Knowing a patient’s credit risk is one thing. Knowing whether a patient will arrive on time for appointments and be compliant with treatment would seem an entirely different thing. But Orthodontic Products recently talked to Paul Zuelke, president and founder of Zuelke & Associates Inc, to learn how its web-based application, the Zuelke Automated Credit Coach (ZACC), can tell a practice more than just the financial risk it is taking on with a new patient.

Orthodontic Products: What is ZACC, and how does it work?

Paul Zuelke: ZACC, the Zuelke Automated Credit Coach, is a web-based application designed to identify/quantify the relative risk of a new or existing patient. While primarily designed to identify credit risk—whether or not you will be appropriately paid—ZACC is also very sophisticated and has the ability to forecast patient clinical and administrative cooperation (oral health, following clinical instructions, missed appointments, arriving late, etc).

Once a staff person has gone to the website and entered very basic patient/parent information, ZACC evaluates issues such as maturity, stability, and integrity. ZACC accesses the patient’s/parent’s credit report and learns how bills have been paid recently, as well as the 10- to 20-year past history.

ZACC’s evaluation of the maturity and stability information, in addition to the information contained in the credit report, results in a seven-level credit “grade” and a recommendation regarding what Zuelke & Associates believes is the most liberal and flexible financial arrangement that can safely be offered to this patient.

That recommendation ranges from $0 down payment and a payment plan that is 125% of diagnosed treatment time—yes, that is a perfectly safe financial arrangement to make—to a highly restrictive 50% down payment and 50% of treatment time payment plan length, to the very small percentage of patients who will prove to be uncontrollable without such a financial arrangement.

Insider SampleA SIZEDOP: How do orthodontic practices benefit from using ZACC?

Zuelke: Every orthodontist has learned that patients/parents who become past due make up a significant portion of the instances of failed/cancelled/rescheduled appointments. A significant percentage of patients who are clinically uncooperative, as well as patients/parents who may be rude, uncooperative, or demanding at the front desk or on the phone, are also found to be delinquent. The great majority of malpractice suits—and possibly more important, the majority of those who threaten such suits—come from patients/parents who are or have been delinquent. So, by knowing in advance that a certain patient or a certain parent is a high-risk person, systems/policies can be put in place that will assist the practice in keeping that patient under clinical and financial control.

OP: How has ZACC evolved since it was first introduced?

Zuelke: I created ZACC after more than 35 years in the banking and financial consulting business. I was not in a hurry, and I spent many years developing it. We did not release it until we were certain it had been properly tested and that it did exactly what we expected it to do. Because of that, other than some minor fine-tuning, which is continuing, there has been no “evolution” at all. Still, on a daily basis, ZACC is being reviewed for absolute accuracy. Changes in credit bureau report formats and changes in what credit bureaus do and do not report require changes in the programming. My staff monitor ZACC closely to ensure continuous updates and accuracy.

OP: What steps do practices need to take to implement ZACC?

Zuelke: I have licensed the sale of ZACC to OrthoBanc. An interested doctor or financial coordinator can go to and get all the information they need, and even do a trial run of the ZACC system. They can, of course, give OrthoBanc a call as well.

OP: What other services/products does Zuelke & Associates offer?

Zuelke: Zuelke & Associates Inc is an orthodontic consulting firm specializing in credit and collection issues, staffing and job descriptions, and the proper administration of an orthodontic practice. We have been consulting in orthodontic practices since February 1980. Our purpose is to ensure that our clients have the best possible case acceptance; that they attract good-quality new patients; and that they enjoy not only a high degree of profitability, but more important, an impeccable quality of day-to-day life within the practice.

OP: Looking ahead, what’s next for Zuelke & Associates?

Zuelke: What’s ahead? I made a promise to myself, back in 1980, that I would create a group of clients who have the same vision for their practice that I had for Zuelke & Associates—to be the proprietor of a high-end practice, with an excellent fee structure, with reasonable case acceptance, and a very high level of profitability. These practices had to be delinquency free and enjoy every day they came to work. I have accomplished exactly that! So, my goal for the future is to take great care of my existing clients; to seek a very small number of new clients; and, along with Betty, to do lots of fishing, hunting, and exploring!?  OP