Episode #511: Say This Not That When Collecting Money, with Christina Byrne, Jenni Poulos & Ariel Juday

As a business, you need to collect money. But dentists aren't collecting what they're owed! And to change that reality, Kirk Behrendt brings back three amazing ACT coaches to help you rethink your habits, your systems, and your language so you can overcome the challenges of collecting money for your practice. Remember — it’s okay to collect! To learn how to do it with confidence, listen to Episode 511 of The Best Practices Show!

Episode Resources:

• Christina’s email: [email protected] 
• Jenni’s email: [email protected] 
• Ariel’s email: [email protected] 
• The ACT Team’s social media: @actdental
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Links Mentioned in This Episode:

ACT Dental’s Say This, Not That document: https://form.jotform.com/221665137804153

ACT Dental’s Verbal Skills Webinar: https://www.actdental.com/verbal

Take Action by Dr. Ann Marie Gorczyca: https://bookshop.org/p/books/take-action-treatment-coordination-for-a-successful-dental-practice-ann-marie-gorczyca/15107051?ean=9781949642384

Episode 506 of The Best Practices Show: https://www.youtube.com/watch?v=6QXdjukwKEk

Main Takeaways:

Get the right thinking, the right language, and the right person to collect.

It’s not “mean” to collect money for a valuable service you provide.

Your practice is a business. If you don't collect, it won't survive.

Don't offer patients the option to not pay you.

Collecting is a collective effort.

Quotes:

“[Collecting money in a dental practice is] a huge deal, because it’s the money that you are owed. And if you don't collect it at the time of service, first of all, it’s not worth what it was the day you did the procedure. But it’s much harder to collect it after the fact. People don't answer their phone, they don't read their mail, they don't check their email. So, you're so much better off when you collect it right then and there.” (3:19—3:44) -Christina

“[Collecting money is] not mean. You're providing a valuable service to your patients, and it’s something that is worth something. It’s worth a lot. It has value. We don't feel like it’s mean when we go to the grocery store, and we have to pay for our groceries. I don't think that someone is being mean to me when I go to a store and pay for the goods or services that I am receiving. For some reason, we have this different belief around dentistry and dental care that it doesn't have that value or that worth, especially for that time-of-service collection. We need to throw that limiting belief out the door, own the fact that these are valuable services that the doctor, the team, everyone deserves to be compensated for.” (3:56—4:48) -Jenni

“Remember, it’s a business that needs money to survive. Bottom line, if we don't collect the money, the business can't continue.” (4:50—4:59) -Jenni

“It’s your service. Don't devalue your service. And team members, they are only concerned about collecting if they feel that coming from the dentist or from the leadership. If the team member doesn't know any differently, they're going to collect. It’s these notions that we put in our mind, or we start perceiving who can pay and who can't pay. They wouldn't be here if they couldn't pay. They know. We all know. We don't leave the grocery store with our groceries and say, ‘Bill me.’ We’re not doing the barter system anymore, so it’s okay to collect.” (6:07—6:46) -Ariel

“Of course, nobody wants to — I mean, I don't want to pay. I might value it, but if I have the option not to, I'm going to choose it. So, we’re not offering that option. [We ask,] ‘How would you like to take care of today’s investment portion?’ . . . If you take one big key word away, it’s that these are investments. It’s not a fee. It’s a return when we invest. We get a return in something. So, I'm going to pose the question of, ‘How do you want to take care of this?’ not, ‘Do you want to take care of this?’” (7:42—8:23) -Jenni

“It starts from the day that we actually diagnose and treatment plan and set the patient up for that visit. So, the first time they hear that they need to pay $500 shouldn't be the day that they have the procedure and they're walking out the door after. They should know that, because when we got them in the schedule, we told them, ‘Here’s what you need to prepare for. This is what your investment will be.’” (8:25—8:53) -Christina

“I've seen the evolution in all of my years in dentistry. I started in 1985, and it was a “price”. Then, it was “cost” because that sounded better. Then, we went to “fee” because that sounded a little bit better. But I love “investment”. I think “investment” is wonderful because, what Jenni said, it implies you're going to get something in return, which means I'm going to have better health, I'm going to look better, I'm going to feel better. So, I think, definitely, that is the way to go.” (8:55—9:29) -Christina

“It goes back to systems. What is your system? Because anyone can ask someone to collect if they already know about it. Now, I may not want to drop the bomb on the patient. But I'm okay with collecting if they already know. So, what's the system? Did I present it to them? And then, what's your system for checkout? There's no reason where you should never ask, because you have a series of questions. Did I schedule? Did I collect? Did I go through my checklist or my notes? So, there's really no reason for you to ever miss part of it if you get yourself in a good rhythm and a good system of that. And then, you don't even have to think about, ‘Oh, yeah. Now, I have to ask.’” (9:33—10:14) -Ariel

