Increasing Treatment Acceptance and Getting Paid

Get insight into how to present treatment to patients so they accept it and pay for it.

Updated 6/30/20

Imagine the impact increasing your patient treatment acceptance rate by 10-15 percent would have on practice productivity. Now imagine getting paid for those services in an efficient manner! These components have significant influence on practice growth and are critical to ongoing practice success.

Determine How Well You’re Doing

In order to track treatment acceptance increase, you must determine a baseline percentage. An important statistic to monitor is what percentage of treatment plans are currently being accepted. This means of all treatment presented, what did the patient actually commit to by making financial arrangements and scheduling the appointment?

As long as treatment plans are being entered into Dentrix, the administrative team can then compare the total treatment plan amounts to the total amount collected upon and appointed to get the treatment presented versus treatment accepted rate. The Case Acceptance section of the Practice Advisor Report provides you with all of these statistics, including the percentage of treatment presented versus treatment accepted.

If the Treatment Acceptance rate is below 75-80 percent, there is potential patient treatment that is not being appointed. Discovering where the treatment acceptance obstacles are and learning how to enhance treatment presentation skills will dramatically improve patient compliance to recommended treatment.

Set Up Office Protocols

The patient begins choosing the office the minute they contact the practice for an appointment. The patient is looking for a quality experience that indicates they are going to receive quality care. It is the responsibility of team members to help validate the patient in making the right decision to choose the office for their care. Eighty percent of gaining treatment acceptance is the ability to connect with patients in a relationship-based experience. People buy from people they like and people who make them feel as though they matter.

You need to design your office protocols to be good for the patient and be good for the practice. If your office systems and patient service skills can accomplish both, you will realize more success.

The Initial Phone Call

It begins with the initial phone call. This should be a two-way conversation to learn the patient’s expectations and discover how the practice may meet their needs as well as their wants. The call should also provide inspiring information about the practice, the doctor, and how well the patient will be treated in your care. Gathering data is secondary to making a warm and welcoming first impression.

Always ask permission before asking questions or providing information. “May I tell you a little bit more about our office?” or “So that I may schedule the proper appointment for you, may I ask you a few questions?” are excellent ways to initiate conversation. Use this time as an opportunity to discuss the level of care your office provides, how patients appreciate your approach to their treatment, and how they are cared for by doctor and team during their visit. Introducing your philosophy of care in an easily understandable way is the start of gaining better treatment acceptance.

The New Patient Examination

The new patient consultation and examination must be scheduled so appropriate time is provided to introduce the patient to treatment possibilities, excluding clinical procedures. It is important to establish a consistent consultation and examination process. The appropriate atmosphere needs to be created to give the patient an opportunity to share their concerns, expectations, and questions and for the dental team to be able to talk about potential treatment possibilities.

One of the main objectives of the new patient examination is to give patients the opportunity to meet the doctor and the team so they feel comfortable and confident they have chosen the right office for their care and to give them the information they need that helps them make the right choices in treatment. This may be done in a consultation room or treatment area. The important factor is that conversation with the patient about who they are, who the practice is, and what the practice offers for care ensues prior to treatment being performed.

Presenting Treatment

Using visual aids is important when talking to patients about treatment recommendations. This means “patient friendly” visual aids–keep the graphic dental visuals away from patient view. The majority of the population is made up of visual learners, which means they have to see what you’re referencing in order to understand. Photographs, intra-oral cameras, and other media improve patient communication. Showing patients before and after photographs of completed treatment (with smiling, full-faces pictures) helps them visualize the treatment for themselves.

The rest of the population are audio learners, which means they have to hear to understand. When you incorporate conversation and photographs or other visual aids into treatment discussion, your treatment acceptance rate is likely to improve.

Take time to talk to patients. Asking for a substantial dental investment on their part deserves time and attention. (And for some patients $500 is substantial.) Present the treatment as a solution to their problem or way to meet their expectations.

Avoid unnecessary details. Put the treatment plan in “patient-speak” and avoid a lot of dental terminology. If you have a treatment plan printed or on the monitor, use it as a reference. But speak to the patient, not the paper or the screen.

