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My Financial Policy Helped Me Become the "Good Guy" Dr. Richard Rosenblatt

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My Financial Policy Helped Me Become the "Good Guy"



by Richard Rosenblatt, DMD

The costs of delivering quality dentistry are going up, yet insurance benefits aren’t interested in keeping up. In fact, for more than two decades we’ve seen little change in insurance benefits from the majority of insurers, and at a $1,000 yearly maximum, it doesn’t take very many procedures for that to disappear. Insurance-driven patients are accepting less and less dentistry because they either cannot or do not want to pay for the care they truly need. They are married to what their insurance has determined as necessary, or in their terms “usual and customary,” based on an out-of-date yearly cap.
Unfortunately, dealing with insurance and patient expectations always makes me look like the bad guy. I’m the one who is making it difficult for patients to receive the dentistry they need. Some might even believe that I’m recommending treatment that is not necessary just because their insurance doesn’t cover the cost. That’s when I decided to develop and implement a firm written financial policy, which helped me go from the “bad guy” to the “good guy.”

The Purpose of a Financial Policy

A financial policy is paramount to the survival of any practice. It is unfair to the patient and to your practice to perform any type of treatment without clearly communicating a financial policy. A written financial policy clearly communicates to patients the “what, when and how” so that the expectations of our team and the expectations of our patients are the same. The “what” is what their financial responsibility is for the dental care they receive. I know that, in many offices, insurance is a large component of their practice and they rely on it for a certain percentage of their income. But, in my experience, it is a very hard fight to make patients understand that their insurance is merely a subsidy and why there is nothing we can do to increase their benefits. When I began developing my financial policy, my first goal was to disconnect insurance benefits from quality dentistry in the patients’ minds. Of course we strive to maximize our patients’ benefits, but we are also working hard to make sure they understand that what insurance covers is not necessarily the ideal treatment. So, if there is a gap between the cost of care and insurance benefits, the patient clearly understands that this portion is their responsibility.

The “when” lets the patient know when we will be collecting payment. Our financial policy lets patients know that they need to be prepared to pay prior to treatment. I often remind my team that I don’t want patients walking out of the office owing me money for dentistry that’s already been done. If we allow that to happen, it will cost me money to get my money and that doesn’t make sense at all. For larger cases, we have included the option to pay in thirds, but the case will not be delivered until the final payment is made.

That leaves the “how,” which is the payment options your patients can choose from to pay for their dental care. In my office we use technology to show patients what’s going on in their mouths so they can take ownership of their oral health. When they see decay enlarged on a screen, their eyes widen and you know they are beginning to understand the treatment we are recommending is the treatment they need, regardless of their insurance benefits. Then, when we present the fee, their eyes open wider, now with hesitation and fear. The fear isn’t of the dentistry they’ll need, it’s a fear that it will be difficult for them to come up with the payment.
How to Create a Financial Policy

Step One:
Create an "internal financial policy." Meet with the entire team and discuss every possible payment scenario. Write down the practice's protocol for handling each situation.
For example:
  • How do you handle emergency patients who do not have insurance?
  • If the insurance company denies a claim or is slow in paying, when is the patient responsible for the fee?
  • Is there a charge for cancelled appointments?
  • Do you offer a courtesy discount for payment in full prior to treatment? If so, at what treatment fee amount?
  • How do you handle payment for an "absent" responsible third party?
Step Two :
From the “internal financial policy” create a “patient payment options form” which outlines the most common payment options including cash discount, credit cards, and payment plans like CareCredit. Also include your policy on collecting insurance payments. This form is used during the treatment and fee discussion.

