Dentaltown January 2017 - 44

orthodontics
message board

drscoles
Post 19 of 115
Member Since: 09/28/02

I think you are focusing on the wrong thing. This is an elective procedure. Most people
"want" it. Tell them they "might get some insurance reimbursement, but it costs $4,500. How
would you like to pay?" Don't put an emphasis or get hung up on insurance coverage. I'd say half
the people I do Powerprox on have insurance; the rest are doing it because they want it, period.
I disagree with the part about having the patient pay up front, because orthodontists don't
make you pay up front. I started losing Invisalign cases to orthodontists solely because of the
payment policy. I'm doing the work over time-why shouldn't I be paid over time? It makes
your A/R's kind of confusing, but that's the way it goes. I set up a different provider for ortho
procedures and pull that provider out of the A/R's when I want to look at them.
Are you uncomfortable with the case presentation aspect, or physically doing the work? If it's
the latter, do a few discounted cases to get your feet wet. ■
3/9/2010

drrick
Member Since: 03/19/00
Post: 22 and 27 of 115

Related Message Boards
Powerprox or Invisalign
Powerprox Invisalign

How Do I Know If I Can
Charge Patient for
Insurance Downgrades?
Charge Downgrades

Wow, half of your patients have insurance! Most of mine do not-maybe 10-20 percent or
so. Most have around a $1,000 max. We always get the full max. It is definitely a wants-based
procedure. People pay for what they want, regardless of insurance, for stuff like this.
I used to allow payments, too, but what a nightmare-people showing up without money,
etc. Plus, $4,200 divided by six = $700 per month, which not everyone can afford, but 12-month
interest-free through outside financing is $350 per month, which is much more reasonable.
The advantage you have over Invisalign is everybody and their brother does Invisalign, but not
everyone does Powerprox and patients want fast ... and will pay for it.
I was going to do monthly payments: I would charge a down payment plus the first visit fee,
then each monthly visit would be prepaid. In other words, they pay monthly for the next appt.
This way if they show up without their payment, you can still see them that day but they would
not get to reappoint until they paid the next payment.
This avoids the whole "financial wire" situation or patients disappearing during treatment.
Plus, patients are always less happy when they owe you money. How many people complain
about their dentures or veneers if they still owe you money?
You can still charge for records, retainers, etc.
Sadly, there is no code for "cosmetic ortho" and it doesn't really fit the current codes. It is
far more than molar uprighting or a simple cross-bite appliance (limited treatment) and it isn't
comp ortho, so it is sort of in the middle. That is why I mentioned the misc. code 8999. I know
docs have had success with that, as well as the piecemeal charging of fees. We have always billed
it out as the limited code and gotten full reimbursement, but we are not limited to a fee schedule.
You can still be profitable at less than $4,500. I used to charge $2,800 and was highly profitable.
The main reason I raised the fees was because patients told me I wasn't charging enough. ■
3/9/2010

drdwm
Member Since: 08/11/04
Post: 32 of 115

The thing is, there is no code for Powerprox or Invisalign. 8040 is limited treatment in one
area, like opening a space, uprighting a tooth or correcting minor crowding in one arch only.
Some may code Invisalign as 8090 comprehensive, but I think it is a stretch in most cases. So we
are stuck with 8999. Essentially, Powerprox or 6 Month Smiles is not a covered benefit, even if
the patient has ortho coverage. Sure, bill for records and retainers-but with Powerprox, charge
the patient. ■
3/9/2010

SkiDoc Wade
Member Since: 03/26/03
Post: 33 of 115

Create your own internal fee for cosmetic ortho. If the patient has benefits, then you may
unbundle it. Charge for ceph, pano, records, bonding, retainers, etc. You can do this within

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