When it comes to insurance, oftentimes you will hear the terms “in-network” or “out-of-network.” Dentists who are “in-network” have agreed to a personal contract with a benefit plan. These contracts have restrictions and requirements and usually dictate adherence to a reduced fee schedule. Therefore, patients who chose an “in-network” dentist typically will pay less of their own money toward treatment than those who choose an “out-of-network” dentist. In addition, an “in-network” dentist usually is paid directly from the insurer and payment is sent to the office.

An “out-of-network” dentist has not signed a contract with the insurer of a particular plan. However, patients may still choose that dentist and have some of their fees covered, but they may pay more out of pocket. Also, plan payment checks are usually sent to the patient, not the dentist. The plan pays the patient, and then the patient pays the dentist. Or the patient pays the dentist and is later reimbursed by the plan.

A dentist who decides to become “in-network” may choose to do so because a large population of patients are on the plan, because s/he likes the security of receiving payment checks directly, or because the fee schedule seems fair. A dentist may decide to stay “out-of-network” because a smaller population of patients uses a particular plan. The dentists may be content with patients receiving payment checks. Or s/he may not be comfortable with the fee schedule. Be sure you have a very clear understanding of what specifically is dictated in the contract before becoming an “in-network” dentist.

Does the cellular phone company proclaim, “Look! Bad News is Here!” when they send your bill? No. Does the grocery store clerk say to the customer, “I’m sorry Mrs. Jones, but you will have to pay for your groceries today”? Of course not. These are businesses that expect payment for goods and services delivered. And the dental office is a business where goods and services are delivered as well. Nonetheless, for some dental office employees asking for payment is practically painful.

Typically, employees that struggle simply aren’t sure how to broach the subject. What’s more, these employees don’t know how to emphasize the value of services provided or how to present payment options. This is where two essential tools come into play #1 – A clear yet flexible financial policy and #2 Scripts.

Consider incorporating the following into your financial options:

• Establish a relationship with a treatment financing company, such as Care Credit
• Allow patients to build a balance on their account before beginning major treatment.
• Allow patients to pay for larger cases in two or three installments over a specific period of time.
• Offer a 5% discount if the case is paid in full and will not be submitted to insurance.
• Make arrangements to bill the patient’s credit card on a recurring basis until the treatment has been paid in full. This is ideal for larger cases. Orthodontic practices often do this routinely. This system streamlines payment and posting while eliminating billing for your practice.

Next incorporate the use of scripts into financial discussions with patients. Scripts help staff to clearly educate patients on treatment recommended, treatment delivered, and treatment financing options that can bridge the gap between treatment diagnosed and treatment completed.

“No problem, Tom. I’m sure Erin my financial coordinator can work up a little arrangement for you to pay – oh say, $50 per month?”

“Uhhh, how ‘bout $25, Doc?”

“Well, yeah sure. We’ll take care of you, Tom, you’re just like family.”

New dentists can find themselves in the awkward position of financial negotiations with patients, particularly when it comes to family and close friends. And that can put practice finances into jeopardy in no time. With so many things on the new dentist’s plate, it can be easy to forget that profitability and collections are the Siamese twins of dentistry. One doesn’t go anywhere without the other.

It’s essential that when it comes to financial plans and promises, new dentists assign this duty to a trained financial coordinator and establish a financial policy that they are comfortable with. Generally, offering patients a few payment options is most desirable rather than a laundry list of payment plans to choose from.

Most importantly, do not get into the habit of extending credit to patients. This will be very difficult to break as your practice grows. Rather, partner with a patient financing company, such as CareCredit.

Consider offering a slight adjustment in the fees for more costly procedures paid in full that are not covered by insurance, such as a 5% adjustment for procedures over $500 paid in full.

Require insured patients to pay a portion of their payment responsibility when services are rendered.

Do not accept post-dated checks.

Give patients the opportunity to pay in full within 30 days before assessing a financing charge on the account.

Sign up for an electronic billing service. And file all insurance claims electronically.

Interested in additional resources to help you manage the financials of your dental practice? Click Here.