Paying patient's balance....

[Tejano]

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Just wanted to see how many people out there are put in the same situation as me and my classmates, having to pay hundreds and some even thousands of dollars for patient's outstanding balances in order to graduate. If your school does something other than screwing its students because of their dead-beat patients, let me know. Oh yeah, is this legal?

 

[groundhog]

What's the deal? Are you forced to treat patients as assigned but only allowed to bill the patients after treatment is complete? That would seem unfair. The school that I know about requires all patients without insurance to pay 100% of projected costs up front prior to treatment and those with insurance to put down100% of projected costs less estimated insurance coverage prior to being treated.

 

[Periogod]

Just wanted to see how many people out there are put in the same situation as me and my classmates, having to pay hundreds and some even thousands of dollars for patient's outstanding balances in order to graduate. If your school does something other than screwing its students because of their dead-beat patients, let me know. Oh yeah, is this legal?

Too bad. You really must be doing something wrong if your patients owe thousands of dollars. Its not very hard to have a patient pay upfront or, each day after treatment, walk them to the cashier to pay. I mean, come on, take a little responsibility. My patients sometimes had balances but it was only the guys that I had developed some trust in. Take this all as a great learning experience for your transition into private practice.

 

[Tejano]

The patient is suppose to pay for treatment as we complete it. For one thing my school does not take insurance. Patients are to pay for at least half of the crown or bridge (or whatever) when we first prep the teeth and before we send it off to the lab and then pay remainder when we seat it. However, most of the time the patients don't have the money and say, "I'll pay it next time". So, we the students, are put in a tough place because we have to finish our requirements and trust that these people will eventually pay. If we waited till they paid to seat this stuff we would never finish...so we have to decide between a couple of hundred (or thousand) dollars or an extra year at this dump!!!

 

[thew59]

I'm in a similar situation as Tejano...The school has us by the balls because I will remember not graduating, but I will easily forget the $300 I had to pay on my patient's account to buy my diploma.

Again, how can this be ethical or legal for the schools to assume no responsibility?

 

[dat_student]

The patient is suppose to pay for treatment as we complete it. For one thing my school does not take insurance. Patients are to pay for at least half of the crown or bridge (or whatever) when we first prep the teeth and before we send it off to the lab and then pay remainder when we seat it. However, most of the time the patients don't have the money and say, "I'll pay it next time". So, we the students, are put in a tough place because we have to finish our requirements and trust that these people will eventually pay. If we waited till they paid to seat this stuff we would never finish...so we have to decide between a couple of hundred (or thousand) dollars or an extra year at this dump!!!

I'm in a similar situation as Tejano...The school has us by the balls because I will remember not graduating, but I will easily forget the $300 I had to pay on my patient's account to buy my diploma.

Again, how can this be ethical or legal for the schools to assume no responsibility?

I'd very much like to know which school you attend. 😕

 

[LarryBobDDS]

Our school will only make you pay the balance of the patient if you see them an additional time after they fail to pay their balance. So if you do a filling and they dont pay for it, but you dont see that patient again, then you do not have to pay off that bad debt. This makes the students stay up with their patient balances and keep their patients paying. I do agree that many times you have to see a patient with a balance if they have a procedure you have to do as a requirement. I've had to play plenty of balances due to this.

 

[DIRTIE]

I'd very much like to know which school you attend. 😕

Probably Temple if I was to guess, I know that it goes on there for sure.

 

[toofache32]

It was against the rules at my school to pay for any patients. But I bought my last 3 crowns. I happily paid $800 since it saved me from paying another $12,000 in tuition for a 5th year.

 

[mdub]

Oh yeah, is this legal?

That's *highly* fact dependent and somewhat law dependent. In other words, it depends on how you get the patients, what the school let you knew when you enrolled (not after), how the school adminsters the program, and what the law is in your area.

The more the school makes it clear that you are paying for materials (and perhaps space) in their clinic, the more likely their actions are permissible. The more the patient is *your* patient, as opposed to the school's patient, the more likely their actions are permissible.

