Oral Health Group

Increase Treatment Acceptance And Get Paid For Your Care

August 23, 2016
by Debra Engelhardt-Nash

Imagine the impact increasing your patient treatment acceptance rate by 10 to 15 percent would have on practice productivity. Now imagine getting paid for those services in an efficient manner! These components of your practice have significant influence on practice growth and are critical to ongoing practice success.

In order to track treatment acceptance increase, a baseline percentage must be established. An important statistic to monitor is the percentage of treatment plans that are currently being accepted. This means of all treatment presented, what did the patient ACTUALLY commit to by making financial arrangements and scheduling the appointment? For example, if you presented a comprehensive treatment plan totaling $6500.00 to a patient, and they asked about doing a portion of it (let’s say $3000.00). They made financial arrangements and appointed for that amount of treatment. The treatment acceptance rate for that patient would be 46 percent.


Evaluating the actual amount of treatment being presented to patients helps the doctor and the team determine where they should focus their growth efforts. If the average treatment plans presented amount is low, does the office need to reevaluate their protocols for diagnosing comprehensive and elective treatment? Do they need to target market a different segment of the population who are interested in this type of care to attract them to the office?

Most dental software companies provide this report AS LONG AS treatment plans are being entered into the system. The administrative team can then compare the total treatment plan amounts by the total amount collected upon and appointed. This will provide the office with Treatment Presented versus Treatment Accepted rate. If the Treatment Acceptance rate is below 75 to 80 percent, there is potential patient treatment that is not being appointed. Discovering where the treatment acceptance obstacles are, and learning how to enhance treatment presentation skills, will dramatically improve patient compliance to recommended treatment.

THE 80/20 RULE
The patient begins choosing the office the minute they contact the practice for an appointment. It is the responsibility of team members to help validate the patient making the right decision to choose the office for their care. The patient is looking for a quality experience that indicates they are going to receive quality care. Eighty percent of gaining treatment acceptance is the ability to connect with patients in a relationship-based experience. People buy from people they like and people who make them feel as though they matter.

Office protocols should be designed to:

1. Be good for the patient.
2. Be good for the practice.

If office systems, and patient service skills can accomplish both, more practice success will be realized.

It begins with the initial phone call. This should be a two-way conversation to learn the patient’s expectations and discover how the practice may meet their needs as well as their wants. The call should also provide inspiring information about the practice, the doctor and how well the patient will be treated in your care. Gathering data is secondary to making a warm and welcoming first impression.

Always ask permission before asking questions or providing information. “May I tell you a little bit more about our office?” Or “So that I may schedule the proper appointment for you, may I ask you a few questions?” are excellent ways to initiate conversation. Use this time as an opportunity to discuss the level of care your office provides, how patients appreciate your approach to their treatment and how they are cared for by the doctor and team during their visit. Introducing your philosophy of care in an easily understandable way is the start of gaining better treatment acceptance.

The new patient consultation and examination must be scheduled so appropriate time is provided to introduce the patient to treatment possibilities, excluding clinical procedures. It is important to establish a consistent consultation and examination process. The appropriate atmosphere needs to be created to give the patient an opportunity to share their concerns, expectations, and questions and for the dental team to be able to talk about potential treatment possibilities.

One of the main objectives of the new patient examination is the opportunity to meet the doctor and the team so they feel comfortable and confident that they have chosen the right office for their care and to also give them the information they need that helps them make the right choices in treatment. This may be done in a consultation room or treatment area. The important factor is that conversation with the patient about who they are, who the practice is and what the practice offers for care ensues prior to treatment being performed.

Utilizing visual aids is important when talking to patients about treatment recommendations. This means “patient friendly” visual aids – keep the graphic dental visuals away from patient view. The majority of the population are visual learners, which means they have to see what you’re referencing in order to understand. Photographs, intra-oral cameras, and media learning improves patient communication. Showing them before and after photographs of completed treatment (with smiling full face pictures) helps them visualize the treatment for themselves.

