AADOM DISTINCTIONcast – How You Too Can Become a Patient Financing Guru: Questions and Answers That Will Grow Your Practice’s Bottom Line
Join Daniel as he guides you through mastering patient financing, empowering you to take full control of your accounts while enhancing patient satisfaction. This course will cover:
- Optimizing Merchant Fees – Understand merchant fees and how they can actually benefit your practice
- Effective Treatment Planning – Learn techniques that make financial conversations smoother and more productive
- Boosting Case Acceptance – Explore proven strategies to increase patient commitment to their care
Through his approach, ‘Make it make sense,’ Daniel will show you how to shift the financial dynamic so patients see the value in paying upfront, freeing you from the role of ‘patient bank.’
You’ll gain practical tools to maximize collections and inspire patients to say ‘Thank you’ for paying in full right away! Walk away with actionable steps to take control of your accounts, improve patient relationships, and ensure prompt payments.
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Read the Transcript Now!
Savanah: Hey everyone. Welcome to DistinctionCast, where AADOM showcases the best and brightest minds in the dental industry from within our dental management association.
I’m Savanah Carlson, Director of Member Services here at AADOM, and thank you for joining us today.
AADOM DistinctionCasts is more than just insights into dental management. It’s a dynamic platform designed to amplify the voices of AADOM’s distinction holders, providing them with the opportunity to educate and inspire their peers. By tapping into the expertise of AADOM’s distinction holders who are in the trenches of everyday management, we aim to empower and support leaders as they navigate the challenges and opportunities of running successful dental practices.
I’m very excited to introduce today’s AADOM DistinctionCast educator, Daniel Schriftman.
Daniel Schriftman, who holds AADOM’s highest distinction of DAADOM, is a seasoned business manager and coach with over 20 years in the dental industry. He is the founder of the Philadelphia Dentist PC, an emergency dental practice serving the community 365 days a year.
And Unicorn Professional Coaching, which focuses on enhancing the dental experience for employers, employees, and patients alike. As the president of the Delaware Valley Dental Connection and a lifetime member of AADOM, Daniel’s committed to helping practices improve through effective management and patient financing.
Welcome Daniel.
Daniel: Thank you very much. Very happy to be here.
Savanah: How are you today?
Daniel: I’m good. I’m good. It’s a nice sunny day for November, so that’s nice.
Savanah: I hear that. I hear that. So, you hold AADOM’s highest distinction level of DAADOM. Could you let us know how that has impacted your career?
How the DAADOM Distinction Has Enhanced His Career
Daniel: Yeah. I work in a family business, so in office, it hasn’t affected anything with the boss. But outside of the office, it’s given me a lot of recognition throughout the dental community.
When I come to the AADOM conference, people know who I am. They see me as an expert in the field, especially when it comes to patient financing, which is something that I deal with often with all of the different finance companies.
In getting my distinction, I wrote some articles regarding patient financing which have further extended the belief in my expertise in the area.
Savanah: Phenomenal. Phenomenal. Speaking of patient financing, we’re going to get a nice DistinctionCast just about that, right?
Daniel: Yeah, absolutely.
Savanah: So, Daniel, the floor is yours. Take it away.
Daniel: So, my presentation today is going to be about how you, too, can become a patient finance guru. The questions and answers that will grow your practices bottom line.
I’m going to start off a little telling you how I got into the dental field and, and how I really discovered that patient financing was so important for my dental practice.
Getting into the Dental Field
I started at The Philadelphia dentist in 2004. I had an eight-year retail background at that point. Every job that I ever worked was in retail. I sold audio video equipment at Circuit City. I sold knives for Cutco. I sold vacuums for a short period of time.
I ran a wedding photography studio that, you know, all I did was sell wedding photography services and packages. So, when I came into the dental field, I had a different mindset than most dental office managers.
I used my sales mentality to alter how our practice presented the treatment plans and used my retail mentality to completely alter our office schedule and really to make us the most convenient dental practice in Philadelphia. And the way I see it, quite possibly the entire country.
I’ve always used financing in retail. There was not a retail business that I worked for that did not offer a way to finance their product.
When I was 18, I worked at Macy’s and as we all know, even Macy’s or any other store that you go to, they have their own credit card. So, you’re financing everything that you do.
