A New Fan of Membership Plans by Dr. Richard M. Yarbro

Dentaltown Magazine

99 percent of this Townie’s existing uninsured patients signed up for his practice’s new monthly payment plan

by Dr. Richard M. Yarbro

Insurance issues
One of the goals for my dental office is to financially accommodate patients who don’t have insurance. In the past, we’ve offered discounted rates on routine care and treatment, as well as opportunities to “stretch out” the maximum timetable for X-rays, exams, etc.

What we ended up with were patients who wanted to do things their way—bargaining for better pricing, refusing X-rays, refusing to come in at all or coming in only when necessary. Sound familiar? It’s “patient-led care,” which not only devalues the overall dental profession but also can potentially set your practice up for lawsuits.

Our office manager periodically brought up the idea of a membership plan, because over time we had seen more and more patients losing insurance benefits or ending up with inexpensive plans that didn’t offer much in the way of coverage. Patients who have retired or are on Medicare have little to no coverage but still desire—and deserve—good dental care. The “race to the bottom” by insurance companies who raise premiums, lower reimbursable rates and add lots of fine print to their plans frustrates staff and patients alike.

In early 2018, our office looked into implementing a third-party membership. I wanted to implement a plan that offered monthly payments, but because we have a small team I knew this would be a challenge. While researching what it would take to create a plan in house, I decided that it would take a substantial amount of internal effort to implement an in-house plan—extra effort that might negatively affect the quality of service to patients.

Some states also have a lot of legal red tape in dealing with plans like these, and keeping credit card information safely and legally on file is another potential headache. Having a different company follow through with payments that don’t clear would also be a huge plus for my office: I need my team to be focused on patient care and on providing a relaxed and excellent environment that garners patient loyalty.

Initial implementation
So far, the membership plan we set up in March 2018 with Kleer is entirely customizable: We use our fee schedule and can set different membership packages, including discounts for additional family members as well as a discount on treatment. Yes, we’re offering discounted rates to “full fee”-paying patients, but we’re also increasing retention and compliance. We still aren’t writing off as much as we are with insurance plans, so it benefits the practice’s bottom line in more ways than one.

Many membership plans available also incorporate customized marketing packages. There is a wealth of information out there regarding a patient’s lifetime value as well as what it takes to obtain those patients. According to one dental financial guru, the average patient revenue per year is $650, or a lifetime value of $4,500, and it can cost a practice $300–$500 to acquire that patient. With our membership plan, we pay $48 a year for that patient (and that number will go down as our membership plan patient numbers go up). When I factored in the extra salary to have a DIY membership plan, not to mention the legal red tape, it was a no-brainer decision for me.

Our practice is small and I hope to keep it that way—not only for my personal benefit but also to enable me to give my patients extra time and attention. Currently, we’re not looking to expand or grow the practice other than what’s necessary to maintain our status quo, so initially our focus has been on reaching our existing uninsured patients.

We did an email blast to all of our patients, using marketing material provided by our membership plan company, then followed up with a more detailed email to our uninsured patients. We also posted on social media a link to our personalized website about the membership program, and we use provided informative displays around our office. A portion of our monthly payment to Kleer decreases as we reach certain numbers of patients enrolled.

To help us implement our membership plan with more patients, the team reviews the next day’s schedule and highlights patients who currently have no insurance. They then have a script of sorts to inform those patients about what we have to offer before they’re seated for their appointments. We keep our initial contact short and sweet, informing them that we have a membership plan at a set low monthly rate, and it includes their dental care for the year, plus one emergency visit, and a discounted rate on all treatment. This allows them to ask any questions they may have without overwhelming them with information.

We’ve found most people are skeptical of any “deals” out there and wonder, “What’s the catch?” We allow the patients to think it over during their appointment and give them the opportunity to ask more questions when they check out. At this point, we can also give them the financial specifics of what their appointment would cost with and without the membership plan, and review any needed treatment and show them an estimate with their discounted rates displayed right on the treatment estimate. Patients typically sign up right there in the office, which our staff can easily complete during the check-out process. The patients then have access to their own portal, where they can change their personal information, update their method of payment, and see all of our fees and their discounts spelled out clearly. So far, it has been an easy sell for us, because it benefits the patients and simplifies the process for everyone involved.

Integral investment
Our uninsured patients save money in the long run, and the problems addressed earlier are resolved: Patients receive the care that I recommend, have a known discounted rate, and are more likely to accept my recommended treatment and recall guidelines. Many of our membership patients appreciate the option of paying for their full year in advance or having a low monthly rate. We’ve also had a few patients who had extensive treatment recommended but never came back to our office for treatment because they didn’t have insurance. They’ve since come back, and not only are they completing their treatment but they’re coming in for routine care as well.

The entire process has been easy on myself and our team. We work with one Kleer representative who knows my office well. I made a point to go say hello to their representatives at a convention last fall, and they knew who I was! Because it is a relatively new company, it’s still looking for feedback and ways to improve its services. Just recently, my office manager was asked to review some proposed changes to its web portal and the company seemed genuinely interested in implementing our suggestions.

We’ve had great success so far. Approximately 99 percent of our existing noninsured patients have signed up for the plan, and we’ve seen quite a few patients come back who had previously lost insurance and stopped coming in.

One patient in particular comes to mind: He’d been planning to call us and cancel his upcoming appointment because he’d lost his insurance when he got our initial email blast. He came skipping through the door on the day of his appointment, grabbed one of our display items and said, “Sign me up!” He was ecstatic that he didn’t have to cancel his appointment and could continue his periodontal maintenance cleanings at a monthly rate he could afford.

Bottom line: I truly care about my patients. I care about them receiving optimal dental care. I care about their finances, and I care about their experiences interacting with my office. While having a membership plan essentially does help my practice’s bottom line and keeps my team treatment-focused, I also appreciate having something that helps my patients.

Author Bio
Author Dr. Richard M. Yarbro, a native Texan, completed his undergraduate degree in cell and molecular biology at Texas Tech University and graduated with honors from the University of Texas Health Science Center in San Antonio School of Dentistry. After working in the community health clinic in Moses Lake, Washington, as part of a federal rural health program, Yarbo moved to Spokane, Washington, and opened his private practice. He is a member of the Academy of General Dentistry, the Washington State Dental Association and the Spokane District Dental Society, and also participates in a local dental study club. He lives in North Spokane with his wife and three daughters.
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