You're going to have to do something about your fees!?


A patient showed up yesterday unannounced , without an appointment, and was stationed at my front desk talking animatedly with my office manager Ida for about twenty minutes. Although I really know that I shouldn't (dentists are not supposed to loiter at the front desk) I wandered over to hear what was going on.... and I got an earful!

Now let me add that my patient has been loyally coming in for over thirty years and we really like each other, but I guess not so much this day. She blurted out "You've got to do something about your fees... Its not fair, me and my husband are retired and now we are on a fixed income and my insurance only payed $600 for the last crown you made for me that I didn't really need!

This interaction was similar to a person asking me if I was still cheating on my wife. I don't think I could answer this and win, but my patient needed to vent and I made the mistake in coming to front desk at the wrong time.  My patient was paying her considerable bill and paying it made her angry. Believe it or not this conversation turned more pleasant after a few minutes and I believe my patient left with us still on pleasant terms.

No one likes owing someone else a large sum of money and extending credit, even when it's interest free, can end up creating bad will. Dentists often face a dilemma either they wait until a patient can pay for a procedure up front or do the procedure and wait for payment. Each approach has its drawbacks.

Waiting for a patient to make their portion of the payment upfront at the time of service sometimes forces people to delay treatment and teeth may deteriorate if they delay treatment. It can even end up costing them more in the long run since they may end up needing more extensive dentistry.

The other approach is forge ahead, damn the torpedos, and do a patients procedure on the assumption that they will pay what ever portion their insurance doesn't cover after the procedure is finished. The assumption is that the patient needs the procedure and one way or another should do the work treatment planned. This way gets the job done in a "timely" manner before a patients condition worsens but can create the bad will we witnessed in the first paragraph of this post.

To be fair to me, my angry patient , at the time of her service, was about to end her insurance coverage due to her impending retirement, and she had a worn out crown that I had wanted her to replace. I explained that sooner or later it would need to be done and I thought it best to do it while she still had insurance and she gave me permission to go ahead. Unfortunately her insurance only picked up about a third of the cost and she was unhappy about how sizable her portion of the bill was.

Probably to avoid any bad will, ninety percent of the time I encourage my patients to allow us to file a precertification with their insurance plan prior to initiating a planned non emergency procedure. Usually the insurance company get back to us in less than a month and we can go over the patient's financial responsibility before starting a new treatment. Its only when my patient presents with a time urgency ( they are leaving their job, moving or just do not want to wait) that we forgo the precertification process and go ahead at the patients request. As witnessed by this post it doesn't always turn out so well, since sometime when paying the bill my patient experiences buyers remorse.




from Ask Dr. Spindel - http://ift.tt/2oYXTk3 - http://ift.tt/1SpPbm6

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