Inside Dentistry
Jul/Aug 2008
Volume 4, Issue 7

Get Paid for What You Produce

Penny Reed Limoli and Angie Skinner

There are few things in life—or dentistry—more frustrating than not getting paid for your work. Why don’t patients pay their bill? Most patients want to pay, but they are confused about what they really owe. The human brain can only focus on one thing at a time. When a patient hears, “Mrs. Jones, your crown will cost $950, and we estimate that your portion will be $550 after insurance,” guess which figure Mrs. Jones remembers? You guessed right—$550.

Now, take a look at this scenario: It’s time to talk with the patient about how they are going to pay for his or her needed treatment. Beads of sweat begin to form on the brows of the entire dental team as the patient makes his or her way to the front for a conversation with the financial coordinator. What will happen? Will your financial coordinator get a verbal or written arrangement? This patient has insurance—what if they have questions? Will the financial coordinator be able to conquer the onslaught of inquiries about what the patient’s dental benefit plan will pay? What if the financial coordinator leads the patient to believe that he or she is only responsible for a certain amount of the treatment? You can only hope that everything will work out okay.

Why does this happen? Why can’t working out payment agreements be easier? It can—and should—be, but you have to be ready to make some changes in the way you handle financial agreements with your patients. First, you need to accept some cold hard facts.

Fact No.1: Patients are confused about their dental benefits, period.

The most qualified person to explain a patient’s benefit plan to them is their insurance company or human resources director, not your financial team. Unless the dental team has the same information as the dental plan administrator, it is very dangerous ground to act as “insurance experts.”

Fact No. 2: Dental professionals have no guarantee that a patient’s benefit plan will pay what is anticipated.

Dentists often make verbal or written statements about estimated insurance benefits with no back-up plan or explanation of what will happen if the office is not reimbursed the anticipated amount by the insurance company. The patients never seem to hear the word “estimated,” but they do have a keen ear for the phrase “patient portion.”

Fact No. 3: Dentistry as a profession has “promised” patients into a zone of mistrust.

By transforming the dental team from salespeople who want nothing more than patients to get their treatment plans completed to collections managers who require payment after the benefit plan has not done what was expected, the dental team has made patients irritated, irate, and suspicious. When the dental staff suddenly wants the patient to be accountable for a bill, instead of insisting on an agreement at the beginning, it is often misunderstood by patients who now believe the dental staff is asking them for payment they never agreed to owe.

Fact No. 4: Many dental professionals state that they make firm financial agreements, yet often the following important factors are missing:

  • The agreement was only a verbal conversation, not a written document.
  • The patient signed the treatment plan but did not make a written commitment as to how he or she would pay.
  • There was no specific documentation as to how, and when, the patient will resolve the balance if there is any lack of anticipated benefit from the dental plan.

The average patient in America spends about $900 per year at the dentist. If you have a practice with 1,200 active patients, this average expenditure would put you well over the million-dollar mark simply by establishing sound financial agreements for bread-and-butter dentistry. However, Dental Genius has watched the dental profession closely. Over the past year, many dentists have seen minimal, if any, increase in their overall net income—much less a $1 million year.

How do dentists overcome the barriers to success? Find out where patients stand as far as what they are committed to having done, and then help them to find a way to get that treatment. While everyone will agree that it is much more profitable to do a root canal, build-up, and crown in one visit, many patients aren’t financially ready to pay for a large treatment plan in one chunk. Rather than insist that the treatment is done your way and within your time frame, you’ll be able to capture more opportunities if you’re willing to create custom financial agreements that use a variety of payment resources, such as insurance, credit cards, or outside financing. If you’re overwhelmed—relax. Dental Genius has a proven system that will make these agreements seamless and effective.


Many patients’ first reaction to a treatment plan quote is to ask, “How much will my insurance pay?” Dental insurance has made dentistry affordable for many Americans, who in the past considered dentistry a luxury or elective procedure; however, we’ve seen many offices become overly reliant on insurance reimbursement and anticipate insurance payments that are woefully less than projected—or nonexistent. Our solution is to put insurance in its place—dead last. Dental Genius and Tom Limoli, Jr, have done this by creating the Ultimate Financial Agreement System, titled “Take It To The Bank” (TITTB).Your patients will finally understand that dental insurance is an option for patient payment, not a substitution.

While credit card payments and outside financing options may be available to some patients, those who have less than stellar credit (particularly in our current atmosphere of stringent lending practices) may not qualify for credit. Should you watch that patient walk out the door? It might be acceptable if there is have very little open chairtime and patients are waiting 2 weeks or longer for a high-production appointment on your schedule. Those types of practices, the top 5% to 10%, may not have to be as creative as most offices. The TITTB system was created to address financial agreements that go above and beyond the slam dunk of payment in full the day of treatment or full financing with an outside payment plan. By breaking the treatment plan and payment schedule into manageable chunks, your patients get their treatment—and you get paid.

Best of all, the TITTB method works equally well for practices that participate in a managed care network and those practices that choose a fee-for-service approach. If you decide to partner with a managed care provider, this tool will take the dental insurance policy and put it where it belongs—in your patient’s hands. Or, if you are a fee-for-service practice, this system makes financial arrangement conversations with your patients crystal clear—and easily collectible.

Want to take TITTB for a test drive? Send us an email to info@dentalgenius.com with “TITTB form” in the subject line, or call 877-791-3993, and we’ll e-mail you a complimentary copy of the form.

About the Authors
Penny Reed Limoli
Angie Skinner
Dental Genius™
Collierville, Tennessee

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