Here, we examine one of the more common conundrums in orthodontic practices today. Quite a number of practices believe firmly in offering patients a monthly payment plan that allows that patient to fit the monthly obligation into his or her budget. Those of us at My Practice Engine fall into that method of thinking. Combine this with the fact that over time, technology has allowed doctors to see patients less frequently. In the distant past, patients had to consistently be seen on a monthly basis. Now, sites regularly discuss 5-8 week intervals between appointments.
Very clearly, reducing the frequency of appointments is a win-win for all involved. For a patient, having to make fewer visits to the doctor’s office is almost always preferred. For the practice, seeing the patient less frees up time to see other patients. Just doing the math, if you see patients every 4 weeks and then move to seeing them every 6 weeks, you now have increased the total number of monthly patients you can see by 33%. That’s without adding chairs, space, staff or any other cost.
The problem that arises comes from the fact that practices intertwine the monthly payment and the frequency of visits. As a result, a practice charging a monthly fee will see patients on a monthly basis so that they can make sure to collect that monthly amount. This eliminates the possibility of the office using all of that wonderful technology available for treatment. Here are some of the objections and solutions raised when discussing monthly payment and non-monthly visits.
Please note that we will not be discussing the quality of outcomes or movement of teeth using one method or another. There are a number of outstanding sources for that type of discussion. This is not one of them.
Patients will pay only if they are in the office
This is a very common and reasonable cause for requiring monthly visits from patients. There is certainly no better way to request payments than face-to-face. And it does eliminate a lot of billing and follow up work that would have to be done during months in which a patient would not have to come in for the appointment.
You usually see this argument when an offices does not have effective receivables systems. Maybe the front desk staff is overwhelmed or maybe the practice just does not want to deal with that. But building an effective system is not an overly complicated task. The work comes at the beginning of treatment and involves what a number of practices call “training the patient.” Beyond that, having a consistent/technologically supported system of follow up is generally uncomplicated. In a post soon to come, we’ll discuss this more in detail.
If a patient comes less frequently, he or she will perceive less value from the treatment and I will not collect my full fee
To the earlier note in this piece, we are not talking about a situation in which the practice purposely schedules a patient to be seen for more months than he or she needs. That gets into issues beyond the scope of what we are discussing here. Rather, the point here is to discuss the notion of why would a patient pay $4,000 for treatment to be seen 24 times over the course of treatment and the same amount to be seen 18 times over the course of treatment. Three main arguments to counter this.
First, the fee arrangement is the cost for treatment and is completely divorced from the path the doctor takes to get to the result of a fantastic smile. So if you are seen once every 5 weeks, 8 weeks or 10 weeks, the cost is still the same because the financial arrangement is separate from the treatment process.
Second, not all appointments are created equally and almost no practice will vary the payment based on the appointment type once treatment has started. In other words, if the patient pays $129 per month, he or she will pay that amount if the appointment is a 15 minute short appointment, 40 minute long or even a 90 minute IB (if you eschew the down payment). Moreover, the value of the actual work has nothing to do with the fee in any month. $129 versus the absolute minimal cost of a simple short is an immensely profitable enterprise for most practices.
Third, there are quite a number of arrangements like this in our economy that are perfectly acceptable. Insurance, extermination contracts, appliance warranties, etc. all require some sort of regular payment with an irregular timing of usage of those services.
My payment plan has been changed to match when patients are seen
Here, instead of charging $150 per month (to make the math easy) for a patient seen every month, the payment will change to $200 per visit (if patients are seen 33% fewer times, the payment will go up by 33%). This swings the other way and defeats the marketing purpose of a low monthly payment. $150 per month sounds much better and is much more attractive to patients than $200 per visit (with the number of visits not being known beforehand which creates additional confusion). Further, that consistent payment can be built into a patient’s budget much more easily.
The solution here is to consider the receivable systems and mentality toward the monthly payment mentioned earlier.
6 week scheduling and monthly payments can happily co-exist in this world. Be a part of that cohesion.
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