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Financial


New Payment Policy

Date

Patient Street Address City, State Zip

Dear Patient:

We value our patients, and want to do all we can to control costs. I am pleased to let you know about our new payment options, which will help provide you and your family with payment options so you can receive the dental treatment you need.

To help keep your costs low, our dental office will be using a new payment policy. You may pay for treatment with one of the following plans:

1 The total sum of treatment is paid by check, credit card, or a healthcare credit card such as CareCredit®.*

2 The initial payment is 1/2 of the total sum. The balance is paid at the completion of the treatment.

3 The initial payment is 1/3 of the total sum. The balance is paid in two equal monthly installments.

4 The initial payment is 1/4 of the total sum. The balance is paid in three equal monthly payments.

If payment is not received by the [date] of each month, it is the office policy to add a late charge of $[amount] to the balance.

If you have a dental benefit plan, you can authorize the insurance company to pay us, and we will let you know about the balance of the bill. We appreciate your understanding of this policy. We look forward to continuing to serve you and your family’s dental health needs!

Sincerely,

Dentist

* Subject to availability/approval

Change in Charges

Date

Patient Street Address City, State Zip

Dear Patient:

Our office works hard to keep costs down, and has not changed its fees since [date]. However, due to rising costs, we must increase our fees by [percent amount] percent to keep our high standards of care. To help you, we offer many different payment plans to make it easier to pay for dental care.

For your convenience, our office offers the following payment plans:

1 The total sum of treatment is paid by check, credit card, or a healthcare credit card such as CareCredit®.*

2 The initial payment is 1/2 of the total sum. The balance is paid at the completion of the treatment.

3 The initial payment is 1/3 of the total sum. The balance is paid in two equal monthly installments.

4 The initial payment is 1/4 of the total sum. The balance is paid in three equal monthly payments.

Thank you for your continued support of our office. Please call us at [office number] if you have any questions.

Sincerely,

Dentist

* Subject to availability/approval

Payment Options for Extensive Treatment

Date

Patient Street Address City, State Zip

Dear Patient:

As we discussed during your last visit, your condition requires rather extensive treatment. Because you are a valued patient, we would like to help you by offering a payment plan to best fit your needs. Below is a list of our payment plans. Please look them over and let us know which plan works for you:

1 The total sum of treatment is paid by check, credit card, or a healthcare credit card such as CareCredit®.*

2 The initial payment is 1/2 of the total sum. The balance is paid at the completion of the treatment.

3 The initial payment is 1/3 of the total sum. The balance is paid in two equal installments during the course of treatment.

4 The initial payment is 1/4 of the total sum. The balance is paid in three equal monthly payments.

Payment is due by the [day] of each month. If payment is not received by the [date], it is the office policy to add a late charge of [dollar amount] to the balance.

Please call the office at [office number] if you have any questions. We look forward to providing continued treatment to you and your family. Thanks again for choosing [practice name] as your dental provider!

Sincerely,

Dentist

* Subject to availability/approval

Introducing Patients to CareCredit®

Date

Patient Street Address City, State Zip

Dear Patient:

We at [practice name] promise to provide you with quality dental care, which includes offering flexible payment plans for our patients. This is why we’re excited to offer CareCredit®, the credit card just for healthcare. CareCredit is an option that lets you pay with convenient monthly payments over time.*

We made the decision to accept the CareCredit healthcare credit card because it offers many more payment choices than we can offer our patients directly. Please read the enclosed brochure about CareCredit to decide if you wish to make payments using CareCredit. There are three ways you can apply for a CareCredit credit card:

1 Standard. Complete a simple and brief application in our office.

2 Online. Visit CareCredit.com and fill out an application.

3 Automated Phone. Call 866.677.0718 and follow the prompts.

Any way you choose to apply, you’ll receive a credit decision almost immediately. Please tell us right away if you qualify so we can convert your current balance to CareCredit. Please call our office at [office number] if you have any questions.

Sincerely,

Dentist and Team

Enclosure

* Subject to credit availability/approval

FACEBOOK POST

Number One Dental

Our practice is excited to offer CareCredit®, the credit card just for healthcare. CareCredit is an option that lets you pay with convenient monthly payments over time, subject to availability and approval.

We made the decision to accept the CareCredit healthcare credit card because it offers many more payment choices than we can offer our patients directly. Please visit www.carecredit.com for more information and to apply.

Cost Estimates

Date

Patient Street Address City, State Zip

Dear Patient:

At your previous appointment we talked about treatment for [condition]. As a valued patient, we believe it is important for you to know approximately what the cost of treatment will be. Enclosed is our cost estimate for your review.

Remember, this is an estimate only. During the course of treatment, other procedures may be needed, and sometimes complications arise that call for additional procedures or treatment. We will always tell you of any changes.

Please look at the estimate. Give us a call at [office number] to talk about the estimate and payment options. I am confident that we can set up a payment plan that will work for you and our office. We look forward to providing you with excellent dental care.

Sincerely,

Dentist and Team

Enclosure: Treatment Cost Estimate

Delinquent Payers (1-30 Days)

Date

Patient Street Address City, State Zip

Dear Patient:

Recently, we sent you billing statements on [date] and [date]. We offer billing as a special convenience to our patients, and would like payment of the balance of the enclosed statement by [date]. If for any reason you cannot pay the balance or if you have any questions, please call us as soon as possible at [office number].

If you have already mailed your payment, please disregard this letter.

Sincerely,

Dentist

Enclosure: Billing Statement

Delinquent Payers (31-60 Days)

Date

Patient Street Address City, State Zip

Dear Patient:

We recently sent you a third billing statement regarding the balance due on your account. Since your account is more than 30 days old, it is important that payment be received by [date].

If you cannot send a check or use a credit card to pay this balance, please call me at [office number] immediately. We look forward to resolving this matter as soon as possible without involving a collections agency.

Thank you for your cooperation, and we look forward to receiving your payment soon.

Sincerely,

Dentist

Delinquent Payers (61-90 Days)

Date

Patient Street Address City, State Zip

Dear Patient:

Your account with us is [number of days] overdue. We have contacted you on [date] and [date] by letter and on [date] and [date] by telephone. We will turn this account over for collection unless we receive payment in full by [date]. Please contact my office immediately at [office number]

Dental Letters: Write, Blog and Email Your Way to Success with CD-ROM

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