Growing a Convenient Dental Office
So let me tell you a little bit about how our office became Philadelphia’s most convenient. We were always open six days a week Monday through Saturday. And about 10 years ago, we transitioned to seven days a week.
As I said, it’s a family practice. My dad and I were together on a Sunday. We had, back 10 years ago, we checked the voicemail on Sunday to see if there were any patient emergency calls. A patient had called that needed treatment and they were in a lot of pain. So, we decided, “Okay, we’re together anyway.”
As you all know, as an office manager, you wear all the hats. So assisting, you know, taking care of every part of the patient’s needs. So, we went into the office. The patient wound up needing two root canals and crowns.
We financed that treatment for the patient. And while we were in the office, we had another call from a different patient who had an emergency and we saw them as well.
So, all of a sudden, we did three root canals and crowns. It was a random Sunday, completely unexpected, but obviously we were happy with the outcome.
We looked at each other and said, “Why are we not seeing patients, you know, seven days a week?”
And my dad said, “Well, we’re never going to be able to find staff that’s going to work seven days a week.”
And I said, “Well, you know, I’ve always worked retail. People work seven days a week. People work Sundays. We can do it.”
So fast forward towards today: we’re open seven days a week, 365 days a year, every holiday. We see over a hundred new patients a month. Most of our patients use patient financing.
There’s a lot of patients, if not most that come in for emergencies. And these are expenses that they are not expecting, so it really helps. We offer many different options to make sure that we do whatever we can to have something that works for each one of our patients.
The Problems with Financing Dental Procedures
Some of our fellow AADOM members—I reached out and I asked a question openly into one of our forums. The comments and concerns that I received back were that the biggest problems were patient denials.
The employees lose confidence in offering the financing and payment plans because they say the patients rarely get approved. The doctors don’t like paying the transaction fees. Patients don’t want another credit card or credit check.
They said the biggest obstacle is: Will the patient get approved or not? And then a lot of patients won’t even try because they’re embarrassed. And they’re really just afraid of being turned down or the doctor has a problem with paying the, the merchant fees.
Those happen to be the biggest obstacles is the merchant fee and the patient’s fear of getting turned down are really the manager’s and the staff’s fear of the patient getting turned down and dealing with that, as well as the merchant fee on top of PPO fees.
We are a full fee for service practice, so it does run a little differently obviously than a PPO practice, but we’ll get into that as well. Okay?
Discussing Financing with the Patient
I believe that it’s always time to discuss financing with your patient. You begin discussing the patient financing with the patients on your website. Offer links and applications on your website to every company that you use.
I discussed patient financing during my new patient phone call. When a patient calls, I tell them, “You know, we accept cash and credit card. We also work with some companies on patient financing that offer convenient monthly payments.” And obviously you’re going to discuss patient financing during your case presentation.
It is always a benefit to discuss patient financing. If you set the rest of your practice up properly around offering the patients financing, the staff, the doctor and the patient will all benefit.
Have a Script for Everything
We believe here in having a script for everything we do, which I’m sure a lot of other offices do as well:
- We script out our new patient phone call.
- We script out how we seat the patient.
- We script out how we go over the treatment plan.
- How we ask for reviews.
- How we schedule.
It’s important to keep reviewing those things, always be training your staff on, on how to do those things and be flexible in making any changes. And then training the changes.
The reason we script everything is that way we know that everyone is following the same script. We don’t have a patient that says, “Oh, I didn’t know you offered financing. I didn’t know you charge an exam fee,” because we go over it with everyone. Everyone is on the same script.
And as a manager, you should always be able to step in to help in any situation.
Prepare for Unplanned Expenses
So some unplanned expenses are your car—you have issues that you go into the dealership that you weren’t expecting or you get a flat tire. Your appliance breaks—your fridge and your freezer were working fine, but all of a sudden, your freezer is completely full of ice and you need to buy a new one.
And then there’s obviously medical and dental expenses—almost always completely unexpected. You know, you hope never to deal with those type of issues. But most of us, we deal with those issues for ourselves and for our families.
Present Every Patient with a Full Treatment Plan
We present every patient with a full treatment plan. And the question is, “Why do we do that?”
If we’re using patient financing, there’s no better time than now to present the full treatment plan. Most of our patients come in with emergencies. They’re currently thinking about their dental health and they don’t want to find themselves in pain again.
