amanda with straight smile solutions straightsmiles solutions.com and today
we're going to talk about what you should charge for your own patient i'm not talking about someone
else's patient because someone else's patient is a whole different story and that's like regular
price there's no discounts right i'm talking about your own patient you finished invisalign or you
finished braces or some kind of ortho and patients asking for a re-treatment due to relapse or not
being satisfied again two different situations but i'm going to take you through all the different
variables that i consider and there is no direct answer to this it is a total fluid answer
and you know your answer may not match with what the patient is expecting and sometimes
that can cause trouble so that's why i have lots of different like benchmarks and checkpoints that
i want to see if they were completed so i'm gonna go ahead and start with my thought process on the
process okay and this happens all the time with orthodontist like quite often like quite quite
often i mean obviously we don't want it to happen but things happen patients get flaky patients are
non-compliant we make mistakes sometimes we could have done things differently you know
and it all depends on where the mistake lies and how careful you were with your checkpoints okay
so first question would be when did the patient finish treatment okay was it did they finish
last week last month last year or more than a year those are my four different checkpoints
in my mind the way i kind of sort it out totally different answer for each one right this the more
recent it was the less the patient is going to pay in my mind and i don't write this out in
any type of contract you know because there's so many different variables there's no way you could
spell it out in a contract i know some of you guys are asking just for an answer but when i i often
meet with doctors whether they're my clients or somebody just looking to do an all-a-cart
session to have me just go over this case kind of troubleshoot what might have happened and
these are the type of things i bring up so we can kind of come with a number right okay so when what
when was it we'll get to the numbers eventually of course what did they pay other question would be
did your patient sign a statement of satisfaction or an accepting debund congratulations form all
different names for that most orthodontists have their patients sign a form when they finish clean
treatment it doesn't matter if it's invisalign or braces or whatever ortho it is when they finish
active treatment they sign a form before we take them off or finish treatment and deliver retainers
always in my world there's two different forms there's one for quote unquote it
looks perfect i'm super happy you're super happy and there's one form of it's not quite perfect
but you understand why and you're okay with it or it's not quite perfect but we had to stop early
because you were non-compliant okay or something happen two different forms regardless did they
sign that form if you haven't implemented that form into your workflow then your liability is way
higher than if you have okay and the chance of you needing to either give a full refund or a retreat
is much higher so if you haven't implemented that form i do have templates in my store on my website
straight smile solutions you can go to my store go to documents it's there these documents are free
for our regular vip or concierge clients and there are 20 for anyone else who wants it easy just go
ahead and go on you can have it same day um it's just a template so again i'm not an attorney
anytime you have a template you're welcome to run it by your attorney make changes edit it
throw you know logos on it whatever you want to do it's just a template also i want to go ahead and
also throw this to you if you feel like there's some type of discord in this whole conversation
and or perhaps you are at fault for any reason even if just a small thing that i'm mentioning
it is best that you call your liability insurance company no this is not going to turn into a
lawsuit because they're going to mitigate that anything that you do whether it's a re-treatment
or it's a partial or full refund you always want to call your liability insurance company
most of them are pretty well versed in ortho some better than others and they will actually hammer
out their own separate document you never want to give anything away be it a retrievement or a
refund without your patient signing something special that's basically like i'm not going
to complain i'm not going to sue you i'm not going to i mean take this from the direct to
consumer aligner companies i watch what they do and i'm like shoot we got to start doing this too
because i've had it happen so many times that we're cool you know we're going to retreat hey
i'm going to do this for half price it's totally clearly the patient's fault i chartered it all
they admitted it and later they go and complain all over social media what a crappy orthodontist
ah you know that's not happening if i'm out of good faith giving you either a retreatment
or a partial refund or whatever i'm doing that i really don't need to do i'm being nice
you better be nice back to me and we're gonna we're gonna map this out and put it in writing
learn from the hard way from a lot of people i know who didn't do this just do this
it is not going to trigger anything for your liability insurance company in fact they're
going to appreciate that you call them because they're less likely to have a payout later
it's just a document they have these things basically they have and i know so many doctors
that have done this and i've been so thankful they did it and it just it just makes you more
responsible so i want to start off and preface that i would depending on the situation or just
do it no matter what okay so we talked about that demon forum statement of satisfaction if
you don't have that as part of your workflow or that you forgot to have them sign it you
might be giving away free treatment or full refund it's probably run it by your liability insurance
second thing um yeah when when did this happen when did they finish third thing of course
did they did you have a regular retainer agreement how it works how frequently supposed to come
in was it in writing did they sign it did they agree to it do they understand it is it in the
chart did they have a copy of it a lot of people don't have that you need to have a retainer plan
how they wear it when they wear it they have to sign it how often they change it essex retainers
they wear out you have to replace them did you explain how that's going to work are they buying
a package like viveira do they realize what the prices how frequently they need to replace them
you can't just have one essex retainer for life it is not going to work and that is a huge mistake
that a lot of general and pediatric dentists make they think oh it's a retainer yeah it doesn't work
that way especially if you make them in-house there's a reason why viveira is only sold in
sets of four and that's the bare minimum that you need i generally have my patients trade them out
and they're going to wear it full-time for at least six months and if you want to know about
where schedule it's again this is customized every patient is not the same you have to understand
this watch my entire retainer series it's completely explained in there how to think about
it how we think how we do it okay so if you didn't have this all spelled out written down signed they
signed it how it's gonna work how often they come in that's again your fault okay so i'm going over
