A Brief History of Collections in Dental Practices

Unlike today, it hasn’t always been difficult for practices to collect fees for their services. There was a time prior to 1980 when collecting fees in dental practices was not a major challenge. Practices generally had excellent collections because patients paid their bills on time. Billing was also less complicated. There were very few insurance plans up until the 1980s and copayments were not a major factor. Most practices billed patients for payment following services and were able to collect at a very high level.

In the 1980s, collections started to become more challenging. The collection problem in the 1980s resulted mainly from practices billing a large number of patients and insurance companies and then not receiving prompt payment. Inevitably, many patients simply delayed paying their bills and logistical problems occurred with insurance companies such as improperly filled out insurance forms. The increase in insurance participation and decrease in collections from billing lead to a new concept that is seen as normal today: collecting at the time of service. Many practices resisted this concept as they felt that it was rude or aggressive to ask patients to pay for dental treatment at the time of service. However, there was also a time before that when accepting credit card payments was seen as almost unethical in dentistry. During this period, many practices were struggling with collection issues.

Today patients are very different as consumers. While most patients do pay their bills and balances, the era of billing for services and sending out statements has ended for two reasons. First, sending out statements takes time, effort, and expense. Collecting at the time-of-service eliminates all of this. Second, there has been a definitive increase in the number of patients who default on their payments if collections do not take place at the time of service. Since the 1980s, there has been a gradual movement toward acceptance that collecting balances due at the time of service was the right method to follow and it has now become the norm.