Money Matters

Presenting financing options will increase case acceptance

When it comes to case acceptance, orthodontics has traditionally had an advantage over other specialties. In most orthodontic cases, parents are not asking if the child is going to have treatment or not, but rather where the child is going to have treatment performed.

Making this situation even more positive is the fact that many parents have a general idea what the cost of an orthodontic case will be due to word of mouth. When this is the case, the overall fees will not be a surprise or even necessarily a barrier to case acceptance.

Orthodontic Economics

While overall orthodontic case acceptance is increasing, there are trends taking place that are of concern. The first one is directly proportional to the economy. As parents struggle with increasing levels of debt, larger houses with higher mortgages, and a less stable job market, they are beginning to become more concerned about expenditures. Because orthodontics is a relatively large expense for most families, more parents are shopping around for the best price. After working with hundreds of orthodontic practices, I have found that parents often schedule an initial consultation appointment after having already visited and consulted with several other practices.

This shopping around is the direct result of an evolving patient mentality about orthodontics. Unfortunately, orthodontics is now often viewed as a commodity, differentiated more on price than on value. To parents in this frame of mind, orthodontic

practices are more or less interchangeable. Parents will often seek out the least expensive orthodontic care they can purchase to achieve what they think will be the same result as they will get from the most expensive care. Due to this consumer mentality, orthodontic offices have often been differentiated by one criterion alone—cost.

Orthodontic practices also report that some parents are beginning to put off orthodontic care for their children. While parents believe that they will provide orthodontic treatment for their children in approximately 6 to 9 months, they are delaying treatment until their financial situations begin to improve. Of this group, an increasing number never return to the practice.

The above concerns are beginning to have an impact on overall case acceptance and starts in the orthodontic practice. Orthodontists must recognize that practice success hinges on effective case presentation. The initial consultation is critical to building value for treatment, educating parents and patients, and developing a strong orthodontist-patient relationship.

A Quicker Consultation

The most effective way to increase practice case acceptance and decrease the incidence of patient shopping is the one-appointment process. It is important to understand that each minute of the treatment-presentation appointment must be carefully systemized. The general process about to be described has been used in hundreds of orthodontic practices. Using this one-appointment process results in an 85% to 95% case-acceptance rate for those patients who are ready to start (nonobservation patients).

A general overview of the consultation appointment includes:

1) Enhance value as soon as possible. I recommend a warm, scripted greeting during the initial telephone call. To dissuade patients from shopping, all new patients should be seen within 7 to 10 days, which is definitely achievable for practices with production levels below $2 million per year that are operating on a 4-day-per-week schedule.

2) Use a dedicated treatment coordinator. An orthodontist’s time is best spent chairside, treating patients. Using a treatment coordinator allows the practice to focus exclusively on the patient without taking up too much of the orthodontist’s time. A treatment coordinator can improve customer service and enhance case acceptance, but his or her performance must be measured against the results to ensure optimal effectiveness.

3) Get to know the patient first. Most parents make a decision about orthodontic care based more on their overall feeling about the orthodontist, staff, and office than on their understanding of the complexity of orthodontic treatment plans. Asking questions about the patient’s background is key to building a strong relationship. Subjects of interest can be school, athletics, and extracurricular activities.

4) Explain the treatment. Once a relationship has been developed, explain the orthodontic treatment most likely to be necessary for that particular patient. After the orthodontist performs an examination and uses radiographs and photos to determine the treatment plan, the treatment coordinator should support the recommendations with value-building scripts. Emphasizing the benefits of treatment is critical to motivating parents (and patients) to accept your recommended treatment. Keep in mind that most parents are more concerned with the aesthetic result that will be achieved for their child than with the process involved to get it.

5) Answer questions and inspire confidence. At this point, if the practice has an orthodontic treatment coordinator, the orthodontist needs to meet the patient and/or parent, develop a relationship, perform a diagnosis, and offer treatment-option explanations to the parent with a clear recommendation. The orthodontist also needs to be available to answer any questions and inspire a level of confidence that has already been established prior to this point in the consultation.

