Dental practice owners are under no obligation to extend credit to patients, and they can require payment at the time of service. However, dental offices can offer patients commercial credit cards and lines of credit like CareCredit to help patients receive the treatment they need. These arrangements can be and have been successful but, in many cases, patients have signed up for third-party credit products without understanding the terms. Consequently, some patients have taken on significant financial obligations under questionable circumstances.
California dental practices that offer commercial third-party credit cards or other financing products to help patients complete their treatment plans must ensure they follow the state laws specifying when and how they can offer these credit products. A required notice must precede the credit arrangement and must include very specific language.
Dentists who are not following the requirements face enforcement action from the Dental Board of California and harmed relationships with financially burdened patients.
Dentists should read the complete requirements of article 6 of the Dental Practice Act, but the key requirements are also summarized here. CDA has resources to help members comply with these requirements, develop and maintain a strong patient financial policy and avoid risks.
The requirements discussed in this article do not apply to credit that patients establish on their own outside the dental office.
Provide written or electronic notice and obtain patient’s signature
Before arranging for or establishing a commercial credit card, loan or line of credit, the dentist must provide a written or electronic notice that:
- Fits on one page or screen.
- Is written or typed in at least 14-point type.
- Contains specific language notifying the patient that (1) they are applying for a credit product for a specific dollar amount or limit (must be documented), (2) the credit product is not a payment plan with the provider’s office but instead is made by (name of company), (3) they do not have to apply for the credit product and may request a different place and additional time to review the terms, and (4) they have the right to obtain a written treatment plan from the provider that includes specific information.
Dentists must use precise language in the notice to patients. CDA members can use Offering Commercial Credit to Patients. The member-only resource includes best practices plus a sample notice in several languages.
Present treatment plan before offering commercial credit product
Before offering a commercial credit card, loan or line of credit, the dentist must provide a written treatment plan that:
- Includes each proposed service and the estimated cost of service.
- States whether the dentist takes assignments of benefits (either from a private or government dental benefit plan) and, if so, the patient’s estimated share of the costs.
- Indicates for Medi-Cal-covered patients (treated by a Medi-Cal-enrolled dentist) whether Medi-Cal would pay for an alternate, medically necessary service.
- Contains all other information specified in article 6 of the Dental Practice Act and provided in CDA’s Offering Commercial Credit to Patients.
Have a strong payment policy, avoid write-offs, consider third-party financing
Dental practices that have a strong patient financial policy will be better protected from the risks of nonpayment and write-offs, but a strong financial policy also helps protect the dentist-patient relationship by clarifying payment options, fees and other terms. As a best practice, dentists should present the payment options and financial obligations during a financial discussion with the patient before treatment and obtaining the patient’s signed financial consent.
Dentists who wish to offer patients an additional way to pay out-of-pocket costs for treatment may consider third-party financing to help them begin the treatment that was diagnosed. CDA Endorsed Service CareCredit offers financing options for dental patients in participating offices plus additional resources to help support staff in payment conversations.
CDA members can use the following resources to develop sound policies and manage patient finances:
- Patient Financial Policy: Includes sample policy scripts, information on managing delinquent accounts and more
- Financial Agreement and Consent Form in English and Spanish
- Benefit Breakdown Form: Document patients’ dental benefits