“When you're collecting, you should be confident about it. You shouldn't apologize. Don't go, ‘Oh, it’s $500.’ So, I think that's really important. The language matters, but it’s also the way that somebody is saying it, the confidence that they have behind the ask.” (11:41—12:00) -Christina

“There's no reason to not very directly ask your team members, ‘Hey, are you comfortable and confident talking about money?’ Because if you have an entire team that's not, you're going to have to practice. You're going to have to roleplay. But if you have someone that's like, ‘Game on. I would love to be the point person for collections,’ then let's utilize that strength and that confidence that that person has.” (12:01—12:25) -Jenni

“You know how they say bees and dogs can sense fear? So can patients.” (12:26—12:30) -Kirk

“I like [saying], ‘Let me help you with your investment options or your investment portion for the date of service. Let me help you understand how we take care of your investment portion on the time of service.’ Again, it’s driving home those value words around the service or around collecting, and I want you to continually layer those in.” (12:53—13:18) -Jenni

“I like that, ‘Let me help you,’ because it also implies that I'm helping the patient. We’re in it together. Our job is to help make this as easy as possible, whether it’s the procedure itself or the ways to pay for it. So, I love that. I love being able to have that conversation and let them know we’re on their side.” (13:32—13:54) -Christina

“That one is also great for past-due balances, ‘Let me help you get caught up.’” (13:55—14:00) -Jenni

“I'm going to lean into how I can help you [rather than say, ‘Our office policy is . . .’]. ‘Let's see how I can help you. Let me help you understand how we take care of this in the practice.’ It’s all about what I can do for you, not what you're going to do for me.” (14:36—14:51) -Jenni

“I think you need to give yourself and your patients a little bit of grace. If you've been operating for 15 years, and people are walking out the door, and you're sending them a statement, you're not going to turn that around tomorrow. So, let your patients know. Let them know what to prepare for. If they're not prepared today, that's totally fine. ‘Let me help you understand what's going to change the next time you come in. We’re going to expect this. This is what it’s going to be. But for today, we understand. You're a great patient. We don't want to drop this on you right now,’ that kind of thing. So, I think that you need to give yourself some grace to get used to the idea, and then also give your patients some grace. Because you have trained them to not pay. So, now, we have to retrain them to pay.” (14:53—15:41) -Christina

“Systems really are designed to assist, not insist.” (16:21—16:25) -Kirk

“When I presented treatment, my system was, I scheduled the appointment and then reviewed the investment. But sometimes, patients don't like that. So, I say, ‘Okay. Well, let's review it. And now, let's get you scheduled.’ There are small tweaks that you have to allow your team members to make. But they have to understand the expectations and the end goal. The end goal was still that I got them scheduled and that I collected. How we went about it depended on the patient. I wanted to guide it towards their experience and what made them comfortable.” (16:45—17:18) -Ariel

“This document, the Say This, Not That, the reason that we have this third column is so there's some variation. There's some authenticity to your practice, to your team members. Because we do want you to be authentically you. We want you to be confident and comfortable, and you're most confident and comfortable in your own skin. So, if you would never say something one way, don't force yourself into it. If you feel like, ‘I am so confident getting them scheduled first, and then reviewing the financials, because that gives me that boost,’ then do that. Do the thing that feels authentic to you that’s going to give you that confidence.” (17:21—18:08) -Jenni

“This is not something that you're going to hand to your team members and say, ‘Here, do this.’ This is going to take probably several team meetings. I would suggest, take a team meeting and work on each section at a time, and really talk about what feels more comfortable. And in that third column, write down what your agreements are. Because the agreements are there to help you to remember. And it’s also there to help keep us accountable. If we have said that this is important, and we want to change the face of the practice, and we want the practice to be profitable, then we have to start collecting.” (18:29—19:05) -Christina

“When we make these agreements, it’s easy for us to say, if somebody says, ‘Hey, Chris. We agreed that this was how we were going to do this, and you're not saying it this way. Let's talk about how we can make it easier for you to have these conversations with the patients.’ Or to your points earlier, am I even the right person in the seat? Maybe that person is not right for that job, but they might shine somewhere else. So, figuring that out is really important.” (19:08—19:38) -Christina

“During these conversations, find out what is comfortable. When team members say that something isn't comfortable, they're like, ‘Oh, I can't say that. That doesn't feel right,’ figure out why. Because it might be that it is actually uncomfortable, and it doesn't flow very well in the current system or process. Or it might be, ‘Oh, I'm not comfortable saying that. I'm not comfortable presenting treatment over X amount because I don't have that myself.’ So, you can start learning. And I always tell everyone, you don't know what people are hiding in their couch. So, don't assume they can't afford it. But our team members, they are the ones talking to the patients. So, we have to figure out, why is it uncomfortable? Can we overcome that with them? If not, what do we do instead?” (19:39—20:28) -Ariel

