Situation:

Patient calls and says ” I need to cancel my appointment for tomorrow afternoon.”

Desired Result:

Patient keeps appointment, reducing time needed to refill schedule.

How to:

The five keys to saving an appointment are:

1. Show concern in your tone of voice and avoid being too accommodating.  Most people want to help the patient and try to be understanding, that backfires in this situation.
2. Tell the patient that Dr. is concerned about the “reason for return” to “save” the appointment.
3. Explain your broken appointment policy and waive the fee for the first offense.  Before implementing this make sure your “own house” is in order (don’t run late, abuse patients time or frequently change appointments).
4. If you are unable to “save” the appointment, create some urgency in rescheduling while maintaining control of the appointment book.
5. Document frequent changes and cancellations in the chart in red ink or in the ledger so they are easily seen by all team members.

Lisa the patient calls to say she has to cancel her appointment tomorrow:

“Oh Lisa, I’m sorry to hear that.  Is there a problem?”
—

“I see.  May I put you on hold so I can get your chart / look up your chart?”
—

“Lisa, I see from Laura’s notes that she is going to evaluate your response to the fluoride treatments.  She also noted that late afternoon appointments work best for you.  I’m afraid we don’t have another late afternoon appointment for 9 weeks!  Would you reconsider and keep the appointment for tomorrow?”
—

“Terrific Lisa, I’m glad you can make other arrangements!  I’d hate to see you wait 9 weeks to see Laura.  We’ll all look forward to seeing you tomorrow.”

If the patient maintains they must change their appointment:

“Lisa, at your New Patient visit we spoke about the broken appointment fee of $50 which we assess should an appointment be canceled less than 48 hours before the appointment.  Of course, we will waive that fee this time as it is the first time it has happened. However, next time we would have to charge you.  Let’s find a time that will work for you so that does not happen.”

• Document in the chart or ledger that the broken appointment policy was explained and the charge was waived for the first time.

Situation:

Your accounts receivable has gotten too high.  Patients continue to have dental needs but have been slow in paying.

Desired Result:

A patient who agrees to make payments within a time frame that makes sense for the practice and for the patient.  For the patient not to feel judged or ashamed and to understand the practice wants to help.

How To:

We recommend calling the patient first before sending a collection letter series.  Here is how to ask for what is owed using 3 simple steps:

1. 1. Sympathize

Show compassion. “I know how this can happen sometimes”
Purpose: Some patients are angry at you for calling to collect on a bill they have not paid. Remember, most people are really angry at themselves or embarrassed by their financial obligation. Show compassion to help diffuse their anger.

1. 1. Restate their obligation

“Mrs. Smith your account was due on, month/date.”
Purpose: Clarification regarding what was due when and to reinforce it is fair for you to be calling them to collect on the account.  Be sure you pause and let them talk, don’t rush to the next step

1. Ask “how much are you short?”
   • If they can pay some now, negotiate the balance within a reasonable, for your practice, time-frame.
   • If short the whole amount, you are in control of where you take the negotiation next and the payment terms.

“Mrs. Smith, of the $200 that is due now, how much are you short?”

Never ask these 3 fatal questions:

• How much can you pay?
• When can you pay?
• Can you pay something towards your bill?

All of the above statements give the patient control and enable them to give unreasonable answers, such as $20 per month for the next 20 years.

If you are unable to contact the patient by telephone or receive no return phone call from your messages, send a series of letters.  Include a deadline of less than 2 weeks to hear from the patient.  The idea is to collect on the balance or turn it over before 90 days has past.  In our next posting we will share a sample collection letter series for you to adapt for your practice.

Situation:

You don’t want to lie to patients and you do want them to experience the great care you offer in your practice – so how to answer these questions without losing the potential patient?

Desired Result:

A patient appointment and a happy patient at the end of their appointment!

How to:

First and foremost the team must understand and believe the true definition of dental insurance. It’s a partial reimbursement for basic care. Basic preventive and basic restorative…and 95% of all adults need more than basic care. Let your patients know this, they understand and have experienced insurance covering less and less.

Eliminate insurance from your team’s vocabulary. It does not cover 100% of anything, it is a benefit, or like a rebate the patient gets, or a coupon they can use for services. Having a policy does not protect a patient from loss, it contributes to helping them pay for care and they are fortunate to have it.

So with that as the background, let’s also remember that most patients ask questions like this because either they don’t know what else to ask (it’s the only way they know to choose a dentist), or they want to know how to pay for services. Help them with both and get the patient appointed in your practice.

Here are Some Suggestions:

• First: NEVER say “We don’t take that plan”. Instead try saying

“Our Dr. is a provider for all benefit plans, s/he does not participate in any plan that expects the doctor to compromise care for patients or not offer services that would help the patient that are not part of their plan. We work with our patients to get the absolute most out of all policies, and we offer financial arrangements for what your benefits do not cover. Patients love our team, and our Doctor. We pride ourselves on really knowing our patients and taking great care of them. We’ll take good care of you and we will make the most of your benefits. Let’s get you appointed.”

