Opening

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Introduction

Hi, my name is [NAME]. I have an appointment with [NAME] to go over the new mandatory compliance issues and the new healthcare forms that now allow new payment abilities for a doctor's office.

If they push back, get into value and what you were "going" to review. Every time you're talking, you're pitching.

Setup

By the way, do you think the doctor would like to join us today?

That's fine, I'd like to go into more detail with you anyway [NAME], because you're the one who deals with most of this, and if you like everything you hear, you and I can hit the highlights together with the doctor between patients to save you the trouble of remembering everything.

Once in a position to comfortably pitch, say "some of the information can be sensitive in front of patients" to move from the desk or window to seating in the back with the manager.

Intro to the compliance issues

There are two major compliance issues I'm here to discuss with you today. The first is regarding the new rules for presenting patient balances required by the No Surprises Act. The second is the new healthcare forms that ensure practices get paid.

Since the No Surprises Act requires giving patients Good Faith Estimates, the major credit card brands are finally recognizing that healthcare practices take payments completely differently than retail, and they are now allowing for new compliant payment options.

Open slide 1. Pick up the paper Rider; do not hand it over.

Addendum for Pre-Authorized Healthcare Transactions

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1 · The Rider · talk track

Say

Right now you're still set up as a retailer in how you process patient payments, which forbids taking payments by phone, website, payment plans, signature-on-file, or any card-not-present transaction, and that's because you don't have this…

Pick up and show the Rider, without handing it to them. Point to the first paragraph.

This is the Rider to the regular retail agreement that converts it into a healthcare agreement. It lists everything you do right here in the first paragraph as a healthcare service, rather than a product, which is what protects you from chargebacks.

It also allows you to use this approved form, which gives you three brand new ways to accept payment.

Point to Exhibit A on the Rider, then go to slide 2. Slide the paper Rider away.

Pre-Authorized Healthcare Form (Myriad interface)

Pre-Authorized Healthcare Form (compliance form)

2 · Pre-Authorized Healthcare Form · talk track

Say

Just to be clear, this form is not the first thing patients see. Many never will. There's a more delicate approach to the patient, which I'll show you in a moment.

Feature 1 · Guarantee any amount not covered by insurance

Now the first box is “balance of charges not paid by insurance”. This is a way for patients to use their existing credit card, so it's not a separate line of credit, they use that card to guarantee any amount their insurance doesn't cover. For example, let's say a patient receives $500 worth of treatment, and it can be any amount, but they say, ‘I have insurance.’ That's the number one way most offices get stuck, because what happens? The patient is treated, and we estimate and try to collect the patient's portion. But it can be so frustrating, because if that patient hasn't met their deductible, they've reached the yearly maximum, or for whatever reason, insurance doesn't cover as much as we thought, it leaves a balance due. Most of the healthcare practices that we consult with state that they are then sending the patient a paper statement in the mail or attempting to reach out over the phone to collect payment.

Can you walk me through what your process is to collect those balances not paid by insurance?

They will typically agree with sending statement, calling, collections, or maybe not try to collect at all. DO NOT always repeat the next line verbatim. Use what they told you about their process earlier when you asked them if they are not sending statements.

Now you have to send out a bill, $3—$5 per bill in administrative time, postage, and supplies (or even pay a billing company to do it for you). And you have to HOPE and PRAY the patient actually makes a payment. And if they don't, you have to re-bill, make follow-up calls, call the patient at work, threaten collection, or even write it off as a loss at the end of the year. Not to mention, we run the risk of losing that patient to another practice because they get embarrassed and go elsewhere. The number one way a doctor loses a patient to another practice is by allowing them to owe money. It has nothing to do with the treatment, but some might say it had something to do with the treatment, and then leave negative reviews to save face, all because they got embarrassed by not paying you. So now, not only have you lost the money that the patient originally stuck you with, and the cost of collecting, but quite possibly future treatments and future referrals from that patient. The average patient refers up to 8 other patients to your practice. So the money mushrooms into thousands, if not tens of thousands, of dollars in loss that most offices don't even calculate.

So how does our system simplify that?

This healthcare payment program automatically provides a live insurance eligibility check and a Good Faith Estimate is generated, the patient signs electronically, and a copy is emailed to the patient. This step is what brings practices into compliance with the No Surprises Act. Now, when insurance comes back and leaves a balance for any reason, you simply charge the patient's encrypted card-on-file for the difference, and the money is in the doctor's bank account the next day, cleared as cash. So, you never have to send a bill, make a phone call, or threaten collection…

Now, keep in mind, your current retail processor does not allow you to accept cards in this way.

Does your current system automatically post payments to the patient's ledger?

