Why Your Surcharges Are Costing You 71% of Your Patients | Ashley Best | MME

Dec 23, 2024

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Navigating the financial intricacies of maintaining a dental practice can be challenging, and this Monday Morning Episode offers a timely conversation with Ashley Best, Director of Partnerships at Dental Intelligence, on just that!

Delving into the controversial topic of surcharging patients for credit card fees, Ashley provides a comprehensive look at why this practice might do more harm than good. She sheds light on the potential damage to patient loyalty and the complex web of regulations that complicate imposing such fees. Instead, Ashley advocates for refining payment processes to sidestep unnecessary costs while sharing insightful statistics on consumer attitudes towards these charges.

Ashley doesn’t stop at highlighting the problems; she offers actionable solutions that can redefine your approach to practice management. Listen in to discover alternative strategies such as renegotiating insurance fees or updating your fee schedule, all without alienating your patient base. For those practices that have already embraced surcharging, Ashley offers practical guidance on reversing this decision and regaining patient trust. This episode is a treasure trove of advice for any practice owners aiming to curtail costs effectively while nurturing valuable patient relationships.

What You'll Learn in This Episode:

The impact of credit card surcharges on patient loyalty.
Regulatory challenges related to patient surcharges.
Insightful statistics about consumer opposition to convenience fees.
Alternative strategies for managing practice financials without surcharging.
Effective methods for reversing already implemented surcharge policies.
Tips on negotiating with insurance companies for better fee structures.
How to reassess and optimize fee schedules in your practice.

Gain valuable insights into managing patient fees effectively—tune in now!

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You can reach out to Ashley Best here:

Email: abest@dentalintel.com

LinkedIn: linkedin.com/in/ashley-best-9052b022

Episode Transcript (Auto-Generated - Please Excuse Errors)

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Michaela: Hey, Ashley. So talk to us. What's one piece of advice you can give us this Monday morning.

Ashley: Thanks, Michael. Appreciate it. I thought long and hard about this and my biggest piece of advice for new practice owners, existing practice owners is to really take a look at your payment methodology in the practice. And I know we have a lot of doctors considering surcharging their patients for those credit card fees, which I'm the first to admit, like they're getting higher and higher, right? It's, a cost of doing business, but absolutely do not pass that charge along to your customer.

It's what's called surcharging to the patient mainly because of the impact that's going to have on the practice. I know it seems like an easy fix and a really quick way to. Avoid the processing fees that you're paying from those credit card companies, but there's a whole set of implications that come with it internally for the practice.

Things like requiring you to notify the credit card companies. If you're going to do this me. Can't just start doing it. It's illegal in some states. And so not knowing your state's legality can get you into some trouble there. And then. Furthermore, you do have to display specific signage in the office. And so it's not one of these things where you can just try to slide it in and hope it has to be its own line item. Right. So the press see it anyway on the statement, but you have to publicly display that.

And what worse way to commoditize your practice than having that little plastic sign that says we're passing along our fees to you.

Michaela: Yeah. Interesting. So have you seen this? Spike, a lot recently practices asking about this asking you actually, how do I present this to the patient?

Ashley: I have.

Yeah, absolutely. Yeah. Started in dental marketing from 2015 to 2021. And in those six years, I cannot tell you I was ever asked about this once. And I know there are companies out there that do, that's a piece of their software in terms of payments is to push the charge over to the patient. So I think that's why it's becoming top of mind because they're hearing it at shows, Hey surcharge, surcharge, and it's top of mind. But what I don't think they've thought through completely in the conversations that I've had is the implications losing patients being a big one. There's actually a study done that said 71 percent of small business customers say that they try to avoid companies that charge a fee to use their credit card. So that's a big number. That's a huge number. 57 percent of consumers think it should be illegal. So we're talking about a big number here. It's not just a few people that are passionate about it in consumer landscape. And making sure that they're following the guidelines if they do it. So you have to cap it at whatever rate you're paying.

So if your 2 percent and you come display a sign that says 3%, like my nail salon does, Again, I don't need Dennis out there that wants to be seen as a commodity or like a nail salon, or that is a commodity. Right. And that's where I see it in my day to day at my nail salon. So 3%, believe 3 percent is the cap, and it's only eligible for credit cards.

Can't do it on debit cards, my nail salon. They're trying to do it on debit. It's like they don't know the ins and outs of it. And they're so it's a can of worms in my opinion, not to mention the fact that patient loyalty is going to just dissipate. I firmly say if I walk into my dentist next week for my appointment and this is displayed, I'm finding a new dentist and I really like my dentist, but I'm with 71 percent of consumers that think, wow, I'm going to avoid. And I don't know that the offices that I've spoken to about have thought through the domino effect of what's going to happen it's a cost of doing business. It just, unfortunately, I encourage them to take a look at their fee schedule the last 10 years in dentistry. I have offices who. They haven't raised their fees, obviously for their fee for service patients. When insurance is involved, it's obviously fee negotiations there and their fee schedule with insurance. But even then there's opportunity. There's companies out there galore that will help you negotiate higher fees with insurance. SoLet's put it this way. If I go to my dentist next week and they've negotiated 3 percent higher fees with insurance or I'm paying out of pocket because I'm fee for service, I'm not going to notice that. But what I am going to notice is that Sign on the plexiglass that says I'm paying for your credit card processing case.