6) Finalize with the treatment coordinator. After answering the patient’s questions, it is time for the orthodontic treatment coordinator or financial coordinator to handle the financial matters. The orthodontist’s time should be saved for treatment issues. Financial matters are best left to the treatment coordinator.

Finances and Case Acceptance

Many parents already have some idea of the cost of orthodontic care—their chief concern is how to pay for it. There are several options that practices can use to address parents’ concerns. It is extremely dangerous to become locked into a restrictive belief system concerning how finances should be handled. Practices have to provide several financial options so that patients and parents can choose one that is comfortable for them.

Options to consider include:

1) Give a 5% prepayment courtesy. In this scenario, the entire treatment fee—including the insurance portion—is paid in advance. Payment is made prior to the initial bonding treatment. Patients may select this option because they wish to pay via credit card to take advantage of air miles or bonus points that they get from their credit card company.

2) Offer an in-house payment plan. For example, 25% of the fee can be paid as a deposit, with the remaining balance divided into monthly payments. Payments should be completed 2 months before treatment is completed. Practices that offer in-house payment plans must maintain an excellent focus on accounts receivable. Any patient who is 1 day overdue with a payment should receive a call that day. This should be followed by a series of phone calls and letters. It does not take patients long to recognize that overdue accounts will be addressed by the practice immediately. Be careful to have some level of flexibility to help patients with limited means.

3) Use patient financing. An increasingly popular option in general practice and other specialties is patient financing, which involves an outside finance company approving the parent or patient for a line of credit or a loan. These approvals can be achieved today within approximately 5 minutes by phone or over the Internet.

While some orthodontic practices may not want to pay the processing fee required to provide patient financing, it is a fact that some patients cannot accept treatment otherwise. The true benefit to patients is that they do not have to come up with a down payment, and that they can extend their payments beyond the actual treatment time. Practices that are willing to accept patient financing will be able to provide care for individuals who do not have sufficient funds to pay for orthodontics on their own. Across the country, patient financing is increasing in popularity in most areas of dentistry, and can benefit orthodontic practices as well.

Making the Financial Presentation

I recommend that patients be offered one or more of the financing options that are available from the practice. Unfortunately, many practices try to plug patients into a single model, which makes it difficult to reach out beyond a certain population. If there is a lack of financial options, certain patients cannot accept treatment. Keep in mind that these same patients are receiving treatment in other practices, paying their bills on time, and complying with office policies. In today’s economic world, a one-size-fits-all policy is dangerous and can result in decline at varying points in a practice’s life cycle, unless the need for change is carefully monitored.

It is essential that the presentation of financial options is carefully scripted and that the individual presenting them is highly trained. This applies to the orthodontic financial coordinator as well as any team member. Quality scripts about each financial option will allow the practice to present financial arrangements in the best possible light and let patients and parents know that the practice is working to make orthodontics viable for them. Practices that add value to the consultation and presentation, and then go the extra mile with financial arrangements, will continue to grow and prosper. Like many businesses, those that are too restrictive may be highly successful today but will, at some point, find themselves in decline and not understand why.

In summary, the consultation, presentation, and financial arrangements are critical aspects of a new patient’s experience. By making an effective case presentation to the patient, the practice has the opportunity to add sufficient value and gain case acceptance before the patient visits (or decides to visit) other offices. Adding value is a key factor for preventing patients from practice-shopping for the lowest fee.

In addition, financial arrangements make a practice’s fees more palatable to cost-conscious patients and parents. In today’s debt- and credit-oriented world, orthodontic practices must begin to think along the lines of other businesses. Those that do will experience significant growth, higher production, and increased profitability.

Roger P. Levin, DDS, MBA, is the founder and CEO of Levin Group. A consultant for more than 20 years, he has published more than 2,700 articles and 49 books, and addresses more than 22,000 dentists each year. He can be reached at (888) 973-0000 or [email protected].