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There's a saying among dentists that "a denture that's paid for fits better."
Sorry I didn't do a good job of explaining the issue initially. This is not punitive at all. Just to be clear, if a patient pays 50% to schedule and STILL doesn't show up for the procedure (very uncommon), I will still refund the entire amount if they simply changed their mind. I don't have any cancellation fees. Because THAT'S what makes people angry. I've found this is just a better way to mitigate the original problem of no-shows. When I can keep my accounts receivables high and minimize my losses, this actually allows me more freedom to do charity and discounts.
That saying about describes it, seems to me.
Your explanation makes the billing process more understandable, IMO, thanks for taking the time to explain things. IMO your policy of returning the entire amount to patients who change their minds about having the work done seems generous, especially if you're left with expenses for the materials you had to preorder and can't use, but hopefully that doesn't occur all that often. But as you mention in regards to cancellation fees, as a business you have to determine policies which will balance keeping your clients happy with consideration for your financial health and goals.
There's a saying among dentists that "a denture that's paid for fits better."
Sorry I didn't do a good job of explaining the issue initially. This is not punitive at all. Just to be clear, if a patient pays 50% to schedule and STILL doesn't show up for the procedure (very uncommon), I will still refund the entire amount if they simply changed their mind. I don't have any cancellation fees. Because THAT'S what makes people angry. I've found this is just a better way to mitigate the original problem of no-shows. When I can keep my accounts receivables high and minimize my losses, this actually allows me more freedom to do charity and discounts.
Fair enough, but what about patients with insurance?. In January my insurance will pay 80% of major work, the total pre-approved fee is $6,400. Would you ask me for a $3,200 deposit or for my co-pay of $1280? I haven't looked at the rules with my insurers (I have two dental PPO's) but if I remember correctly when I had Delta Dental providers couldn't require you to prepay the amount of the bill that they cover.
Fair enough, but what about patients with insurance?. In January my insurance will pay 80% of major work, the total pre-approved fee is $6,400. Would you ask me for a $3,200 deposit or for my co-pay of $1280? I haven't looked at the rules with my insurers (I have two dental PPO's) but if I remember correctly when I had Delta Dental providers couldn't require you to prepay the amount of the bill that they cover.
It's 50% of YOUR portion, regardless of if you have insurance or not.
It's 50% of YOUR portion, regardless of if you have insurance or not.
But I am asking you an honest question here. I don't think most Dental Insurance PPO's allow you to charge patients in advance for any more than their co-pay, how can you get around that?
"If you visit a Delta Dental dentist, you do not have to pay the entire bill and wait for reimbursement from us. Delta Dental pays its portion directly to your dentist. We send you a notice of payment explaining your portion of the bill. You pay the dentist only that amount."
Yes I think you and I are actually in agreement here. Let's say the total fee will be $4,000. Let's say insurance is expected to pay $1500 of that which leaves $2500 for you to pay. We collect half of your 2500 when scheduling the appointment and the remainder of the 2500 on the day of the appointment.
Yes I think you and I are actually in agreement here. Let's say the total fee will be $4,000. Let's say insurance is expected to pay $1500 of that which leaves $2500 for you to pay. We collect half of your 2500 when scheduling the appointment and the remainder of the 2500 on the day of the appointment.
But I am asking you an honest question here. I don't think most Dental Insurance PPO's allow you to charge patients in advance for any more than their co-pay, how can you get around that?
"If you visit a Delta Dental dentist, you do not have to pay the entire bill and wait for reimbursement from us. Delta Dental pays its portion directly to your dentist. We send you a notice of payment explaining your portion of the bill. You pay the dentist only that amount."
Not an attorney, but I think this is wrong. We're certainly not allowed to charge more than Delta's payment + your copayment, but I believe we could charge the whole amount and have Delta reimburse you instead. You know why this might be the case? It's because Delta Dental, and all insurance companies, won't guarantee their portion of the payment. It's because they can't verify that the conditions that exist when you check it will be the same as when the claim is received. You could lose eligibility, or another claim could be paid before this one. But--I don't know. I don't ask for more than the copayment. Hmmm... maybe I'll ask Delta one day...