So let's just avoid it. If you want to be seen as a trusted advisor, you want to set yourself apart from the competition. There's so many dentists in your area, right? I don't want to be seen as a commodity. What's my unique selling proposition? How can I offer a service to patients?

This is just not the way to go about it.

Michaela: So then If you don't mind me asking, Ashley, what's the emotion behind it? Like the surcharge, is it more like, I don't want to pay that extra, however much dollar amount, or is it more like you can't cover this. You can't cover this for me.

Ashley: I think it's the latter.

Yeah, for me, 3 percent of whatever number. Now, I will also add to that, Michael, I have a pretty healthy mouth. So 3 percent of my fees, what I'm paying, it's probably a small number. But to me, it's more about the principal. But if I'm coming in for a big case, and we're talking a big number, 3 percent of a really big number, That's impactful to people's pocketbooks.

It just is. So for me, it's the emotional side of it. And like, come on, really, for me personally, just because I'm not investing thousands and thousands of dollars at my dental practice, but there are people who are.

Michaela: Yeah. No, that makes a lot of sense. I know, for example, whenever you order something, at least I do this, I don't know if you do this actually, but like there's Amazon or something, and you make a big purchase or Let's just say like big purchase, like a car, right? Not an Amazon, but a car. And then they try to do the little, Oh, the shipping is this. And you're like, Oh my gosh, nevermind. I mean, but it's like, like a little small fraction of the whole thing. And technically we're like, we're already paying this.

We should pay for that.

Ashley: Right.

Michaela: But that ops me out. It's the mentality

Ashley: of it. You know what? I had this conversation with girlfriends and they'll go shopping online for clothes, whatever, spend a couple hundred bucks and then go to checkout and it's 7. 95 to ship it. And they're like, no, I'm done. Like they don't check out. And we're like, why it's 8. We were going to spend hundreds on clothes. And it's the, frankly, I would rather that sweater cost 7 more and the shipping be free. There's something about the mentality. It's just, I can't get around it. It's really hard for me. And I think there are others who have the, same thought as I do on it, and then let alone the people who are spending big bucks at the practice and then realizing, oh my gosh, now I have to cover this 2 percent fee that you're trying to pass along.

Michaela: Okay. Is there ever I guess for someone who has already, they're listening and they're like, Oh, yeah. Oh my gosh, Ashley, I've started doing this a year ago though, and they have been seeing the drop off or they have been seeing the negative effects. How can they just stop doing it? Is that it?

Do you just stop doing it and that's it? And take off the sign? Or?

Ashley: That's a great question, Michael. I don't know the ramifications with the credit card companies. If you chose to reverse this, if you saw the negative implications and said, Oh, I made a horrible decision. I can't imagine the credit card companies are going to be upset about that because if you think about it from the credit card company's perspective, what you're doing is encouraging that patient to pay by cash or debit card or write you a check. So the credit card company wants their processing fees, whether it's coming from the doctor or the patient. So my guess and total speculation is. It's not going to be too hard to just stop doing it, which obviously, other things involved, like you're going to have to probably obviously get rid of the signage, but then redo the way that your current setup is because when you collect that fee from a patient, you're not actually collecting what the fee was. It's above and beyond. So reconciling that with the practice management system is a beast too. And so there are systems that probably do it for them, but if not, and they're just going rogue and surcharging there's a bigger set of complication there because if your total bill, Michael's supposed to be 1250, we placed a crown and it was 1250, you're paying out of pocket, and then that's added on you're collecting a different amount than the balance that was actually due, if that makes sense. So to reconcile that in the practice management software, because the office is walking that 1250 out onto the patient's ledger and then collecting. 1250 plus. So that's just a nightmare. If the software is not doing it for you, but I would argue even if it is, there's ways to stop doing it.

You're not locked in to doing it, and I'm sure there are people listening that are trying it and haven't seen a huge drop off. Maybe their existing patients are staying and they do have loyal patients and that's great, but how many new patients are not coming? They'll never know. You'll never know.

can't tell me just because I didn't leave. If my friend says, Ashley, I'm thinking about going to Dr. Smith. Is he great? Is she great? I'm going to say, yeah, but guess what? They pass along their credit card fees to you. They might go somewhere else. So that wasn't necessarily a loss.