It’s our job as practitioners to give them the full picture. They need to know exactly what’s going on. They definitely don’t want to be in pain again.
It’s more expensive to wait and to do their dentistry later. A bond now is a root canal and crown later if they don’t take care of it. A root canal and a crown cost ten times more than a bond does.
We’re doing a service to our patients by telling them everything they need to know right now.
It’s important not to be afraid to present a full treatment plan. The patient deserves to put out all the fires and to rebuild the house. Payment plans offer your patients the flexibility to take care of their dental needs.
That’s the fire. We’re putting out the fire and then obviously rebuilding the house. That’s our big saying here in the office here.
Somebody comes in with an emergency. We want to make sure that they put out the fire first and we take care of what their problem is and their toothache. And then we want to rebuild the house to make sure that they don’t have any structural problems later.
Insured Patient vs. Non-Insured Patient
Okay, so this is important: the insured patient versus the non-insured patient.
We’re a fee for service model, so we submit claims on the patient’s behalf. They receive their reimbursement from the insurance company and can choose to put it towards the payment plan if they used it or whatever they want. It’s their money to do with as they choose.
When we offer payment plans to patients with insurance, it reduces missed appointments. Missed appointments cost us money. You know, how many of us have patients who you know are not showing up for their appointment because they can’t afford their treatment? It happens to us.
Also, if a patient has scheduled their first visit and has yet to pay, a lot of times they’ll miss that visit entirely. You may never hear from them again. And, you know, or they call and reschedule and maybe you’re wasting another appointment time.
Your patient will get the care they need and more of it. You’ll do a more comprehensive treatment plan, which still means more money now even if they’re insured because you’re giving them a more comprehensive treatment plan.
You’re planning out more necessary treatment. So, if they’re using a payment plan for that treatment, you’re getting more today and you’re putting it in the bank rather than thinking like, “Okay, well, you know, that tooth looks like it may have an issue.” A bigger issue two months from now or three months from now, we’ll wait till the patient calls and then we’ll take care of it.
Your patients will be satisfied that you have a better way for them to manage their out of pocket expenses. And again, you lose money every time a patient misses an appointment, cancels last minute, or delays treatment entirely because they can’t afford to pay for it.
Making it Make Sense
I believe in the philosophy of making it make sense for the patient.
You’re the expert. You need to demonstrate why you’re the expert to the patient and then sell them the dentistry and the financing that they need done.
You know the treatment. You’ve been in this industry for a long time. You know why they need the treatment that they need done. You know how to help them.
You know the payment options that your office offers, and you’re able to explain to the patient why one payment option may make sense for them over another option based on what their needs are. You’re going to do a much better job selling the patient on treatment if you’re able to figure out what their needs are.
If their need is that they can afford to pay $300 a month, then, you know, then you can work on figuring out which of your options will help them with that. If their need is that they don’t have any money for a down payment, then you can figure out what their options are as far as that goes.
But you’re the expert and you need to demonstrate why you’re the expert in order to sell the patient on your office and your treatment.
Again, you need to be able to explain to the patient why it’s important to do comprehensive treatment plan because maybe they need a root canal and crown and they need two bonds, but they only want to do the root canal and crown now.
You need to be able to explain to them like, “Okay, well, we can do that. But a bond not done today—it’s going to be a root canal and crown later, and it’s going to be 10 times as expensive.” Or “a root canal and crown that’s not done now, you know, may become an extraction and then replacing the tooth is much more expensive than fixing the one that you have in your mouth now.”
Don’t Forget This
A major worry for a lot of dental office managers is what their patient’s credit worthiness is. That has nothing to do with your responsibilities.
Unfortunately, there are a lot of people who have issues with their credit. Your job is to help find a way to get them financing.
You didn’t create their toothache. You don’t feel responsible or afraid to tell them that they need treatment done. But for some reason you feel afraid and responsible to tell them that they weren’t approved for credit, or, you know, maybe they have issues with their credit, or maybe they’re going to have a down payment because they have a worse credit than someone else.
This is not your issue. This is their issue. The same way they came into your office with a problem with their tooth. They came into your office with a problem with their credit. And that is for you to help them move forward and get some treatment done. But it’s not for you to be afraid to present because of that.
We Are Not the Bank
Okay. We’re not the bank and our bank does not do dentistry. Okay, that’s also our big philosophy here.