If the school gets the patients, collects the money, and doesn't make it clear what your responsibilities will be from the outset, then your claim is much stronger than if the school tells you that *you* are billed for materials, time, etc. and you then have to recover the costs from your patient.

You just don't have enough information in your original post to answer the question.

 

[thew59]

The school is responsible for:

Assessing/Screening the patient.
Assigning the patient to the student.
Having the patient check in with Cashier prior to each dental visit (to obtain an "encounter form")
Creating requirements gilded under the synonym "minimal essential experiences"

The school is not responsible for:

Any outstanding balance of patient.

 

[food4thots]

i'd also like to know which school the OP attended.

 

[TKD]

i'd also like to know which school the OP attended.

Paying for patients. that's ridiculous. doesn't happen in the schools i'm familiar with (in NY, CT and MA - although i graduated a couple yrs ago).

 

[mdub]

The school is responsible for:

Assessing/Screening the patient.
Assigning the patient to the student.
Having the patient check in with Cashier prior to each dental visit (to obtain an "encounter form")
Creating requirements gilded under the synonym "minimal essential experiences"

The most important remaining fact is the explicit (or lack of) arrangement between the school and the student regarding fees. Is the student charged for materials and/or seat time? How do you know? Is it in a contract? Is it in the student handbook which was made available in completed form before enrollment?

The *practice* of charging students doesn't speak to whether there exists some prior arrangement that makes clear the legal relationship regarding billing between the school, the student, and the patients.

 

[Extraction]

Many classmate of mines we forced to pay patient balances off to get credit for their last root canal etc. You were supposedly not responsible for patient finances unless you treated the patient when they had an existing outstanding balance or had defaulted on their payment plan. I personally paid for a friend's occlusal guard to get credit one semester to make an A in pros. If you want to get into a residency or need the credit to graduate a few hundred dollars out of pocket is minimal compared to the alternatives. The school also extorted a few hundred dollars from me for supposedly losing a slow speed attachment (we leased equipment which ironically cost about the same as if I had purchased hmmmm 😕 ). The diploma was worth the $400, and the school lost substantially more money in potential donations that I will never give them.

 

[SuperC]

I don't see the problem with paying balances. It is the same as a real practice. When your patient does not pay, it comes out of your pocket. Grow some nuts and ell these people to pay... other wise don't perform procedures on them .
-C

 

[aphistis]

I don't see the problem with paying balances. It is the same as a real practice. When your patient does not pay, it comes out of your pocket. Grow some nuts and ell these people to pay... other wise don't perform procedures on them .
-C

That's awfully easy to say from the comfort of undergrad, without a pile of graduation requirements staring you in the face. 😉

 

[toofache32]

I don't see the problem with paying balances. It is the same as a real practice. When your patient does not pay, it comes out of your pocket. Grow some nuts and ell these people to pay... other wise don't perform procedures on them .
-C

I don't think you understand the gravity of this scenario. And it happens daily. You HAVE to perform a certain number if each procedure to graduate. If you don't complete a procedure (often taking 4-6 appointments) then there is no partial credit and you have lost all that time with your patient in the chair and all the after-hours work you have done. Many patients know how the system works and they will come back for the final appointment without the rest of their money on purpose. They know students will gladly pay the remaining balance if it keeps them from doing a 5th year of dental school....including tuition. Many school's have a policy to "protect" students by forbidding them to pay for their patients, but I swiped my credit card more than once to pay for work towards the end of my 4th year.

For people that haven't been to dental school, it's hard to understand how I graduated near the top of my class, but I almost didn't graduate because low-life patients kept playing me.

Grow some nuts if you want to....you'll have a pair of nuts larger than any 5th-year dental student.

 

[DDSSlave]

The diploma was worth the $400, and the school lost substantially more money in potential donations that I will never give them.

My school pulls the same crap. And the administration wonders why their alumni support is so low. Well, I already gave my alumni donation paying for patients' treatment. Hope they spend it wisely.

