How to get your patients to pay????!!!??

[quantumhead]

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In another discussion a good topic was raised, one that I see alot of articles and hear alot of discussion on. That is, "how do you get your patinets to pay." and in addition, should you "sell" dentistry.

This is actually two topics.

One way to get the money... payment due at time of service. I believe that some refer to it as a "cash on the barrel head" operation. I like the idea, however, I have not heard of many that do this. These also include no insurance.

Another, accept credit cards. Down side is that you have to pay to accept them. Maybe not so bad if you are doing enough business.

Yet another, third party financing. Like when you go to get a sofa. Someone elses line of credit. Again, a portion of your money goes to someone else and some will be turned down for credit.

I know one doctor who makes the patients file all clames with their insurance for reimbursement.

And there is the idea of financing patients. OK for some but you can tie up alot of cash quickly. If you manage your accounts how the IRS wants you will pay taxes on that money even if you don't collect it. OUCH!

I am not sure what to do with all of this. I have a little while to figure it out.

THe other topic. Selling Dentistry,,,, some hate the idea. I have mixed feelings. It depends how far you go with the selling. High pressure sales (the booth) turn me off. I want more of the altruistic method, offer all options and highlight the best, not the most profitiable. Ultimatly it is the patients decision but, I would think most will do what the Dr. says and just pay.

On the other hand you have to sell a little.

"Hey Mrs. Jones, your smile could benifit from some whitening or possiable veneers."

How do y'all feel?

 

[DesiDentist]

Fee for Service.

I know several dentists that don't mess around with insurance and they are doing really good. Patient goes in gets the treatment done and pays (cash, check, credit card) and leaves.

DesiDentist

 

[Big_Poppa DDS]

Fee for service is a type of insurance usually with a 1000 dollar maximum and will usually cover a portion of procedures. Do not confuse this with private paying patients who just pay out of there own pocket.

 

[DesiDentist]

Thanks for clearing that up Big_Poppa

DesiDentist

 

[DrJeff]

The insurance debacle/nightmare/explanations..... Remember insurances companies are in business to make money for themselves, and as much as they try to promote themselves as patient advocates, THEY AREN"T!!!! Additionally, remember that MOST insurance companies haven't increased their yearly patient maximum coverage expenditures in around 30 years!!😱 Back then a 1 surface amalgam went for 10 to 20 bucks and crowns were often comfortably under 100 bucks. That not withstanding, a good munver of your patients will have some type of dental insurance, the big companies are Delta Dental (probably the best big one from the dentsits perspective), Met Life, Cigna, Aetna, and Blue Cross/Blue Shield (probably the worst big one from a dentists perspective) Plans can be subdivided into a number of categories, the first division being network vs non network.


What that means is that if you as a dentist enroll with a specific insurance company they'll list as as one of their member dentists and "encourage" their patients to go and see you. What plans you enroll with will vary and I'll hit on those in a minute. Roughly, as a netowrk member dentist you'll treat patients with those plans at for fees that are pre set per contract. These fees in theory are set by survey of fees in the area of your practice and then set at the 90th percentile level. The various types of plans are basically as follows:

DMO (basically the dental version of the HMO) where you accept a set fee per month per patient from the insurance company to provide essentially what ever work need to be done. I.E. if you have 500 DMO patients assigned to your office, and the insurance company pays you 10 per patient, you'll get a check from the insurance company for $5000 each month to do whatever treatment needs to be done on those patients whether 1 shows up in your office or al 500. This is generally not a popular option amongst dentists where often you need to hope patients won't come in, or cut corners to turn a decent profit. Hence, not alot of dentists enroll in this one. This is the cheapest plan for employers to provide.

PPO (preferrred provider option) This is a very common plan. Basically, once you sign up for the plan, your listed in the insurance company's book. You agree to treat the patients with this plan at a preset rate (generally the 90% level I mentioned earlier). Patients generally have between 50 and 100% of the treatment fee upto that 90% level based on type of procedure paid by the insurance company and then have a copay equal to the difference upto that 90% level. (I.E. if your doing a crown where the allowable fee per the contract is $750 and your fee is $800, you'll first write off the $50 that is above the $750 fee, and then if it's at a 50% coverage rate, the insurance company will write you a check for $375, and the patient pays you the other $375). Once the insurance company has paid out the yearly maximum its all out of the patients pocket. In theory based on this, you could do $2000 worth of dentistry with a $1000 yearly max and a 50% coverage rate. Don't worry if your confused, because alot of your patients will be too. These are of moderate/high costs to employers. Your enrollment or not in these as a dentist, alot of times is based upon how many area companies/patients are enrolled in these plans.

Traditional plans. Basically you can go to any dentist you want, whether or not they are "networkl providers" or not. Then the plans work just like the PPO's. These are typically the most expensive for an employer, and the least common plans you'll see.

Once the plan is in place, then the frustration set is about what procedures they cover(or don't) and how they will try and downcode (i.e. pay for a less expensive alternative for the same procedure {re-imburse you for a porcelain to base metal crwon when you did a porcelain to ceramic crown}). Arghh, Arghh, Arghh. All that I'll say is that there is a reason why multiple states are sueing insurance companies over re-imbursement plans/rate settings!

 

[ktran02]

Dr. Jeff, you're awesome! Thanks for the explaination