Interesting conversation so far. I'm a dentist so I'm obviously going to side with dentists. But I think we have a very good argument.
Suppose some random guy says he'll pay you $1000 to do something. You think it's a good deal so you agree. However, he says he'll pay you in installments. Would you do it? Hell no! You know nothing about the guy and have absolutely no reason to trust him. If your kid told you someone made this same proposition, would you advise him/her to do it? Of course not. Put into a different perspective, that dentists don't want to accept payment plans makes sense. In my own experience, 90%+ payment plans fail. Yes, 90%+. We stopped doing them.
California has a law called "reporting pay". It means that if you're scheduled to work your employer MUST pay you for at least half the scheduled hours. That prevents employers from telling you to come in to work, finding there's no work, and sending you home without pay. You just wasted a day where you could have worked somewhere else or enjoyed the day off. That sucks, right? Well that's what it's like for no-shows. A dentist must commit time and money (it does cost a lot to run a dental office) for you to come in, and when you don't show, it just cost us money. A no show is not free... we pay our staff salaries whether you're here or not. We pay rent, utilities, insurance, etc... No employee would ever be ok PAYING money to work, but that's exactly what business owners do when a patient no-shows.
Lastly, it seems the people participating in this conversation have a different mindset than the people that are being talked about. All of you agree that you'd pay your bill and that you'd provide sufficient cancellation notice. Well, that's not often the case. Some patients will constantly schedule and then no show or cancel last minute over and over. I can't imagine myself doing that to anybody, but apparently other people don't care. If I get a bill, if I agreed to it I'm going to pay it. Any other option is just unthinkable. Apparently other people don't think that way.
Not an attorney, but I think this is wrong. We're certainly not allowed to charge more than Delta's payment + your copayment, but I believe we could charge the whole amount and have Delta reimburse you instead. You know why this might be the case? It's because Delta Dental, and all insurance companies, won't guarantee their portion of the payment. It's because they can't verify that the conditions that exist when you check it will be the same as when the claim is received. You could lose eligibility, or another claim could be paid before this one. But--I don't know. I don't ask for more than the copayment. Hmmm... maybe I'll ask Delta one day...
How can it be wrong, I posted a direct link to that language on the Delta Dental website. The same terms are listed in the benefit book for the two policies I currently have with Ameritas and Renaissance, and that's how it worked with Met Life. As far as I know all dental PPO's work like that. I think if you sign up as a preferred provider you understand and accept the risk of no shows or limit your deposit to the patient's deductible and copay.
But here's a question for you, I have not been to a dentist in a long time where they had no down time, so is it realistic for a dentist to have an expectation to be reimbursed thousands of dollars for their downtime for a no show? I understand collecting money for materials in advance but I doubt if materials usually comprise 50% of the total bill and that's what some dentists in this thread said collect in advance. If a cancellation is that damaging to the dentists bottom line, maybe they need to change the way they book appointments? I have a friend who is a pediatric dentist in Nevada, almost his entire practice consists of medicaid patients, he said they have no out of pocket so you can't get any kind of deposit so he double and triple books to cover no shows which in his practice run 30-40%
It's sort of like how car insurance works, I had a comprehensive claim with USAA, I had to pay the body shop my deductible, they had to bill the insurance company for the balance. The body shop I went to required a $150 deposit that they would keep if you were a no-show and they collected the deductible on the day they started the work, but since they were under contract with USAA they could not ask me to prepay the total amount of the claim, $4,000.
I wonder how many dentists have considered some other options to ensure that patients don't stand them up? It's fine to require a reasonable non refundable deposit for no shows, but if the patient shows up then don't require deposits for subsequent treatment.
Or cultivate the favor of patients like myself, I'm 10 minutes from my dentist's office and retired so it's easy for me to be there in less than 20 minutes if they have a no show. I've always been willing to drop what I'm doing and go in but to be honest it's not usually even acknowledged with a 'thank you' which sort of irks me. I bet more patients would be willing to be flexible with their schedule if there was some token of appreciation like a small gift card or discount on services not covered by insurance such as teeth whitening, or if that's asking too much maybe just a simple "thank you, you saved the day!"
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