“We got some great feedback from someone that's in our awesome To The Top study club where we were talking about investment. One of the docs said, ‘My team isn't comfortable referring to very small dollar amounts as an investment.’ So, we calibrated around it, and we made the decision that we have to hit a certain dollar amount to be comfortable using that word. So, they had this conversation around, ‘What feels right to us? What feels authentic? I don't like saying your “investment portion” is $3.’” (20:30—21:02) -Jenni

“I usually like to say [the deposit is] to secure the appointment. ‘In order to secure the appointment in doctor’s time, or to reserve the time in doctor’s schedule, this is what we’re going to do. We’re going to ask you for $250 today, and then we’ll get your appointment scheduled. And when you come back in, your investment will be,’ whatever. I think that makes sense. And the thing too, that deposit is less about the money and more about the commitment. It’s more about the predictability. If I have put down $250, I'm not going to cancel that two-and-a-half or three-hour appointment. But if I have no skin in the game, that's a huge chunk of time for somebody to, on a whim, decide, ‘Oh, I don't think I want to go today,’ and not show up.” (21:44—22:35) -Christina

“Every medical procedure, I think I've even paid in full, not even just the deposit. So, we expect it for bigger procedures. We know. We’re just waiting. We’re not going to say, ‘Oh, do you want me to pay for this now?’ We’re waiting for them to tell us, ‘Okay. We’re going to go ahead and collect this to secure the appointment.’ And patients will say, ‘Okay,’ or they’ll say they can't. And now, you say, ‘Okay. Let's talk and figure out when you can.’ It might just be timing. And that's okay too.” (22:38—23:10) -Ariel

“I always want to have my financial arrangements completely signed, set in stone, completed prior to the patient sitting down in the chair, walking in that day. I love Barrett’s “no surprises”. We want our patients to be comfortable and confident when they arrive that day and not worrying about what happens. And it might be that there are a few payments leading up to it, or it might be one before one day of, and one after. But let's get to that day with that plan already set in stone, signed, and scanned into the patient’s chart.” (24:50—25:29) -Jenni

“Patients are already worried about what's going to be happening once they're in the chair. So, let's take [out] one more fear of, ‘How am I going to pay for this?’ Let's talk about that ahead of time. That way, when they show up, all we have to do is worry about making them comfortable.” (25:32—25:47) -Ariel

“You want to advocate and help the patient as much as you can through the process. But even before that begins, when we know that we’re going to be utilizing financing, we’re going to be presenting financing, [say], ‘Let me help you understand how a lot of patients are able to afford this treatment right now.’” (26:57—27:16) -Jenni

“Be honest with it as well. You don't have to say “loan”, but you can tell them it is a healthcare credit card. So, ‘The benefit is you can use it here, here, and here.’ And I always throw in the vet, because that's where everyone’s like, ‘Oh, yeah. I spend money there.’ And then, if you do offer a promotion, ‘We offer six months no financing.’ Now, I will tell you, ‘You have to be able to pay those off.’ That way, there are no surprises. So, they don't come back and blame you of, ‘Oh. Well, you tricked me into using this.’ Give it to them of, ‘Let me benefit you. Let me show you how you can use this. I'm going to give you all the information, and you can make the decision.’” (27:19—28:00) -Ariel

“I utilize CareCredit myself at the vet. And when I've presented financial options to patients, I've actually been able to say, ‘Hey, I have experience with this myself. This is how it went for me. This is how I made sure to take care of it and pay it off in time within the promotional period.’ So, I could authentically talk about, ‘It worked. I got the care that my little love needed immediately.’ And that gave the patient confidence because it was like, ‘Okay. You've been there. You've done that.’ We don't want to go first. We don't want to be alone. We want to know that someone else has done it, and that it’s going to be okay.” (28:02—28:41) -Jenni

“Let them know, ‘This is how we can do payments.’ Now, I will say, this is the biggest thing I always hear, ‘But they didn't qualify.’ So, the doctor is like, ‘But Ariel, make payments for them because they didn't qualify for CareCredit.’ Let's think through this. CareCredit is a very large company. They know how to collect money. They don't qualify for CareCredit, yet I'm willing to make payments for someone who is proven to have bad credit history? Usually, when they didn't qualify, they probably shouldn't qualify for payments with us either.” (29:25—30:02) -Ariel