If they say no: Well this system can if you want it to.

If they say yes: Oh great! Our system fully integrates with any practice management software so that every patient payment AND digital insurance payment can post directly to the patient's ledger and these forms can be signed electronically right within your current workflow.

Feature 2 · Recurring charges

Now the next box is “Recurring Charges, On-Going Treatments”. There are two separate features on one line. Recurring Charges are, in essence, an interest-free payment plan on an existing credit card. For example, let's say a patient's treatment is $1,000 (it can be any amount) and they tell you, “I can't pay this all at once, can I mail you a check every month?” We know that this is the worst chance you have of collecting on time for all the reasons I mentioned earlier. Because the doctor is the last one paid in any survey ever done. Over half of all patients feel that there are more important things to pay than their doctor. They'll go on vacation or give to charity before they pay their doctor. So you have very little chance of getting paid on time if you leave it up to your patients' own initiative. So instead of taking the risk of all of that. You simply check off Recurring Charges, for this example, $250 every month for four months. You set up an automatic Recurring Charge one time, you set it and forget it!

And with our Healthcare Program, we have a Card Account Updater built right in, so if a patient ever gets a new card or the card expires, it's going to automatically update to the newest card on file without having to call the patient — kind of like what Netflix and Amazon do.

Feature 3 · Ongoing treatments

Now the same line has another feature, On-Going Treatments. Most good office managers work out payment arrangements with patients. You might say: “the doctor wants you to come in for 3 visits, so bring a third, a third, and a third, and by the end of the treatment, you'll be paid up.” This works great on paper, but you can bet one of the times the patient comes in and gives you the Dental Macarena and says, “oops, I forgot my checkbook,” or “I left my wallet in the car” and you end up with a balance due. If you had this form filled out, you never have to be the bad guy at the front desk with these tools, you simply say, “no problem, Mr. Smith, we have the card from last time, you're already covered.” The reality is that it never even has to get that far because when the patient knows their information is on file - it gently holds their feet to the fire, and they come in prepared to pay. And if they want to pay you by cash or check, of course they can- but the bottom line is never again does a patient walk out with a balance due.

To help the practice collect existing balances, our system can also send electronic invoices that can be texted or emailed to the patient with a secure payment link.

Gesture gently toward the manager with one hand at “Most good office managers”.

Real-time posting into your practice software

Patient Option Letter: choose payment option

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Good Faith Estimate Patient Option Letter (compliance form)

Scroll · 2 pages

3 · Patient Option Letter · talk track

Pause and slow down.

Say

Now, this form by itself can be insulting (PAHF). We are certainly not suggesting that you shove this form in front of your patient's face and say, “Give us your credit card information, or we're not going to see you!” Of course not. Our goal is not to insult your patient, but to preserve and enhance the doctor/patient relationship — because a paid-up patient is a happy patient. So we've come up with a very delicate approach to the patient. We've developed this letter, and I'll let you read it in a moment.

I just want to brief you on it so you get the most out of your initial read-through. This form is copyrighted; we license you to use it. It complies fully with the No Surprises Act, presenting the dollar amount the patient is expected to pay and the full amount of the procedure. We design it for you with your practice's logo, so it's very professional looking. It's given to the patient when they first come into your office, alongside their medical history and new patient forms.

Most importantly, it's worded in such a way that communicates, “We've enhanced transparency and expanded our payment options to better serve our patients,” so it's always taken positively and never feels insulting. So take a moment to read through this, and I'll skip to the last step.

Let them actually focus on reading the letter on the slide. Stay quiet.

So, some of the advantages are obvious when you first read this, but there's a whole lot more to it than anybody can possibly get on a first read-through. We developed this program because we found that 72% of patients try not to pay their doctor on the way out of the office. Yet in any consumer survey ever done less than 1% of people leave their home without some form of payment.

Let that sink in.

This could only mean one thing. Your patient is being a little less than truthful when they say “I forgot my wallet, or I just wrote my last check”. And I'm sure you already knew that instinctively; these stats just back you up. The question you have to ask yourself is “Why?”. Why do your patients feel so comfortable not telling you the truth? It's Psychology 101. They are in control on the way out of the office. You've already treated them, and they know you can't take the treatment back. They certainly know that you would never cross the line of professionalism. They can tell you any crazy story in the world and you have no choice but to accept it.

The flip side is true as well. You are in control on the way in. Here is what your patient will now see.

Point to the letter on the slide. For the full check-in flow, use “Demo this section” below.

Now, you can have this available to your patient as a link texted or emailed when you initially set the appointment OR they can check in on our provided kiosk when they arrive.

