influence of general anesthesia, conscious sedation, or nitrous oxide.

• Provide options and convenience. Offer as many financial options as possible, within the practice owner’s comfort level, that do not place the practice at unreasonable risk. Break down payment options according to patients’ monthly budgets. While practice owners are under no obligation to extend credit, often the total treatment fee is overwhelming, but when broken down per month it is easier for the patient to accept. Although it is critical to provide as many financial options as possible, do keep in mind that you ultimately must protect the integrity of the practice. If a patient cannot charge a credit card and does not gain third-party financing, evaluate the extent to which your practice can help. Some practices will come up with creative ways to help patients reach the minimum deposits prior to the start of treatment. For example, you can offer to have a patient pay the deposit over two or three months and delay the start of treatment. The usual rule of thumb is to collect the full fee or copayment by the end of treatment, which is recommended as a protection for the practice.
• Don’t wait until the day of treatment. Some practices will hold a financial consultation with the patient the day treatment is scheduled to begin. This puts the practice in a risky position, as the patient may not accept the payment terms and will either create a loss in production on the schedule or, worse, begin treatment and back out of payment or not be prepared for payment that day. To ensure the patient fully understands his or her financial portion and has agreed to the financial terms of your practice, have this conversation before treatment begins.
• Complete the financial agreement with the patient. Once the financial coordinator and patient decide on the payment method of choice, the financial agreement should be completed with the patient. Some practices prefer to have the agreement available electronically on a nearby computer, so the financial coordinator completes the information with the patient and prints the completed agreement for both parties to sign. Other practices prefer to print a “carbon copy” financial agreement and write in the specific payment method along with the patient in the consultation. The important point to keep in mind is that the agreement serves as a visual for the patient as the financial coordinator explains the practice’s financial options. A copy of the agreement should be given to the patient upon closing the consultation.
• Be clear on your collections process and gain patient acknowledgment. Whether you are meeting with a new or established patient, the financial coordinator must clearly communicate when payment is due and the practice’s process for delinquent accounts. This should be conveyed in a straightforward, pleasant manner. Explaining this process in advance eliminates any misunderstandings regarding when payment is due. Patients appreciate the advance notice so they can prepare for payment, rather than being surprised when partial or full payment is requested at the beginning of treatment.
• Eliminate any assumptions regarding patients’ ability to afford treatment. Often assumptions about a patient’s ability to pay for treatment are made based on appearance, dental benefits coverage or other information shared by patients. It is the financial coordinator’s job to eliminate financial barriers to the extent the practice owner is comfortable, which requires the financial coordinator to be unbiased and open to every patient. You never know where oral health and appearance lie on a patient’s list of priorities — regardless of if patients present themselves as financially able to pursue treatment or not.
• Create a “follow-up” consultation with non-compliant patients. Although you have created a system in your practice to communicate your financial policies and patients’ responsibilities, there will likely be a small percentage of patients who are delinquent with payments. Part of your financial process should be to establish when your financial coordinator should have follow-up communication with non-compliant patients. Without a communication plan process, delinquent accounts can easily get out of hand. Typically, the consultation is the final step after sending statements, conducting a phone call or two and possibly sending a letter. The goal of the consultation is to 1) get the patient in financial good standing with the practice and 2) review the financial agreement the patient signed and committed to at the beginning of treatment. Also, keep in mind that there may be a period of adjustment when introducing a new financial system with your existing patients. For most of your patients who are in good standing, the financial agreement should be subtly introduced when a new treatment plan is presented. However, for the long-standing patients who have repeatedly struggled to submit payment on time, a more overt effort to educate the patients on your new financial system and agreement may be necessary.

Following these tips and making the effort to prepare for the consultation will allow you and your financial coordinator to talk openly with patients and focus on what is most important — making treatment possible and meeting the patient’s oral health objectives.