Once while consulting in a small practice, I watched as a 35-year-old man was informed by the financial coordinator that the root canal, post and core and crown recommended by the dentist for his abscessed tooth would be $2,400 and would be due and payable at the time treatment was rendered. He paled upon hearing this news, clearly exacerbating the physical pain he was already feeling. When he stated he did not have the money and asked if there was any other option, she told him the only alternative treatment would be to extract the tooth for $150. This distressed him even more. When I gently suggested we offer him some dental financing, I was told they never used financing because no one was ever approved. It turned out the box with the financing materials was under the desk, unopened.

Not wanting to see this gentleman's tooth extracted, I stepped in and easily gained his relieved consent to apply for a credit line. I found their merchant number in the unopened materials and we were off… but not done. To my disappointment the man was denied. I asked the financial coordinator to listen while I told him that I was sorry but his application had not been approved. When he looked disheartened, I told him that I could see he really wanted to save his tooth and asked if there was anyone else who wanted him to have the best dental treatment and might be willing to co-sign on the loan with him. He brightened and said, "Is that a possibility? I'm looking for work right now but I live with my girlfriend who has a steady job and has been after me to see the dentist for months. I'm sure she would co-sign." In minutes he was off, application in hand, promising to call back within an hour.

Shortly thereafter he called to say his application had been approved for $4000. He wondered how soon he could get started restoring this tooth and set up a complete exam to begin work on other teeth. This practice had been trying unsuccessfully all morning to fill a two-hour opening for the following day.

The day had been a success, not because I had helped to fill the production hole the following day but because, without stepping in and counseling this man, he likely would have extracted the molar and lived with the long-term problems associated with that decision.

It has been said, "We are what we think." If you currently see your role in your practice as "The Money Lady," then chances are that's how everyone else, including patients, see you too. If on the other hand, you shift your internal focus to "Financial Counselor," then patients and teammates are likely to shift with you and your results will improve.

As "The Money Lady" your goal is to collect money from patients as services are rendered. However, as a "Financial Counselor" your objective shifts to helping patients achieve the best dental care they desire and can afford, by a method that is not only practice-safe but also practice-building. You make a commitment to learn the verbal skills, people skills and dental/financial knowledge you need to truly help your patients overcome the obstacles standing between them and their dental health or esthetic desires. Patients can sense when you are committed to helping them find a way to afford the treatment they want.

As an in-office trainer and coach, I've seen significantly better results in large case acceptance and higher dollars per patient, by altering a few pre-conceived ideas about what constitutes an excellent financial policy, arrangement and conversation. Here are a few common misconceptions and what you can do to improve your results as the financial counselor in your practice.

Misconception #1: Presenting fees is equal to a financial arrangement.
Presenting a treatment plan with the associated fees and estimated insurance benefits is step one in a great financial conversation. Step two, which actually completes the whole, is helping the patient understand the financial options that your practice makes available to help them afford this care. Simply stated, part one is fees; part two is how the patient will pay those fees. Your job is not completed until both have been thoroughly presented and understood. These parts require separate documents, separate understandings and therefore separate signatures.

Misconception #2: Payment at the time services are rendered is the ultimate financial arrangement.
I couldn't disagree more. While getting paid at the time services are rendered is practice-safe… it is not necessarily practice-building. Helping your patients pre-pay for their entire case (whether through their own means or an outside financing company) will increase your production, collections and dollars per appointment - significantly. In addition, you will see a reduction in last-minute schedule changes and no-shows. Typically, patients who pay at the time services are rendered will get less dentistry done per appointment ("one-tooth-at-a-timers") because they must "pay as they go." This is why they change their appointments at the last minute although they will not admit the real reason: money. When you have helped a patient prepay for their dentistry, they make appointments and complete treatment in fewer appointments: Good for the practice, great for the patient. I recommend all your options be in writing and you review every option with patients, with no pre-judgment about which option you think a patient will desire. I feel it is as unethical to withhold available financial options from a patient as it is to withhold treatment options. I observe offices making these judgments based on their perception of what someone will like, can afford, or would be willing to endure. Be careful of your own preconceived ideas based on appearance, ethnicity or age. I've seen an 18-year-old college student obtain a loan co-signed by parents for treatment as well as an 82-year-old woman in excellent health agree to an implant-supported over-denture because she was sick of not feeling good at restaurants with friends and family. It's simply unethical for us to judge another person's motivation or personal situation. Likewise, we have seen the approval rate of dental financing rise dramatically when the practice positively and enthusiastically presents this option to every patient whether they ask for monthly payments or not. Make it your policy to present every option to every patient every time.

Misconception #3: Patients understand these options the first time we present them.
Well, they might. But to make sure they understand exactly what you are offering, put it in their language and in their dollars. For an example Financial Policy Form, e-mail Info@KatherineEitel.com with the words Financial Policy Example in the subject line. You'll notice spaces where the financial coordinator can calculate exact amounts for the patient ahead of time. This allows the patient to clearly understand what your options mean to them.

Misconception #4: Patients would rather have a treatment plan mailed to them than to wait around for you to prepare and deliver a great financial arrangement.
There are two definitive decision-making moments in any treatment presentation: The first occurs when the dentist recommends treatment. He or she must ask the patient for a decision about going forward with treatment to determine if there are any concerns or unclarified objections. The second is when the financial coordinator presents fees and financial options. She or he must also close for a decision. It is possible for the patient to respond positively to the dentist concerning treatment, and negatively to the financial coordinator after hearing the cost of that treatment. However, it is impossible for the financial coordinator to save the case if first there has been no agreement on treatment. These two decision points cannot happen when a treatment plan has been sent through the mail. Learn the skills you need to get comfortable with presenting fees and options, asking for a decision and overcoming patients' concerns in person.

While no patient wants to wait, they also do not want negative surprises about the cost and payment of their treatment. In addition, there are many ways you can avert this wait time: 1) When you inform patients about their anticipated appointment time, include an additional ten minutes for financial consults. 2) Ask the assistants and hygienists in your practice to dismiss any patient with newly diagnosed treatment into the consult room instead of directly to the front desk. Play a DVD educational video related to the recommended treatment while the patient waits a few moments for the financial coordinator to prepare a treatment plan and financial forms. 3) Stock a nice leather-bound professional binder with everything you need to do a quick but effective financial presentation including a calculator, calendar, note pad, pen/pencils, financial forms and financing brochures/applications, etc. Then you can "grab and go" whether you'll present in the consult room or chairside for an emergency patient.

Katherine Eitel is an experienced communications coach in the dental and discretionary healthcare fields with over 25 years experience as a chair-side assistant, treatment coordinator and marketing director, and practice management consultant. Katherine's revolutionary verbal skills training programs have helped hundreds of practices improve marketing results, organizational systems, professional image, client service and verbal skills, and their bottom line. She is a nationally-renowned author and speaker, recipient of the coveted "Spotlight-on-Speaking" award from the Speaking Consulting Network as well as a published author. Featured in Dental Practice Report and Dental Lab Entrepreneur magazines, Katherine is currently a monthly columnist for Insurance Solutions and Modern Hygienist Magazine. Katherine's remarkable client results are not only recognized by the healthcare industry, but also by her peers. As a result, Katherine teaches annual Transformation Training workshops, called The Lioness Principle, which are sell-outs for dental and healthcare educators, consultants, and trainers nationwide. Katherine is proud to be President for the Academy of Dental Management Consultants for the years 2007 and 2008. She is also an active member of the National Speakers Association and Speaking Consulting Network.