I didn't leave, but I prevented three of my friends from coming as new patients. So I think there's things that you can't track. You'll never really know the extreme implication, but I think there's a lot.

Michaela: Do you ever think there's like practices that say this is minuscule or small.

We just need to care more, do more, be better, streamline the process better, or present the surcharges in a way that the patient's kind of like, Oh yeah, of course. no problem.

Ashley: how would that sound? I can't think of a way to make it not sound like it's about me because as a patient and humans in general, it's what's in it for me. maybe I'm just like got my blinders on. But if you're a patient, Michael, I articulate that to you in a way that didn't make you feel like it was me? Me, me, me.

Michaela: Yeah.

Ashley: About my bottom line so much that I'm willing to pass that charge on and potentially lose you as a patient or prevent you from referring others.

I don't know how you articulate that well.

Michaela: Yeah, that's true. Yeah.

because if you are doing it, there could be a good way to articulate it well that you're not doing it anymore on behalf of them or something like that. You know what I mean?

Ashley: Potentially, yeah, yeah. I was going to say the places that I've frequented or seen this happen, it's never been verbally articulated. It's always that sign that says, If you pay by credit card, you're going to pay a 3 percent surcharge. You're paying a 3 percent fee. Never have I ever had a conversation. It's never come up and I'll see it and roll my eyes and like, okay, like it is what it is. Like you're at the nail salon. I'm going to keep using that. Cause by the way, that's the place that does it in my neighborhood. I, Don't have any medical providers that I see doing this.

I will tell you that dermatologist, dentist, my eye doctor, none of them are doing this. So that's great. But the nail salon, like your nails are already done and you don't have cash. What are you going to do? you're going to pay the 3 percent you are. But it's never been a conversation.

So I don't know how you articulate that you're. Starting to do it and make it not sound about you and, kind of self centered from the practice perspective, but I can see your, point of view, if they stop doing it, being able to say, Hey, we tried that we care so much about our customers.

We're actually not going to do that anymore. We're waving it. Yeah. However you want to articulate it. But yeah. think that would come across well. I just don't know of a way to deliver that message when you're doing it.

Michaela: No. Yeah. But it's interesting. I like this topic because I remember seeing it a couple of times in a couple of Facebook groups. And that's when it was like made aware that, Oh yeah, it is. a pain point that practices are experiencing. And I guess it could be an easy pain point that you just erase. If you're just, Hey, this is the cost of doing business. Like we gotta eat it right.

Ashley: Yeah. There's so many other things they make that exception for in their practice.

When you think about everything that they're investing in, there's lots of things they're making exceptions for and costs of doing business Make this one of them, right? find other ways to get that, like literally hire a company to negotiate your fees for you. There's so many good ones out there.

I've seen some awesome ones. And then taking a look at your, fee schedule for your fee for service patients. Not that you're penalizing them for being fee for service, but looking at it from both angles or finding an area in the practice to save. think if a doctor sat down and have partners that I work with that do this, they do an analysis of your spend and where everything's going and try to, make things more efficient, start there before you just default to, Hey, I'm going to just pass that along to the patient is my advice.

Michaela: Yeah. Any specific companies that you recommend that can help with negotiating?

Ashley: Yeah. Yeah. We have a few, I won't throw any out just because there are so many, I don't want to seem like work with all of our partners and I have another team that works with our partners. So I definitely don't want to seem like I favor anyone else over the others.

But yeah, if you Google dental fee negotiation The good ones will pop up. I've done those searches recently and the good ones are kind of rising to the top, but yeah, I mean, offline, if somebody wants to shoot me a message on LinkedIn or, something like that, I'm more than happy to provide a few resources, but there's plenty that I've been doing it a very long time actually.

And they're really good at it. So I would love for practices to start there if they're able to, obviously there comes a fee with that too, but I think the benefits outweigh the fee or the negative there. So,

Michaela: Yeah. Awesome. Ashley, I appreciate your time. And if anyone has further questions, you can definitely find it on the dental marketer society, Facebook group, or where can they reach out to you?

Ashley: Yeah. LinkedIn's great. I'm very active on LinkedIn. It's Ashley best director of partnerships at dental intelligence. If you're trying to find one, I don't know if there's too many actually best out there seems like a common name shoot me an email. You can always email me a best at dental intel.

com. I'm happy to answer questions provide referrals or references to the companies that I know do this really well with practices.

Michaela: Awesome. Awesome. So that's going to be in the show notes below. And Ashley, thank you for being with me on this Monday morning episode.

Ashley: Thanks for having me, Michael. Take care.

Why Your Surcharges Are Costing You 71% of Your Patients | Ashley Best | MME

What You'll Learn in This Episode:

You can reach out to Ashley Best here:

Other Mentions and Links:

Episode Transcript (Auto-Generated - Please Excuse Errors)