Always present the doctor’s preferred or ideal treatment option first. If you never tell the patient what your ideal treatment plan will be, they will never choose it. Once you present your treatment plan, give the patient an opportunity to respond. Be careful not to assume that silence is negative. Avoid giving them all the options at once. That may confuse the patient and they are likely to defer to the final option listed.

Listen with intent. There should be no interruptions when presenting treatment to patients. Body language is important. Sitting near the patient (not too close!) and leaning slightly forward signifies the conversation is important and the focus is on the patient. Avoid sitting too far away from, or with your back to, the patient, staring at the computer monitor, or studying models on an articulator. The focus should be totally on the patient.

Discussing Financial Information

When the patient asks “How much?” this signifies that they may be ready to proceed and prepared to work out the financial details. When they ask this question, provide their total treatment investment. If they want a breakdown by procedure, they will ask for it. Be prepared to discuss total treatment payment. When we assume patients are reluctant or have an issue paying fees, our confidence may falter. When that happens, our competence falters as well. Be confident in your fees and comfortable with your established financial protocols.

Your financial arrangements should be friendly to the patients and also fiscally sound for the practice. They should be designed to achieve a minimum ninety-eight or ninety-nine collection percentage. They should also be orchestrated to minimize the accounts receivable balance.

Establish the right atmosphere. Financial discussions should be done privately, away from the clinical setting. The course of treatment should have already been discussed and agreed upon. The decision to accept treatment happens with the clinical team. The financial team is responsible for negotiating payment.

Introduce your financial protocols in a way that shows how they benefit the patient. Present your ideal outcome first. If that means having the balance paid in full with a courtesy, offer that option initially. This may be an opportunity to explain that many patients take care of this with outside healthcare financing, offered in your practice. Wait until you present other alternatives so the patient has time to consider this option before you move on to your next preferred option. This continues until the patient has chosen a payment arrangement that will work for them and for the practice.

If the patient is asking for payment arrangements that are not offered or unsound for the practice, ask them to tell you what they had in mind. If it is unreasonable (small monthly payments on a large balance carried by the practice, for example), explain to the patient that the office can provide that service using outside financing, upon credit approval.

Sometimes a patient may say that they simply cannot afford the treatment, or don’t think they would get credit approval for healthcare financing. When that happens, thank the patient for their candor. Other financing options for these patients may be to pre-pay for their dentistry, or break down their payment per visit, not per procedure. Divide the total treatment plan fee by the estimated number of appointments. The patient would be required to bring in the same amount at each visit, regardless of the procedure being performed on that day.

Financial discussions are two-way conversations that requiring negotiation skills that are supported by consistent financial protocols that have been established for your practice.

Presenting treatment to patients so they accept it and pay for it requires skills training. The more prepared the dental team is in helping patients understand and appreciate the dental care being offered, the more confident and competent the team will become. Spend time learning how to talk to patients about ideal treatment. The patient will benefit from the outstanding care they receive and the practice will benefit from increased productivity.


Learn More

To learn more about treatment case presentation, read “Give Patients the Info They Need to Say Yes” or see “Printing treatment cases” in the Dentrix help files.


By Debra Englehardt-Nash, Co-founder The Nash Institute for Dental Learning

Debra Engelhardt-Nash has been in dentistry over 25 years. She is a trainer, author, presenter, and consultant who has presented workshops nationally and internationally. She was a contributing editor for Contemporary Esthetics and Restorative Practice and an editorial board member for Contemporary Assisting. Debra was also an instructor for the Central Piedmont Community College Dental Assisting Program and a guest instructor for Medical College of Georgia School of Dentistry. Debra is a founding member and former president of the National Academy of Dental Management Consultants. She is an active member of the American Dental Assistants Association and the American Academy of Dental Practice Administration. Debra has been listed in Dentistry Today as a leader in continuing dental education and dental consulting since 2005. She received the American Dental Assistants Association’s highest honor, the Kay Moser Distinguished Service Award, in 2008, and she has been chosen as one of the Top 25 Women in Dentistry for 2014 by Dental Products Report. Debra was the 2015 recipient of the Gordon Christensen Lecturer Recognition award, which was presented during the 150th Chicago Midwinter Meeting.

Originally published in Dentrix Magazine, Spring 2015