The patient enters or confirms their basic information, and we can upload your customized intake forms. Once we're in the insurance section, the patient will either take a picture or scan their insurance card right into the system. The eligibility waterfall verifies benefits and prepares the estimate instantly with a high assurance rating.

First, the patient reviews proposed services and an estimated balance, which communicates expectations with full transparency. Every patient will have access to this new tool, Dr. ClearCare, which clarifies their insurance coverage in simple terms.

This program then further empowers the patient by offering them 1-2-3-4-5 options of secure payment…

Point to the different payment options on the screen. If eligibility has piqued their interest, the assurance rating is explained in the demo (hover the i icon).

…and there's one option at the bottom, the option of non-payment. And I know that sounds crazy, but I'll come back to that in a minute.

There are six things for your patient to choose from. Simple reason and logic tell us they have to choose one. They'll tell you; “I'm going to pay in one of 5 ways, or I'm not going to pay you at all.” There is no in between.

The great thing is in the vast majority of cases, your patients will choose one of the top 3: Cash, Check, or Credit Card. Even if they have pre-planned to give you an excuse, you have foiled their plans. Because they have to choose an option and electronically sign the form before seeing the doctor. So now you have a whole different psychology and an entirely different scenario because you have a patient who has already made up their mind that they are going to pay. They've resigned themselves to that fact.

You will see more payment by cash, checks, and credit cards at the time of treatment than you ever dreamed possible, and we ask you to put this to the test.

Our system will calculate your reduced accounts receivable, and the reduced number of bills you didn't have to send out. Try this program out for a few months, and if your accounts receivable don't drop dramatically, we'll take the program back at no cost.

If they choose guarantee or a payment plan

Now, let's assume the patient doesn't choose cash, check, or credit card. Instead, they choose 1 of the next 2; “Guarantee any amount not covered by insurance” or “Set up a payment plan”. Then and only then do they see this Pre-Authorized Healthcare form we reviewed before. At this point, this can never be insulting because they are filling out the option of their choice!

This is my favorite part of the entire scenario. Some of the patients will review this option, and think to themselves, “Hmm, I don't really want to leave my card on file-I'd rather just pay today.” They could then go back to the previous screen and pick the option they are most comfortable with.

Perfect! That is exactly what this is designed to do. I don't mean to downplay these new options entirely. If your patient needs them, they'll use it, but if they don't, they'll choose another option. But do you really care? They either pay today, or at the very least, they guarantee payment with a card on-file. So far, you're golden.

The option of non-payment

So now there's only one other option: The option of non-payment. Now, let's think about that for a moment. A new patient walks through your door, you've never seen them before. This new program has disclosed their Good Faith Estimate and even after seeing their patient responsibility they were not comfortable choosing one of the options of payment. Now, What are they saying? They are serving notice on you that they have NO intention of paying. They are saying “I can't pay you today by cash, check, or credit card. I can't go on an interest free payment plan or I can't even guarantee my insurance will cover this without taking one single dime out of my pocket today.” You stand a 350% increase in your risk factor of never getting paid by that patient. What a luxury to find out before the doctor even sees the patient or starts ‘active treatment’ and runs the risk of ‘abandonment’.

Now, you never want to turn a patient away. So, what we suggest you do in this situation is to smile, you're never the bad guy with this program, and say: “No problem, Mr. Patient” and seat that patient in the operatory. Our system will automatically alert you and flag the patient. The doctor could then find some delicate reason, without the patient knowing what's going on, to make it a simple ‘examination only’ that day and avoid starting ‘active’ treatment. For example, “This is what we need to do, but I'm going to need you to come back in two or three weeks to begin.” I'm here to tell you that, if that patient doesn't come back or doesn't make another appointment, that was the patient that was never going to pay you in the first place. Your initial suspicions were confirmed, and now it's time and money saved. They'll go stick another practice somewhere else, and it's an element you probably never wanted in your practice in the first place.

The reasons we recommend to seat that patient, however, are because the vast majority of patients who didn't fill out the form the first time do make another appointment. And when they come back, they come prepared to pay. Why? Because you have trained them to. And to be 100% sure, you give them these options again. I guarantee they'll choose a payment option the next visit and you get paid. Also they won't walk out the door with a chip on their shoulder and badmouth you around town or online because you refused to treat them.

The bottom line is with this program every patient that walks out of your door treated has either paid in full, guaranteed payment in the future, or you haven't started active treatment.

Scroll · 2 pages

4 · Good Faith Estimate · talk track

Say

This healthcare compliant system uses the verified benefits to calculate an accurate and protective Good Faith Estimate. The patient signs electronically and a copy is emailed to them. This step is what brings the practice into compliance with the No Surprises Act.