everything that is your fault as the doctor you should have done things differently so you should
probably be treating this patient for free even if it was their fault or giving the refund okay
learn from learn from your mistakes don't do it again um number i don't know what number
i'm on okay um were they coming regularly to the schedule retainer appointments that
you spelled out if you did have that so what's your frequency my frequency was always one month
three months six months six months and then done so that's four appointments did they come did you
set them up did they know show them if they know show them did you call them and try to get them
in do you have all this documented if they had the appointments they knew what to do they signed they
didn't show you called them they still didn't show but it's not your fault then so this is
not your fault it's their fault so have you done everything in good faith to make sure they knew
what they needed to do what the rules were how it worked is it all written out is it all signed
did they just blatantly fail and sometimes you'll have patients that are just awesome patients and
it happens quite often the parents come in we are very disappointed little johnny lost his retainer
two months ago we didn't know about it you know he wasn't wearing it clearly because he lost it
you know it's a whole different thing as he lost it or it doesn't fit why doesn't it fit you know
that's a completely different story if they lost the retainer completely different story right
now remember covet threw a little bit of a link link a loop in here where if your
office was closed and you guys weren't dealing like following up on stuff because your office
is closed it's kind of on you so if you had to be super on it whether your office was
closed or open making sure your patients had what they needed whether it was virtual or in person
and a lot of doctors dropped the ball on this um so it's on you if you can't blame coving okay
so just like a lot of companies are being super flexible about their policies be it airlines or
hotels and stuff travel same thing you guys need to be flexible on that so pretty soon that whole
coven thing is not going to fly because we're going to be too far because offices are open so
i'm almost done with that excuse um what else what else we talked about retainers retainers
schedule retainer appointments ah one more thing did you take a picture at retainer delivery
with the retainers on most people don't do this i learned to start doing this because i can't tell
you how many times they're like the retainer never fit nah never fit to begin with and you're like
bs i never let the patient walk out when their tainters don't fit if you didn't capture that it
fit okay that's on you again so all kind of things i just wanted to bring up that one picture can
save you five thousand dollars super super smart to take that one picture just documentation so
you can't just chart and say it fit you need to actually document visually prove that it fit um
what else retainer fits you've got the paperwork you have the frequency of appointments they
showed up um yeah i mean that's pretty much it i mean just making sure every appointment
they're coming in you're taking pictures of the retainers on showing that it still fits um
yeah and if they lost it or broke it or for whatever reason it quote-unquote stopped
fitting then you know from there you should have everything that you need to help make a decision
on where the blame lies this is kind of almost like when you get into a car accident and it's
kind of both people's fault sometimes you have to just meet in the middle okay unless it's
clearly you know patient went to camp lost the retainer came back three months later t3 laps
okay that's not your fault so again if it was the sooner it was whether it's one week one month the
less i'm going to charge and of course it's going to depend on how long the treatment is it also
depends if it's an invisalign or a clear cut case is it a light case is it a moderate case is it a
express case or is it a comprehensive case are we within that three that five year window you
know can i do this for free without a labview obviously if i don't have a lab fee that's gonna
lower the price i'm gonna be super honest with the patient hey you got lucky we're still within the
warranty period for invisalign so i'm not gonna have the fee that i had before so it's only a
fee for my time so the fee is about half price you know and often you know with re-treatments
even if there was even it was a braces case sometimes it's way quicker if it's very minor
stuff to just do some easy express aligners whether you do invisalign express seven which
is the most affordable version it's my favorite express and they they have this in all countries
in the us they have express five seven and ten but seven is the only one you wanna use for
express and in very simple cases only because it's the only one that comes with a free refinement
of seven more aligners so that's the clue five and ten do not you have to pay for the refinements i
have no idea why but they don't so generally i do express light or moderate try to do a cheaper
version you know and even for braces cases i say you know what it is going to cost you more to put
the braces back on because it it's such an easy case but yet it's going to take way more time
and way more effort for me you know so i'm going to charge you less if we can do express aligners
or you know or you can even do white label you know liners really cheap 20 bucks a pop i mean
for a simple case a simple retrieval case you should be able to do this for less than 500
lab fee whether you do an express or you do a white label or something like that light
obviously is more like twelve hundred dollars but um try to do the cheapest you can and that
is something that i'm glad to look at that case if you want to schedule an a la carte session you
can go to my website street smile solutions click on services a la carte case just a couple hundred
dollars we can help you do all this stuff figure out exactly what you need accurately what's fair
obviously we're not attorneys so you're gonna have to talk to your liability insurance for paperwork
if you're looking for that for you know something customized we're not gonna write that for you but
we're just gonna give you our recommendation you wanna do it the right way because if you do it the
wrong way you're going to get a complaint either to the insurance company or the dental board
or really bad nowadays social media is so much worse than all that it really really is and
i really appreciate when i first first started that there really was no social media
no facebook no nothing um no yelp so there really was no way that they could ruin your career
now i can tell you your career could be ruined by just one person so you have to be very very
very careful on who you're dealing with and there are times honestly if everything is not lining up
and it's looking like it's leaning more towards you just keep the full darn refund and get rid
of that patient have them sign that paper from the liability insurance company and good bye you
know they can never complain about you talk bad about you because it is on them and the liability
insurance company will go off after them if they do it's not you having to pay for the attorney so
definitely definitely and i know a lot i've done this before i know a lot of doctors that have done
this before and i know some patients that have done this before so anyways so i know that was
a lot of things to think about and you're probably freaking out but i hope it was helpful thank you