Challenging financial arrangements

Sept. 23, 2009

By Teresa Duncan

Our most recent meeting in beautiful Vancouver featured full meeting rooms and inquisitive crowds -- our favorite kind! I helped present the Implant Treatment Coordinator program. Part of our program deals with treatment planning and discussing financial options. The mostly Canadian crowd asked specific questions about how to expand the payment options available to their offices. Why do I distinguish the crowd as Canadian, and what is important about that?

Third party financing is difficult for them to come by. CareCredit is no longer available to them, and Springstone Financial does not do business there either. Local banks are an option, but they don’t offer the templates or online tools that we’re accustomed to here in the United States. I started thinking about how much harder my job as an implant coordinator would be without that extra offering. In the class we use this hierarchy of financial discussion:
1. Ask patients for the full amount.
2. Offer a discount for payment in advance of appointments.
3. Offer patients the option of third party financing.
4. Phase payment in accordance with treatment.
5. Deposit half the treatment fee with scheduled payments for the remainder.
6. Offer in-house financing (the office accepts partial payments from the patient).

Removing the option of third party financing poses a significant challenge for offices that do not want to hold the balance on their books. I would bet this is most offices! This highlighted the importance of a solid financial policy to guide an implant or financial coordinator when discussing payment plans. For example, one office may be comfortable financing a $5,000 balance for 12 months, and another office may only extend credit up to $3,000 for the same time period. Will the office barter for services? This is becoming very popular in today’s economy. Please consult with your accountant for possible tax ramifications.

Operating within set financial guidelines avoids frustration and awkward conversations about payment. By moving down the “payment ladder” in an expected manner, you can stop at the rung that is best for the patient.

With more than 20 years of health care experience, Teresa addresses topics such as insurance coding, fraud and embezzlement, and new media marketing. She is a Fellow and Educator for the Association of Dental Implant Auxiliaries. Teresa is also coauthor of The Ultimate Office Planner, a newsletter for dental administrators and dentists. You can visit Teresa’s blog at or her Web site at She can be reached by e-mail at [email protected].