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What 9 Years at the Front Desk Taught Me About Patient Payments

In short: Bry Walker spent nine years in a dental practice, five of them running a multi-location front office. The biggest payment problems she saw were patients denied financing with no backup option, financing disputes that cost the office money months later, and payments that had to be re-keyed into Open Dental. Multiple buy now, pay later options, financing that doesn't leave the office liable, and payments that post directly to Open Dental solve all three.

I spent nine years in a dental practice. I started as a dental assistant and worked my way up to office manager, and for five of those years I ran the front office for a multi-location practice. If you've sat at that desk, you know the job is never just one job. You wear a million different hats, and so does everyone on your front desk team.

Payments were one of the heaviest hats. Here's what I learned, and what I wish I'd had.

 

What happens when a patient is denied financing?

Patient financing is great when it works. A patient comes in excited to finally fix their smile; they get approved, and you get to watch them light up.

When it doesn't work, it's devastating.

We had a patient in her mid-20s who'd just been in a car accident. She needed root canals on her two front teeth. We brought her the tablet to apply for financing, and she was denied. Without another option, she was facing losing those two front teeth and looking at a bridge or something else entirely. She sat in our office and cried, and there was nothing we could do, because we only had one financing option to offer.

I think about her a lot. If I'd had two or three options to try, she might have gotten that treatment.

What does a financing dispute cost a dental office?

The hard part doesn't end when financing is approved. Sometimes it starts there.

We had a patient finance a root canal. She came back for her follow-up, and six months later she disputed the charge with the financing company. With that company, we had to keep the signed, inked copy of every receipt. It took me about an hour to find hers. Then we sent the receipt, the X-rays, the treatment notes, and the final photos.

The financing company sided with the patient anyway. Our office paid back all the money she'd financed. That wasn't a one-time thing: our office would lose money due to dispute cases like that one.

Multiply that paperwork across every financed patient, and you get a backlog that adds stress to people who already have too much on their plate.

 

Why doesn't the end of day match in Open Dental?

When payments come in through a separate system, someone has to post them into Open Dental. When the end of day doesn't match, someone has to go hunting for what's missing, and that someone is usually the office manager.

 

What would make patient payments easier for the front desk?

The problem I lived with

What FlexPayments changes

One financing option; a denial meant no treatment

Multiple buy now, pay later options give patients a better chance at approval

Disputes months later, sometimes paying the money back

With BNPL through FlexPayments, the office isn't liable for the patient's payments after they finance

Payments re-keyed into Open Dental by hand

Payments post and allocate directly in Open Dental

Patients had to create a login to pay online

Statements by text or email; patients pay with their date of birth

Any one of those would have been a lifesaver. Together, they'd have given my team hours back and given patients like her a real chance at the care they came in for.

 

For the office managers reading this

You do so much. You shouldn't also have to be the payment reconciler, the receipt archivist, and the person delivering bad news about financing. The tools exist now to take those hats off your desk.

 

About the author

Bry Walker worked in a dental practice for nine years, starting as a dental assistant and becoming office manager of a multi-location practice for five years. She now works at Flex Dental Solutions, helping Open Dental practices simplify front-office workflows.

 

Frequently asked questions

What can a dental office do when a patient is denied financing? Offer a second or third option. With FlexPayments, practices can offer multiple buy now, pay later options, which gives patients a better chance at approval.

Is a dental office liable if a financed patient stops paying? It depends on the financing company. With BNPL through FlexPayments, the office isn't liable for the patient's payments after they finance.

How do I stop re-entering card payments in Open Dental? Use a payment processor that posts directly to Open Dental. FlexPayments posts and allocates payments to the ledger automatically.

Can patients pay a dental bill without creating an account? Yes. With FlexPayments, patients open a text or email statement, enter their date of birth, and pay.

See how FlexPayments works in your Open Dental practice. Book a demo