The Most Common Challenges - Part 1

The Challenge of Collecting Payment Owed 

Difficulty collecting payment for dental services rendered is a recurring issue, often disguised in different scenarios but rooted in the same core problem, and a clear solution.

• “The patient said they forgot their wallet at the end of the visit and now won’t answer our calls. What do we do? ”The patient is threatening a bad review or legal action unless we write off their balance due to a less-than-perfect experience.”
• “The patient showed up for their crown seat appointment but refuses to pay the remaining 50%. Do we have to seat the crown?”

These types of situations come up almost daily in dental offices. The common thread? Payment wasn’t fully secured in advance or at the point of service. The real challenge isn’t the patient’s behavior, it’s the system (or lack thereof) the office uses to collect payment. When a patient leaves the office with an unpaid balance after treatment, the power dynamic shifts. You’re no longer a healthcare provider, you’ve become a collection agency. And that’s not just difficult; it’s a major distraction for the entire team.

Nothing strains a relationship faster, even with friends or family, than unpaid debt. So why set yourself up for that kind of conflict? Unless there’s a clear, written, signed payment agreement in place (ideally with automatic payments), you’re assuming unnecessary risk.

Solution

Collect money BEFORE you start work (full copay or signed payment agreement).  Always.  No exceptions. That’s it. It truly is that simple. The complexity only comes in because we try to go out of our way to make it complex.

What if the patient doesn’t want to pay up front?

• That’s perfectly ok. They are signaling they probably won’t pay you after either. They can go to the next dentist and “not” pay them.  Problem dodged.

What if the patient complains?

• See above. Best response from your team … “we want to make sure there are no surprises for you, and our patients appreciate being able to leave after treatment.” (Never say office policy)

What if they cannot afford it?

• No problem.  At that point, you can help them start a layaway program and schedule treatment when they have banked enough to cover their cost.  Or the patient may be communicating with you that you need to come up with a different, less costly option.

I get it, everyone wants to think they have some unique, different scenario where this doesn’t work.  You don’t.  Everyone deals with the same issue in every industry.  The solution is the same for every industry: collect before you provide the service/product.  

When you get your car fixed, you must pay the bill before you get the car back.  Before you get the keys to your new house, you either pay cash or sign a loan agreement. If you don’t have insurance, medical doctors will request payment before you leave the office.  You cannot even get a plane ticket without paying in advance.    Your mental scenario about “what if” is not unique.  All you have is a mental block to change, which is normal.  Just ignore it, try something new, collect up front, and start avoiding all the above patient hostage situations.

Shifting your policy and collecting full payment before services are rendered will help you achieve the minimum goal for collections percentage: 99%.  Sadly, the average in the country is 92%.  What really gets depressing is that 7% difference for an average 800k office is $56,000 lost.  Work that was provided but not collected.  Stop the leak!

Now, one challenge with collecting correctly is knowing what the patient’s out-of-pocket expense will be if you are dealing with insurance.  Estimates are the bane of both office and patient lives.

Coming up next: How to deal with the “estimate” problem.

In the meantime, change your collection process for services, and start seeing both higher collections and happier patients because they don’t owe you money anymore.