“That would be the, ‘Let's begin making payments and building up that credit to go towards it,’ not, ‘Let's begin making payments after.’ You didn't sign up to be a bank, so let's remember that.” (30:03—30:21) -Jenni

“Doctors are hard. They want to just have a handpiece in their hand and do those procedures. But you have to think about, what is the outcome of that? Like Ariel said, if they don't qualify, if their money is not good enough for CareCredit, then I don't think that we should be extending them that courtesy. Because we've said this for how many years, if a patient is tight at the end of the month, what bills are going to be left unpaid? It’s not going to be their mortgage. They're still going to pay that or their rent. They're still going to buy food. They're still going to pay their utilities. They're not going to pay their doctor. So, you don't want to get into that situation because it’s uncomfortable for everybody.” (30:22—31:06) -Christina

“Even if they get declined [for CareCredit], now you know where to lead your talking points, as Jenni said. That's not the end of the road. It doesn't mean they can't afford it. Now, we say, ‘Okay. Do we need to make payments ahead of time? Do we need to ask family members? Do you have other savings? Do you need to move your money around?’ Get them thinking. And it’s okay to have silence because they have to think. We don't know their situation. Sometimes, they're just thinking. They're not thinking of ways to say no. They're trying to figure out, ‘How do I make this work?’ Let them come to you with a solution, and it may work.” (32:55—33:31) -Ariel

“We invest in what we value . . . If we find value in something, we are willing to pay for it with our time and with our money. We have these limiting beliefs. We’ve got to let those fly out the door. These are valuable services. And if we communicate value to our patients, they are going to make the investment.” (35:10—35:39) -Jenni

“Don't think you don't need to practice this, or you only need to go over it once. I think it’s important to practice it over and over again and test out these new verbal skills, just like anything else. If you're going to get a dress for the prom, you're going to try on a bunch of them. Try on a bunch of different phrases and do it together as a team so that the first time you're using this language is not with a patient.” (35:45—36:11) -Christina

“[Get] the whole team involved and [have] everyone understand, ‘What is our system? What is our process?’ outside of, ‘What are we going to say? How are we going to do this?’ And you'll see the confidence because they’ll know, ‘This is what we do. This is how we do it.’ And it takes the fear out of it because now they have practiced it. Everyone does it the same way. It’s not, ‘Oh, Ariel does it differently than her, so who do we listen to?’ And doctors, encourage and help them and say, ‘Hey, I understand this is hard and it’s not easy.’ And don't let them tell you, ‘Well, I've tried it, and it didn't work.’ ‘How many times did we try it?’ So, get everyone involved in the process because collecting comes from the entire team.” (36:26—37:12) -Ariel

Snippets:

0:00 Introduction.

3:10 Why collecting money is a big deal in dentistry.

3:45 Collecting money is not mean.

5:49 Major reasons why dentists don't get collections right.

7:11 What to ask instead of, “Would you like to pay today?”

12:40 A better way of saying “We collect at time of service.”

14:24 Rethinking, “Our office policy is . . .”

16:13 Systems are designed to assist, not insist.

18:08 Give team members space to use their own language.

21:04 Say something better than, “We need this upfront.”

24:26 Have financial arrangements set in stone before the visit.

26:30 How to think better about third-party financing.

28:42 What to say about the payment plan.

32:06 CareCredit is now much easier.

34:59 Last thoughts.

Christina Byrne Bio:

Christina Byrne has been involved in dentistry since 1985. Over the years, she has held many positions on the dental team, including dental assistant, business office, and dental hygienist. Christina’s extensive knowledge of the front office and clinical procedures is a great asset, and she loves to impart her knowledge to guide dental teams do the best they can to achieve a Better Practice, Better Life!

Jenni Poulos Bio:

Jenni brings to dental teams a literal lifetime of experience in dentistry. As the daughter and sister of periodontists and a dental hygienist, she has been working in many facets of the dental world since she first held a summer job turning rooms and pouring models at the age of 12. Now, with over 10 years of experience in managing and leading a large periodontal practice, she has a firm grasp on what it takes to run a thriving business. Her passion for organizational health and culture has been a driving force behind her coaching career. She has witnessed firsthand how creating an aligned and engaged team will take a practice to levels of success that they never believed possible! 

Ariel Juday Bio:

Ariel has a master’s in healthcare administration and several years of dental experience in all aspects of the administrative roles within the dental office. Her passion is to work with dental teams to empower team members to realize their full potential in order to better serve patients, improve office systems to ensure a well-functioning team/office, and to help everyone have fun in the process!

Outside of work, she can be found by the beach or the pool reading a good book, enjoying sporting events with her husband, Alex, or exploring the outdoors with her Bluetick Coonhound, Maddux.