 

[toofache32]

My school pulls the same crap. And the administration wonders why their alumni support is so low. Well, I already gave my alumni donation paying for patients' treatment. Hope they spend it wisely.

My last "gift" to my school was this:

A few weeks prior to graduation they requested our future mailing addresses. I filled out the form with my name, but the address of a certain department chairman that I didn't get along with. I'm sure it took him weeks to get his address off all the computer systems in various departments sending out all that junk mail & donation requests. The best part is that my name was still on all the junk mail, so he knew where it came from.

 

[12YearOldKid]

The school also extorted a few hundred dollars from me for supposedly losing a slow speed attachment (we leased equipment which ironically cost about the same as if I had purchased hmmmm 😕 ). The diploma was worth the $400, and the school lost substantially more money in potential donations that I will never give them.

We don't pay for patient's treatment, but my school does "lease" us instruments. This is one of those things that just eats at you. I pay ~$1000 / semester for instrument rental. This works out to just under $12,000. I could have bought some NICE stuff for $12,000, but instead we get 10 yr old squealing handpieces and old burs that have been autoclaved about a thousand times.

Now I will admit that my tuition is cheap so it wouldn't be that big of a deal if they didn't nickel and dime us for every little thing that happens with those instruments. I got an email the other day saying that I had to return a mouth mirror or an $8 charge would be assessed to my next semester's tuition. I didn't remember getting a mouth mirror so I asked when I had checked it out.

The response: sometime in Aug 2003. 😱 That is the month I entered dental school. Almost three years ago!!! I can't imagine why I would have needed a mouth mirror during freshman orientation. But I was still charged the $8.00.

Or when you go to ask for material to make bleaching trays the dispensary people treat you like a criminal.

"Can I please get some bleaching tray material?"

"Why?" (asked suspiciously)

"I'm making some bleaching trays" (what do you think I need it for? my denture patient? 🙄 )

"O.K." rummages around and finally gives me splint material

"I'm sorry. I need the thinner material."

"This one?" She gives me ONE piece of material.

"Could I get 2 of those please?"

While looking accusingly down her nose "Are you sure you need two?"

At this point I am ready to scream. A good sized line is forming. Patients aren't being treated on time because the dispensary thinks I am trying to scam them out of an extra piece of bleaching tray material. 🙄

 

[toofache32]

... Patients aren't being treated on time because the dispensary thinks I am trying to scam them out of an extra piece of bleaching tray material. 🙄

I must have had that conversation twice a day! Jeeeez....

 

[mdub]

Don't forget the joy of small claims court. It wouldn't be hard at all to sue your non-paying customers for the balance. You'd almost certainly win, and it's not that much trouble. In most jurisdictions you'll be awarded costs. Most places require arbitration or mediation before going to court. You'd likely not have to go farther than that.

You might ask "well, it they're poor, how are you going to get money from them?" File a document indicating that they defaulted on the judgment. That will cause all sorts of trouble for them and it will allow you to garnish their wages and sometimes government issued or administered aid (e.g. welfare checks and child support).

If it's only $100 or $200, it's probably not worth your time. But if it's much more than that, I'd look into it.

 

[Kniles5]

Too bad. You really must be doing something wrong if your patients owe thousands of dollars.

At the end of your career, unpaid work will be over a million.

Its not very hard to have a patient pay upfront or, each day after treatment, walk them to the cashier to pay.

It can be quite difficult. You have no idea. I have worked at several dental offices and this is always one of the biggest sources of stress;the patients that expect free care. A patient will go to get $5,000 implants and then expect the GP to give them free or discount dentures because they have "already paid so much". There are always going to be people that think that they do not have to pay their dental bills because they think dentists make bank anyway. Doesn't matter that we do back breaking work!

 

[futrdentist]

Several interested people have asked where the students attend school that are paying for their patients balances. What schools are these? Please let us know, because I certainly am interested! Thanks!!!

 

[GuidoPedo]

As someone above said, I know Temple is one that does this.

