Telling a patient that their credit application was denied can be one of the more uncomfortable aspects of making financial arrangements. If not handled correctly, the patient feels embarrassed and it can get awkward.

More importantly, it could also mean that the patient won’t get the treatment they need to improve their oral health. A patient who was “on board” with their treatment plan just a few minutes ago suddenly had the wind taken out of their sails.

That said, if you handle this correctly, it doesn’t need to be awkward and it doesn’t need to mean they can’t still make arrangements to get the treatment they need.

In this post, I’m going to give you a few tips to make the financial discussion easier.  It should be comfortable for all parties and you should be able to confidently shift to a “backup plan” if a patient isn’t approved for financing.

(Related: How Much Should a General Dentist Produce Per Day?)

As an aside, full training for the Financial Coordinator position (including how to handle financial arrangements with patients and third-party financing) is provided in the Financial Coordinator Training Course on our on-demand video training platform, DDS Success. If you want to improve in this area, I’d definitely recommend you check it out. For a free demo of the platform, click here.

Beginning the financial discussion:

When it’s time to make financial arrangements, the first thing I would do is tell the patient the full amount and ask, “How would you like to pay for that?” (Alternatively, you could ask, “How would you normally pay for something like this?”)

They may say, “I could use a credit card,” or “I’ll write a check.”

…Or they may say, “Wow, that’s a lot more than I expected. I have no idea how I could pay for that.”

In this case, you can ask them, “Could you put it on a credit card?”

(Related: What is Your Hygiene Department’s Maximum Potential?)

Then this opens up into a discussion about payment options. You may suggest some other ideas.

I don’t bring up lending companies immediately as the first option. I would usually explore other options before bringing up financing, unless the patient asks if they can do financing, in which case we’ll get right into it.

And if you go over some other payment options first, then if the financing doesn’t go through, you may have other options to fall back on.

One “tell” that the patient isn’t really sold on doing the treatment is that they don’t participate in trying to come up with a solution.

Ultimately, it’s the patient’s responsibility to figure out how to pay for the treatment—not yours. And if a patient truly wants to do the treatment, they will try to come up with solutions.

So if they won’t give specifics and just say general things like, “I can’t afford that right now,” and deflect—then it’s possible there is another reason they don’t want the treatment (fear of needles, had a bad experience, or simply don’t really understand the importance of the treatment). The money is an easy way out.

So if you pay attention during this part, it’ll tell you if money really is the problem or if you need talk with them a little more to find out what the real barrier is and get them truly on board with the treatment.

Before submitting the application:

When you bring up lending options with the patient, I have two pieces of advice:

  1. Work with multiple lending companies. There are several out there (CareCredit, Lending Club, GreenSky, etc.). More companies mean you’re more likely to get the patient approved. And several companies have options for loans with interest, even if the patient isn’t approved for an interest-free loan.
  2. Prepare them for the possibilities and frame it in a way that they won’t be let down if it’s not immediately approved.

I don’t just tell the patient they may get approved or disapproved. I wouldn’t frame it that way.

I would explain to a patient that all the lending companies have different criteria and you never know. So, we may submit to multiple companies, and they may provide the money now or they may ask for a cosigner.

(Related: How Your Hygienist Can Help You Increase Case Acceptance)

If they are denied:

Not getting approved is not a big deal. So just treat it as a normal everyday occurrence. If you’re casual about it and just get right into finding a potential cosigner, then it won’t seem like a big deal to most patients.

Conversely, if you feel awkward or immediately start sounding sympathetic or like your walking on eggshells, then they’ll pick up on that and it’ll be more embarrassing for them. So just move on, business as usual.

If the patient is dismayed about it, let them know it happens. I wouldn’t’ get into a huge discussion about their credit as a) it’s information that you’re not privy to anyway – it’s between them and the credit bureau (or finance company), and b) Unless the reason for disapproval is stated as such (which it normally wouldn’t be), you probably don’t even know why the patient was disapproved! Could be any number of reasons – amount of debt, cashflow, length of credit history – who knows? All you know for example is the company requested a cosigner. Well, this happens from time to time. Keep it upbeat and  find out who the patient  could call to cosign.

Setting up a cosigner is quite easy. A quick phone call and within 10 minutes you’ve got a cosigner and reapplied.

Find out if they have a parent, a sibling, a friend, etc., that would be willing to help. Most people have someone they could at least call and ask.

If the patient is hesitant to ask, explain how it works. Find out if the patient can handle the estimated monthly payment, and if so, the cosigner won’t be paying anything.

When the conversation can become awkward:

If you’ve been reading this and thinking, “Geez, I don’t want to feel like I’m badgering the patient and asking personal questions about their finances or who they could ask for help…” then this is a key point to remember:

You should only be having this conversation if the patient wants the treatment and is working together with you to solve the finances so they can start.

If the patient is trying to help come up with solutions, this won’t be an awkward conversation at all and will flow naturally.

People with poor credit still have a car, a new iPhone, etc, that required lending. They were able to figure out a solution for those things because they wanted them. If they want the treatment, they’ll come up with a solution for it if it’s possible.

On the other hand, if the patient isn’t forthcoming with you and doesn’t seem to want to come up with ways to get the money together—then I wouldn’t badger them with these questions. I would go back to reviewing the treatment plan and finding out why they aren’t fully on board with doing it.

We cover how to do this at the MGE Communication & Sales Seminars, which are essential for both the doctor and Financial Coordinator or Treatment Coordinator.

If you’ve tried everything and the patient absolutely cannot get approved for lending:

A small percentage of patients just won’t be able to get financed or be able to pay for their treatment plan – no matter what is tried. Hopefully there’s another solution; if it’s urgently needed treatment that will impact their health, then perhaps a family member can help or they can arrange a way so get the money together in the next few weeks or months.

Depending on what the treatment is, you might be able to start with what is needed now and go from there.  Again – depends on the case. And keep in mind that this will not be the majority of patients. Despite a patient claiming, “they can’t afford it,” in many cases they can.  They just don’t understand why they need it! And thus, don’t want it! That said, there will be a small percentage of patient who truly can’t and you may be able to,  depending on what’s needed, do the treatment plan in pieces.

One thing I will say is that I don’t recommend going to great lengths to provide payment plans where you are trying to collect the money in lengthy installments after the treatment is delivered. Your practice is not the bank. Trying to become your own lending company can be a major financial liability and creates a ton of extra work and staff hours down the line. It’s not worth it.

I hope this helps! If you’d like to learn more, don’t hesitate to reach out to us at (800) 640-1140 or fill out this form to schedule a free practice analysis and consultation today.


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