Step Three:
Practice presenting the “patient payment options form” through team discussion and role playing and include the “patient payment options form” with your new patient information packet and on your Web site.
 From Bad Guy to Good Guy
The options we offer patients as part of our financial policy have turned me from the “bad guy” into the “good guy.” Of course we accept cash, checks and major credit cards like Visa and MasterCard. But the gap between insurance benefits and treatment fees is getting larger, so for most patients, any treatment fee more than $500 is difficult to manage with just these payment options. That’s why we made the decision to add an outside patient payment plan, so we could be the hero and make it easy for patients to accept our treatment recommendation and achieve their oral health goals. We brought in CareCredit, an easy-to-use program that offers patients several payment options including no-interest and low-interest plans. I’ve talked with several doctors who have been practicing for years and are very stubborn about offering patient financing. They say they aren’t going to let some company take a percentage of their hard work, but what that means is they will either lose the case up front, so they’ll make no money at all; or they extend credit themselves, which will cost them the same amount or more. I will gladly pay $50-$100 to get a $2,000 case any day. I make more money that way and I’m no longer the “bad guy” who is telling my patients “insurance won’t cover the treatment, so you need to come up with money or I’m not doing the dentistry.” With CareCredit, if patients find it difficult to pay with cash or check and don’t want to max out their credit cards with dental care, I have another payment option that can help them get the dentistry they want and need, without having to wait.
How to Effectively Implement a Financial Policy

The thing about having a financial policy is that it needs to be shared with patients comprehensively, not in parts. Our dialogue with the patient goes something like this:

“Mrs. Jones, your portion of the cost for your treatment that we’ve discussed is going to be $1,200. To make it as easy as possible for you to get healthy, we’ve created a financial policy that gives you several convenient ways to be able to schedule your next appointment. As you can see, we do require payment prior to treatment and we are happy to provide you with all the necessary documentation so you can get reimbursed from your insurance company.
  Of course you can pay with cash or by check, and we do accept Visa, MasterCard and American Express. We also work with a company called CareCredit, which is a line of credit exclusively for your healthcare needs. The payment option that is popular with so many of our patients is the 12-month, no interest plan. You can pay for your dentistry over the next 12 months and there will be no interest to you… we cover it for you. If you’d like even lower monthly payments, if that’s your preference, there are options up to 60 months with a low interest rate – probably lower than your Visa and MasterCard. We really want to make it easy for you to get healthy. Which option are you interested in?”
With this dialogue, we clearly communicate our policy and provide patients with payment options before they get stuck on the cost of the dentistry. Then we have them sign the treatment plan, which includes the payment option they have selected and details the agreement of when that payment is due. If they are interested in CareCredit, our front desk gets them immediately approved, which makes it even easier and quicker for patients.

A lot of doctors get into trouble when they go to implement a financial policy because they – or their team – want to please the patients more than they want to protect the profitability of their practice. I don’t allow my team to make the financial policy “flexible.” It is not their role to make financial judgment calls for my practice. If I choose to let a long-term patient take a little longer to pay for his or her treatment, it only affects my income, not my team’s. Their paycheck is not as closely tied to practice profitability as mine is. Now, in practices that have a full-time treatment coordinator, giving more responsibility and flexibility to offer additional payment options might be a good idea, especially if that team member’s compensation is tied to a production goal.

It’s hard to imagine that simply developing and implementing a firm financial policy can improve production, profitability and even patient satisfaction, but above all, it’s improved my own personal and professional satisfaction. I get to do more of the dentistry I like doing, I’m not restrained by insurance benefits, and my patients appreciate that I’m upfront, honest and am doing everything I can to help them achieve oral health. That not only makes me feel good, it makes me the “good guy.”
Author’s Bio
Richard Rosenblatt, DMD, is a graduate of the University of Medicine and Dentistry of New Jersey, and practices in Lake Forest and Chicago, Illinois. He completed a General Practice Residency at St. Joseph Medical Center in Reading, Pennsylvania. He has lectured internationally on CEREC – CAD/CAM computerized dental restorations. Dr. Rosenblatt is active an active member of the American Dental Association, the Illinois State Dental Society and the Chicago Dental Society. He is also a member of the Lake Forest Chamber of Commerce.
Dentaltown Magazine
September 2025
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