• What if the patient has Medicare or Medicaid and you are not a provider? Here is an idea of what to say, rather than we don’t take that plan

“We do our best to make the most of all benefit plans patients have.  Unfortunately, you have a type of plan that we are unable to work with, it will not pay us for your services nor will it send the benefit check to you. We are happy to work out payment arrangements so you can get the care you need.”

• If the patient is not interested

“In our area, the practice I know of that can receive payment from your plan is XYZ Practice.  We would be happy to see you and work out a payment arrangement if you decide to receive care outside of your plan.”

Situation:

Introduce the benefits of the intra-oral camera to the patient.

Desired Result:

An average of 90% case acceptance on significant treatment. The patient completely understands why the treatment is needed and the benefits of quality comprehensive dental care.

How To:

It is important the entire clinical team is trained in the efficient and effective use of the intra-oral camera. It is an important diagnostic and educational tool to be used at every visit.  We recommend radiographs up on the operatory computer screen or on a view box, and a photo series available during patient evaluations. These tools help the Doctor diagnose needed treatment and the patient understand their needs. Introduce the camera with enthusiasm and prepare the patient for what they will see.

“Mrs. Smith, so that you can see what I see when I look in your mouth, I am going to use this small camera to take pictures of your teeth and gums. They will show up on our monitor here, for you to review with doctor. We can see areas that have improved and areas in your mouth that are perfect. Also we will be able to zoom in and magnify areas of concern so that you can understand our treatment recommendations.

Often times we can see problems early, before they cause you pain, or before something breaks down and requires more extensive and expensive treatment. Our goal is to allow you to clearly see the condition of your oral health and to help you make wise treatment decisions and so you have conservative, affordable care.”

The camera can also be an important part of the emergency appointment. Along with a PA, take a picture of the painful, rough tooth. Leave the picture on the screen in the operatory while waiting for the Doctor to arrive. The Doctor might consider asking the patient “Well, what do you think?”. The patient will often diagnose themselves, and help the Doctor understand what further explanation is needed for the patient to move forward with appropriate treatment.

Situation:

Patients want to schedule appointments when we are not open or during a time that it is not in their best interest to have the procedure done.

Desired Result:

Patients accepting our preferred appointment times

How To:

Have the clinical team prepare the patient in the back for the times the Doctor prefers to do the procedures.

“John, I know Doctor will prefer you to have the first visit for this procedure in the morning. He likes to have things ready for the lab to pick-up the same day and the light is better earlier in the day.  When you return for the second visit we can schedule you later in the day.”

Then, to gain patient acceptance of desirable practice appointment times, offer a choice between two times which meet the practices scheduling objectives. Use the doctor’s preference for the times which you offer.

“John, Doctor would like to see you for the first visit for this procedure on Tuesday at 10 a.m. or Thursday at 11 a.m., which would be best for you?”

Often a practice will ask opening questions which give control to the patient. The practice thinks that they are being helpful, however they often make it more difficult to schedule according to your guidelines because you get an answer that you do not want. The following questions are commonly heard in the dental practice.

“When would you like to come in?”
“When will it be convenient for you to come back?”
“When is the best time for you to come in?”
“Did you want to go ahead and make an appointment?”
“Do you need to make an appointment?”
“What is better for you, morning or afternoon?”
“I imagine Mondays are best for you?”
“Do you need to come in after work (school)?”

Avoid using these opening questions. When we use these questions, we give control to the patient and lose focus on the best time for our patient to receive ideal care. Try offering two appointment times and gain control of your schedule.

Situation:

Patients are past due for their hygiene preventive care visit.

Desired Result:

Schedule a hygiene appointment and invite other family members to make an appointment.

How To:

A strong hygiene department is the life blood of a general dental practice. To keep patients current requires a commitment of time and a great attitude.  Research shows that a minimum of 4-6 hours per week is required to work this system effectively. Using your computer reports, start with the most current past due patients (the last 3 months). Research your available hygiene appointment times and offer two choices. Use the name of the provider to build the value of the appointment.

“Hello Mrs. Jones. This is Jane from Dr. Smith’s dental office. Deb, your dental hygienist (or Dr. Smith) asked me to call you because she recently reviewed your chart and noticed that you were not scheduled for your preventive care hygiene appointment. She was concerned about you and asked me to give you a call to let you know that we have an opportunity to see you this Thursday at 11:00 or next Monday at 1:00. Which of those would work best for you, Mrs. Jones?”

After you successfully make the appointment, ask about other family members who also may be past due or who aren’t seeing a dentist at all. The patient might have a family member who just moved back to town and needs a dentist, or maybe there’s a young child in the family who needs to come in for a first visit. Inviting family members is a great way to get new patients into the practice.

“Great! We look forward to seeing you on Monday at 1:00. While I have you on the phone, is there anyone else in your family we can schedule an appointment for?”

Leaving a message:

With today’s busy lifestyle, it is common to receive voice mail or an answering machine message. Rather than being specific, try leaving a friendly, yet vague message.

“Hi, this message is for Mrs. Jones. This is Jane from Dr. Smith’s dental office and I have a question I would like to discuss with you. Could you please give me a call at (123) 456-7890.”