First of all, the dentist you see here is my dad. I love working with him. There’s nothing better than working with family in my opinion. We both have a deeper interest in seeing the business succeed. We’ve spent the last 20 years building this business together and sharing vision to offer our patients the best experience possible.
I never show up to work just to collect a paycheck. It’s really easy for me to jump out of bed every morning and head to the office.
There’s only one thing that makes it difficult to want to leave the house in the morning. And that’s the lady in the picture there. So, that’s my beautiful wife. We have four wonderful sons. They range from 18 years old all the way down to seven months. And I value my family very much, both at work and at home. Okay.
Every time that we become the bank for our patients, it winds up becoming a major issue. We generally do not want to do any type of in-house financing.
Certainly, patients will say, “Oh, well, you know, if you offer this payment plan, can I just pay you monthly?”
So, the question is—so we’ve already done the treatment or we’re doing the treatment pretty quickly. Obviously, we’re not going to set something up that the patient is going to pay us monthly. We are not a bank. We cannot afford to have the patients pay us off over a long period of time for work that’s already been done.
If the patient’s not credit-worthy through a bank that has billions of dollars, they are obviously not credit-worthy for us to be taking care of their treatment.
Sometimes the fee is too much to pass up if it’s a small payment arrangement. So, I have somebody who comes in and they need $15,000 worth of work and they say, let me give you $5,000 today. I’ll give you $5,000 in two weeks. I’ll give you $5,000 two weeks after that.
A lot of times it’s too hard to pass up. I’d say, nine times out of ten, the arrangement doesn’t work out as promised. The patient cancels their appointment. They come in and it’s time for their arranged payment and they don’t bring it in with them. And they’re aggravated with us, we’re aggravated with them. We did something nice to make an arrangement and then it just turns into a negative situation, unfortunately.
Using Many Patient Finance Companies
Okay. So, can you use too many patient finance companies?
There are so many patient finance companies. I’m only listing a few here:
- CareCredit
- Healthcare Finance Direct
- Sunbit
- Cherry
- Scratchpay
- So many others
We have used so many finance companies over the 20 years that I’ve been here. Every finance company that comes into existence—I’ve tried them, pretty much—Capital One, GreenSky, Wells Fargo.
There are so many companies that we’ve used. If it seems too good to be true that everybody’s just getting approved and there’s no down payment and they are only charging you, you know, 5 percent anyway—it’s too good to be true. Those companies almost always fail over time.
But still take advantage of every opportunity to use the new payment options if they seem good. If it works well for 6 months, then good, you benefited for 6 months.
But there are so many—have your hand in as many as possible. Have the availability to direct your patients to one company or a different one based on what the benefit is for the patient.
Becoming a Pilot
I want you to be a pilot. Okay.
Pilot programs for these companies—if you are seen as someone who does great with financing programs, the companies all know that. They figure that out.
If you can talk to them and have a discussion about what’s good about patient financing, what’s not good about patient financing—they are so blown away that you have any knowledge in the subject that they will make you a pilot in their programs.
If you talk to your reps and they say, “Oh, I have this new program coming and it’s going to be great for your office,” you want to jump on that because those are the programs that will make you money especially at the beginning of the program before they’ve let anybody into it.
I’ve piloted programs for the entire country that I was the first office doing the program. Then they’re, you know, put out so everybody can use them. And, you know, the next time there’s a program to pilot, they’ll come to me as well. And you know, that only benefits my bottom line and my patient’s needs.
So make sure that your reps know that you are interested in piloting their newest programs.
Presenting All the Available Options
Okay. So, we want to present all options available. Different types of financing are going to work better for different patients. And different types of financing are going to work better for your practice specifically.
You’re going to ask questions, as I said earlier, that are going to help decide the best finance company for your patient. You’re the expert. So, help the patient decide. They don’t know. They walked in and they have no clue what the different options are.
They may have heard of CareCredit before. They may have gad CareCredit for their dog or their pharmacy. But, it may be a different company that works best for them, or it may be CareCredit that works best for them, or, you know, it just may be a specific program.
We have programs that offer financing for great credit. We have, you know, those generally don’t offer that. You don’t have to have any type of down payment as far as a patient.
But we also have companies that take average credit or even poor credit with a guaranteed approval, but a down payment.