The rest of the population are audio learners which means they have to hear to understand. When you incorporate conversation and photographs, or other visual aids into treatment discussion, your treatment acceptance rate is likely to improve.

Take time to talk to patients. Asking for a substantial dental investment on their part deserves time and attention. (And for some patients – $500 is substantial).

Present the treatment as a solution to their problem or a way to meet their expectations.

Avoid unnecessary details. Put the treatment plan in “patient-speak” and avoid a lot of dental terminology. If you have a treatment plan on the monitor or printed, use it as a reference. But speak to the patient, not the paper or the screen.

Always present the doctor’s preferred or ideal treatment option first. If you never tell the patient what your ideal treatment plan will be, they will never choose it. Once you present your treatment plan, give the patient an opportunity to respond. Be careful not to assume that silence is negative. Avoid giving them all of the options at once. That may confuse the patient and they are likely to defer to the final option listed.

Listen with intent. There should be no interruptions when presenting treatment to patients. Body language is important. Sitting near the patient (not too close!) and leaning slightly forward signifies the conversation is important and the focus is on the patient. Avoid sitting too far away, or with your back to the patient, staring at the computer monitor or study models on an articulator. The focus should be totally on the patient.

When the patient asks, ”How much?” this signifies that they may be ready to proceed and are prepared to work out the financial details. When they ask this question, provide their total treatment investment. If they want a breakdown by procedure, they will ask for it. Be prepared to discuss total treatment payment. When we assume patients are reluctant or have an issue paying fees, our confidence may falter. When that happens, our competence falters as well. Be confident in your fees and comfortable with your established financial protocols.

Your financial arrangements should be friendly to the patients and also fiscally sound for the practice. They should be designed to achieve a minimum ninety-eight or ninety-nine collection percentage. They should also be orchestrated to minimize accounts receivable balance – outstanding money owed to the practice.

Establish the right atmosphere. Financial discussions should be done privately away from the clinical setting. The course of treatment should have already been discussed and agreed upon. The decision to accept treatment happens with the clinical team. The financial team is responsible for negotiating payment.

Seventy percent of treatment plans that are not accepted is due to financial arrangements not presented properly. Introduce your financial protocols in a way that shows how they benefit the patient.

Present your ideal outcome first. If that means to be paid in full with a courtesy discount, offer that option initially. This may be an opportunity to explain that many patients take care of this with outside healthcare financing, offered in your practice. Wait until you present other alternatives so the patient has time to consider this option before you move on to your next preferred option. This continues until the patient has chosen a payment arrangement that will work for them and for the practice.

If the patient is asking for payment arrangements that are not offered or unsound for the practice, ask them, “Tell me what you had in mind?” If it is unreasonable, (small monthly payments on a large balance carried by the practice, for example) explain to the patient that the office can provide that service utilizing the resources of outside financing, upon credit approval.

Sometimes a patient may say that they simply cannot afford the treatment, or don’t think they would get credit approval for healthcare financing. When that happens, thank the patient for their candor. Other financing options for these patients may be to pre-pay for their dentistry, or breakdown their payment per visit – not per procedure. Divide the total treatment plan fee by the estimated number of appointments. The patient would be required to bring in the same amount at each visit, regardless of the procedure being performed on that day.

Financial discussions are a two-way conversation requiring negotiation skills that are supported by consistent financial protocols that have been established for your practice.

Presenting treatment to patients so they accept it and pay for it requires skills training. The more prepared the dental team is in helping patients understand and appreciate the dental care being offered, the more confident and competent the team will become. Spend time learning how to talk to patients about ideal treatment. The patient will benefit from the outstanding care they receive and the practice will benefit from increased productivity.

About the Author

Debra Engelhardt-Nash is the founding member and served two terms as President of the Academy of Dental Management Consultants. She is currently the Vice-President/President Elect for that academy. She is an active member of the American Dental Assistants Association Foundation and serves on the board of the American Dental Assistants Association Foundation. Debra is also a member of the American Academy of Dental Practice Administration. She has been repeatedly recognized by Dentistry Today as a Leader in Continuing Dental Education and in Dental Consulting.

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