Negotiating successful payment arrangements

Looking for perfect payment arrangements? Janice Keller reveals four easy steps to help you succeed every time, with every patient


Wouldn’t it be nice if every payment arrangement interaction between your practice and your patients went smoothly, with no awkwardness or misunderstandings? The bottom line is that you can make that happen. “Perfect” payment arrangements are possible if you follow these four easy steps:

  1. Information gathering
  2. Preparations
  3. Negotiation
  4. Documentation

Let’s look at each step in a little more detail.

  1. Information gathering

Gather information before speaking with the patient. A discussion with the dentist 1 to 2 days prior to the consultation is important in the preparation process. If the negotiation process occurs on the same day as the appointment, the team will need excellent communication skills. Relaying the recommended treatment from hygienist to dentist allows the patient to hear it for the second time. Again, communication regarding recommended treatment should be communicated verbally. Ask the patient if he/she has any questions before the financial coordinator takes over. If the patient is ready, the financial coordinator can start the negotiation process.

  1. Preparations

Prepare where the negotiations will take place. A private, quiet area with computer access is ideal. If you do not have a consultation area or private area to hold negotiations, having the treatment coordinator address it with the patient in the treatment room, sitting eye-to-eye and knee-to-knee will work. The bottom line is – be prepared, and have all the information you need in hand (e.g., X-rays and a written treatment plan). It’s also important to prepare for resistance or discussion. Going into a negotiation situation without being prepared will almost surely lead to failure.

  1. Negotiation

Don’t be afraid to negotiate. Let’s say Mary, the financial coordinator, presents the first payment option to the patient. If the patient is agreeable to this option, Mary moves on to documentation of the arrangement, gets the patient’s signature, schedules the treatment, and thanks the patient. Job well done!

But, if the first option is not acceptable to the patient, then move to the second option, according to your practice guidelines. The key here is to always stop and wait for the patient to respond. We are often uncomfortable with silence, and do not allow the patient a moment to think and respond before jumping in with the second and third options because we’re afraid he/she will say no. It’s okay if they say no!

The goal is to negotiate until they agree. They have already agreed to the treatment – you are now negotiating how they pay for it. Remember, if a patient has a question, or hesitates, it does not mean he/she doesn’t want the treatment. It simply means you have not yet found the solution that makes it acceptable from a financial point of view.

  1. Documentation

Documentation is critical. Patients should always sign consent forms that clearly define the negotiated payment arrangements. On the off-chance the patient declines treatment, documentation is still crucial. In this case, a declined treatment form should be signed, noting the reason the patient is delaying or declining the recommended treatment. Use your software to assist with this documentation. Create reminders for follow-ups if you have discussed contacting the patient in the future to discuss scheduling treatment.

Janice Keller has more than 25 years of experience in dentistry as an office manager and software trainer. Now, as a practice management consultant, she provides high-quality, customized practice development and education to clients and their teams. Ms. Keller is certified by Bent Ericksen & Associates in employee law compliance, and also certified by the Institute of Practice Management. She is a member of the prestigious Speaking Consulting Network, and the Academy of Dental Management Consultants. She is also an independent certified Softdent trainer.

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