I would never, ever attend a dental school that puts its students in this type of position. It shows you how they view them...not too good IMHO. Although I guess going there versus nowhere is better.

 

[Periogod]

It can be quite difficult. You have no idea. I have worked at several dental offices and this is always one of the biggest sources of stress;the patients that expect free care.

Two things. I was referring to dental school, entirely different. Secondly, I am already graduated and you, a Class of 2010 graduate, have the nerve to tell me that I have no idea. Now don't get me wrong, I think that it is great that you have "worked at several dental offices" but to tell you the truth, you don't know ****. My wife works full-time as a General Dentist (operative word) and has a collection rate over 99%. It’s largely in how you deal with your patients and partially due to your ability to screen your patients (telling them upfront a reasonable estimate of costs and seeing how eager they are to proceed with treatment). Sure, there are some deadbeats but it’s not very hard to pick them out and send them on their way. Before you start running your mouth and stating your ignorant opinion as fact, you might want to hold off until you’re out of school to attempt to educate your superiors on “real life”. Peace. 😀

 

[toofache32]

This has nothing to do with the schools. It has to do with the type of patients who seek care at a school. This only happens when you offer to pay for the patient.....the school never knows about it. It's easy to say you will never do that until you're 2 weeks away from graduation and you're only crown patient has no job....which means he can be there any time but can't pay for it.

 

[aphistis]

This has nothing to do with the schools. It has to do with the type of patients who seek care at a school. This only happens when you offer to pay for the patient.....the school never knows about it. It's easy to say you will never do that until you're 2 weeks away from graduation and you're only crown patient has no job....which means he can be there any time but can't pay for it.

Bingo.

 

[mdub]

I would guess that non-payments could be meaningfully reduced if patients knew that students would have to pay their bills if they don't. (Though I still think there are situations in which the school could be acting in illegally -- probably in breach of contract -- by forcing the students to pay as a condition of getting their diplomas.)

If there were some appropriately placed signs and some language on the bills and estimates indicating that students themselves would be forced to pay for unpaid balances, the rate of nonpayment would probably drop. Of course, there are always going to be scammers out there. My suggestion won't eliminate non-payment, but it would probably reduce it for a very little cost.

 

[12YearOldKid]

I would guess that non-payments could be meaningfully reduced if patients knew that students would have to pay their bills if they don't. (Though I still think there are situations in which the school could be acting in illegally -- probably in breach of contract -- by forcing the students to pay as a condition of getting their diplomas.)

If there were some appropriately placed signs and some language on the bills and estimates indicating that students themselves would be forced to pay for unpaid balances, the rate of nonpayment would probably drop. Of course, there are always going to be scammers out there. My suggestion won't eliminate non-payment, but it would probably reduce it for a very little cost.

I think maybe you haven't dealt with this class of people. If patients knew their bill would be payed by the student - the rate of nonpayment would SKYROCKET!!!

 

[paceman]

At my school, we're not financially responsible for the patients. If a patient doesn't pay within 90 days, their treatment plan is simply deactivated and their bill is sent directly to a collections agency for a good old shake-down.

That usually teaches them to screw around with us.

 

[toofache32]

At my school, we're not financially responsible for the patients. If a patient doesn't pay within 90 days, their treatment plan is simply deactivated and their bill is sent directly to a collections agency for a good old shake-down.

That usually teaches them to screw around with us.

So your school lets you complete treatment with an outstanding bill?

 

[paceman]

So your school lets you complete treatment with an outstanding bill?

Not really. The patient has 90 days to pay the bill starting from the day that the treatment has been initiated. If the patient doesn't pay within that time, all treatment is halted until he pays. The school usually sends the patient's file to collections agency.

 

[Extraction]

Not really. The patient has 90 days to pay the bill starting from the day that the treatment has been initiated. If the patient doesn't pay within that time, all treatment is halted until he pays. The school usually sends the patient's file to collections agency.

You could do ALOT of requirements on a patient in 90 days. In that situation it would be beneficial to see patients who cannot afford treatment ASAP and space out the ones who could pay.