Eight easy steps to conducting successful, less stressful payment arrangements

Sept. 21, 2011

By Jan Keller

Money has a strong emotional tie for all of us, and discussing it, especially when you’re the one asking to be paid for something, can be downright stressful. But it doesn’t have to be that way. In fact, the best outcome, in which both parties feel they have an agreement that is fair and reasonable, is absolutely achievable. In addition, communication regarding fees can actually help build trust in patient relationships, if done correctly.

The process that leads to implementing this type of payment arrangement is a straightforward, eight-step process that covers all aspects of the payment arrangement system.

Step 1: Develop your internal credit guidelines

“Make sure our patients pay.”
“Just collect the money.”

Regardless of experience in dentistry, familiarity with the profession, or level of willingness and ability, if this is the only guidance you are giving your financial coordinator, you are setting your practice up for a hodgepodge of payment arrangement approaches that confuse everyone and benefit no one.

By investing a minimal amount of time in developing your internal credit guidelines, you will bring clarity to the payment arrangement process in your practice.

Step 2: The characteristics of a “winning” financial coordinator


Attitude is a little thing that makes a BIG difference. The most successful financial coordinators apply their knowledge of the practice’s internal credit guidelines, along with effective communication skills and personal characteristics, to ensure a win/win outcome for patients and the practice on a consistent basis.

Step 3: Make it a team effort

“You’re only as strong as your weakest link.”

When it comes to the success of the payment arrangement system, each person on the staff plays a role. Does this mean that everyone on staff will be asking for money or negotiating payment arrangements? No. What it does mean is that each staff member must understand what they can do to help the financial coordinator get the job done.

Step 4: Prepare for a successful outcome


Preparation is the key to being able to fully focus on partnering with patients during the payment arrangement discussion. When you have done your homework and are clear on the treatment being diagnosed, you can then give your full attention to the patients and their needs.

Step 5: Find the location that best supports the process


Dental facilities represent a wide range of square footage and space utilization. The best location for treatment presentation and the payment arrangement discussion is a designated consultation room, which is used only for treatment presentation and the discussion of payment arrangements. Ideally, the setting should be nonclinical, which is helpful in putting patients at ease.

To assure as much privacy as possible, try not to conduct this discussion at the front desk or the reception room. Most patients will be unable (and unwilling) to fully engage in the process if they know they can be seen and/or overheard.

Step 6: Learn to conduct “perfect” negotiations

A negotiation is a discussion with another to reach an agreement, in this case, a discussion between a financial coordinator and a patient regarding a mutually satisfactory payment arrangement. When payment negotiations are conducted within the boundaries of the internal credit guidelines, win/win outcomes can be consistently achieved.

Step 7: Seal the commitment with complete and accurate paperwork


1. Verbal review with the patient

Once you have reached a verbal agreement with the patient, begin the documentation on the appropriate payment arrangement form. Verbally communicate the agreement you have reached as you are filling out the form. Explain terms such as estimate of total treatment charges and anticipated insurance payment.

2. Federal truth-in-lending form

Payment arrangement forms can protect you from some forms of liability. There is a federal truth-in-lending law which requires a practice to use a Federal truth-in-lending form every time the practice assesses a finance charge and/or when a patient agrees to pay their charges in four or more installments – that’s installments, not months!

3. Complete forms while the patient is present

It is important that the necessary paperwork is completed while the patient is present. This allows them to hear and see in writing the agreement they have reached with you. It also makes it much easier to get the patient’s signature.

4. Obtain the patient’s signature

Without the patient’s signature, the payment arrangement is just words on a page. Getting the patient’s signature seals the patient’s commitment to the payment agreement. The patient’s signature indicates a high level of commitment, understanding, and comfort with the payment arrangement.

5. Set expectations and review statement

To eliminate confusion, enhance patient relationships, and minimize the number of phone calls after statements are mailed, review with the patient what they will see on their statement in relation to the payment arrangement.

Step 8: Monitor your success

Monitoring your success is a crucial element in the payment arrangement process. All successful businesses take a proactive approach to monitoring their activities and results, and your practice should be no different. The monitoring process provides an opportunity to celebrate your successes, as well as a system to identify and circumvent negative trends before they become an issue.

Janice Keller has 25-plus years of experience in dentistry – clinically, and as an office manager and software trainer. Now, as a practice management consultant, she provides high-quality, customized practice development and education to clients and their teams. Jan’s clients praise her ability to recognize, understand, and adapt to their specific training requirements, and to provide the necessary tools and skills they need to meet their practice goals. Jan is certified by Bent Ericksen & Associates in employee law compliance, and is also certified by the Institute of Practice Management. She is a member of the prestigious Speaking/Consulting Network and the Academy of Dental Management Consultants. She is also an independent certified SoftDent trainer. Contact her at [email protected].