And then you want to let your patient know that you have these different options. You let them—again, you cannot assume what type of credit the patient has.
So, you’re going to say, “Okay, well, I have programs for patients with great credit and I have programs for patients with good credit. And then I have a program that offers guaranteed approvals for patient with average or less credit.”
The patient has no problem telling you that that’s the one they’d like to apply for, and they love hearing guaranteed approval. And as long as you’re letting them know that there may be a down payment, they’re going to figure out whether or not they can handle it.
Payment Plans Bring in Lots of Revenue
So, in our office, payment plans account for 50 percent of our revenue.
People are nervous about the economy right now. The world’s in a scary place. Prices are up on almost everything, as we all feel groceries, gas, housing, utilities—and credits being used more than ever.
Your patients would prefer to have a monthly payment than to give you their readily available cash up front. Patients seem less worried about interest rates currently. They’re more concerned with the amount of the actual monthly payment.
We used to have a lot of patients, as I’m sure all of us have, that would come in, you’d give them a comprehensive treatment plan, and they’d say, “I’m gonna go get a home equity line” or “I’m going to go transfer money for my savings” or “I’m going to transfer money from my retirement.”
There’s less and less of our patients are interested in doing those things right now. I don’t get much of any of that now.
Most of our patients choose to use the payment plans.
Financing Fees and Discounts
Okay. So, these are just a few examples. We have fees as low as 2% for patient financing, and we have fees that are as high as 22%.
The patients with a 22% merchant fee would have no option of getting their treatment done if we didn’t offer payment plans that charge us this high a fee.
The finance company also charges the patient a down payment based on their credit worthiness. So, the patient may be paying % to the finance company and then we’re picking up 22% as a merchant fee.
The risk for the finance company becomes much lower at that point, which is why they’re able to offer it to us. But we’re able to provide the payment plan option to the patient that has—maybe they haven’t been able to get any type of credit for years and all of a sudden they’re able to start to work on rebuilding their credit.
And otherwise, they wouldn’t be able to do it. And they’re so used to being turned down that they’re just truly happy to be accepted for something.
But, you know, having the ability to offer these options is obviously going to cost us as well. But the benefits outweigh those high merchant fees.
It’s important to set your fees accordingly. For us, being fee-for-service, obviously we can set our fees to whatever we want.
We figure that on average, there’s 10% coming off the top for merchant fees, whether those fees are credit card or payment plan related. So, we set our fees accordingly.
A patient with a $10,000 treatment plan using our most expensive level of financing is still putting at least $7,800 in our bank.
We’ve learned that our patients think that dentistry is expensive no matter what it costs. You may have patients that have a $15 copay that are complaining that they have a $15 copay.
We charge $495 for an extraction. Years ago, it was $295. Patients thought it was expensive when it was $295. They think it’s expensive when it’s $495.
We’ve seen no drop off in our patients accepting treatment based on what the treatment costs. Because no matter what, they believe that it’s expensive.
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Learn About the Presenter:
Daniel Schriftman, DAADOM
Daniel is a business manager and coach. He has his MBA with a focus on Human Resources.
Daniel coaches dental practices to run their business models more efficiently. He is the innovator of The Philadelphia Dentist, P.C., an emergency dental practice serving the Philadelphia community 365 days a year. Daniel has been in the dental industry for 20 years, and he is also a founder of Unicorn Professional Coaching, LLC, a burgeoning organization seeking to improve all aspects of the dental employer, employee, and patient experience.
Daniel is President of The Delaware Valley Dental Connection, a Philadelphia area learning network for anyone in the dental field. Daniel is a lifetime member of the American Association of Dental Office Management (AADOM) and earned his Fellowship (FAADOM) in 2020, his Masters (MAADOM) in 2022 and most recently, Daniel received his AADOM Diplomate (DAADOM) in September of 2023.
In his spare time, Daniel enjoys spending time with his wife and 4 sons. They enjoy rooting for their Philadelphia sports teams, fishing, spending time in Ocean City, NJ, and fostering animals.
Daniel has a passion for learning. He believes that learning the small things will lead to big successes in business and in life.
Daniel is considered an expert in all aspects of patient financing. He has piloted multiple financing programs for industry-leading companies. He has also written multiple articles on the subject. Daniel wishes to provide other office managers with the tools at his disposal to improve their practices through the art of sales and patient financing.