Point at the document, top to bottom.

Format

Up top: the estimate, clearly labelled “patient estimate, not a bill,” prepared for this patient, this service, this date. Then every item with the provider charge, the adjustment, the allowed amount, what the plan is expected to pay and what the patient is expected to pay.

Disclosures

Page two carries the required disclosures and patient rights under the No Surprises Act: that this is only an estimate, that additional services may be recommended, the patient's right to dispute, and that it is not a contract, with the federal dispute instructions.

Why it matters to you

The patient acknowledges the estimate at check-in, and the electronic signature and date-and-time stamp are affixed to their copy. That acknowledgement, the Rider, and the signed Pre-Authorized Healthcare Form are the evidence the card brands look for when a transaction is disputed. It is what protects your transactions from a reversal.

If the manager says “we already do eligibility”: keep their workflow; this adds the estimate presentation, the disclosures, and the payment options after it (Objection 1).

5 · IncomeIQueue · talk track

Say

Let me show you where this gets really powerful. Once insurance claims are settled, IncomeIQueue takes over. Think of this as your centralized portal where you can manage the entire practice without reviewing accounts and chasing balances individually.

IncomeIQueue lets you take action on your entire patient list with a single click. You can automatically collect balances remaining after insurance, issue refunds when insurance pays more than expected, charge up to the authorized maximum and invoice the difference, or automatically invoice patients without a card on file.

Point at the suggested action column, then the "Execute suggested actions" bar. Tap the Chargebacks tab if the Rider conversation came up.

Tie it back

This is the other half of the form you signed earlier. The estimate said what the patient would owe, the pre-authorization said how it could be collected, and this is where it happens, after the remittance, with nothing for your staff to chase.

Healthcare Program savings and payment analytics

Scroll for the breakdown

6 · Healthcare Program savings · talk track

Say

Our system will calculate your reduced accounts receivable and the reduced number of bills you didn't have to send out. Try this program out for a few months, and if your accounts receivable don't drop dramatically, we'll take the program back at no cost.

Point at "Total saved since go-live" and the "Guaranteed reduction achieved" badge, then "Where it comes from".

Where the savings come from

Three places: statements you never send, staff time you get back, and patient A/R that is secured up front instead of chased later. Every figure is reported to your practice so you never have to take our word for it.

Into the proposal

Now let me show you how this compares to your existing retail program. Please, you get back to whatever work you need to do and I'll take a few minutes to put together a proposal that we can review together. One last question: how much volume do you think the practice does per month?

Generate the proposal. The savings figure comes from the proposal, never a round number from memory.

Present the proposal

Doctor, with everything we discussed: reducing billing, reducing accounts receivable, keeping patients in your practice for future treatments and referrals, compliance, the protections; the whole Healthcare Program will save your practice [X] per month. If our program fails to do any of these things we will take it back at no cost or penalty. It is 100% guaranteed.

Close

Closing

Primary close

Doctor, we are finished here. I'll let you get back to your patients. Of course, none of this happens today. I'll simply collect some basic business information with [Manager's Name], and we will set another time in about two weeks for me to pop back in and walk you guys through everything so that you can see it live and utilize the program starting that day. When you have 30 seconds between patients, I'll grab you to okay everything and set up a time to come back with [Manager's Name].

Soft close, to the office manager

If not fully sold, or not a decision maker.

As I mentioned at the beginning, I have a very quick 30-second version to save you the trouble of remembering all this for the doctor. I have plenty of time before my next meeting, so don't worry about me. I'll just grab a seat in the waiting room, and when Dr./Owner pops out between patients, we will grab them together to give a brief overview.

Alternative soft close

Once questions and the rate discussion are answered. Guide gently, never hard close.

Now, let me tell you what we need to do if you decide to go with this program. I have to be there in person to do the paperwork. It takes about 3-5 minutes for me to fill out. The day we do the paperwork is not the day you get the program; it's usually 2-3 weeks after because I am scheduled in advance. So best-case scenario is you can have the program in 2-3 weeks from today or 4-6 weeks from today if you want me to come back.

If the Gold Sheet is done

Now, Doctor, let's see how this compares to your current retail program. In truth, I don't expect you to do anything to save a couple of dollars on rates. Let's look at what you're actually getting for less than you're paying now: the healthcare agreement and protections, the forms that are guaranteed to reduce accounts receivable and billing, and the technology if it applies. The efficiency savings and reduction in billing costs will dwarf what I can save you in rate, and if it doesn't fulfill all these promises, we'll take it back at absolutely no cost to you. You don't need to take my word for it.