Pay Points

A solid payment policy helps to keep your practice or medspa on track.
Pay Points

Payment policies for aesthetic services are more akin to booking a luxury cruise than buying a car. You can’t repossess a facelift, so it only makes sense to require payment in advance and to charge a substantial booking fee. The business of medical aesthetics may seem straightforward—you provide a service, the patient pays a fee—but the reality of patient billing is more complicated. For example, how do you handle payment for procedures like neurotoxin or filler injections that may vary by appointment? Do you charge for consultations and no-shows? How can you protect yourself against charge-backs? Following are seven timely tips on how to create payment policies that improve workflow, patient satisfaction and practice growth.

No. 1: Don’t be a money handler.

“When it comes to money, aesthetic practices need to set up an interface between the doctor and the patient,” says Christina Majeed, chief product officer of Nextech. “It’s important to hire a patient coordinator as a conduit for money matters. Patients need to view their doctors as healers, not merchants.”

Andrew Rosenthal, MD, plastic surgeon in Boynton Beach and Boca Raton, Florida, and medical director of Modernizing Medicine’s Electronic Medical Assistant software, EMA Plastic Surgery and EMA Cosmetic, agrees. “Our patient care product coordinator presents payment information both verbally and in writing during the initial consultation,” he says.

No. 2: Do adopt payment policies that reflect the type of practice you want to run.

Payment policies start with the forms of payment you are willing to accept and comprise details ranging from when payment is due to how you handle missed appointments. Here’s a typical policy based on a review of practice websites:

All cosmetic services must be paid in full on the date the service is scheduled. We accept payment by cash, debit card, personal/cashier’s checks with valid ID, and Visa, MasterCard and American Express credit cards. We assess a $25 fee for each check returned because of insufficient funds. For your convenience we do partner with [name of patient financing firm] which may allow you to pay for some services over time.

“The forms of payment you accept can depend on the type of practice you are trying to establish,” says Majeed. “If you pride yourself on being a small, high-touch practice, maybe you can get away with accepting cash and checks only and keeping overhead down. If you want to grow your practice, it will certainly be better to accept whatever form of payment is easiest for the patient. Taking credit cards is often the easiest and being able to accept payment online through your website makes payment even more convenient. For example, a patient who bought the Obagi system during an office visit and loves it is more likely to buy it through you again if you offer the convenience of online purchases. You want to offer the payment type patients prefer.”

Every form of remuneration has its advantages and disadvantages—even cash. “It is wise to at least consider offering a small discount for payment in cash because credit card transactions do cost you, and with cash in hand there is no risk of charge-backs or canceled checks,” says Dr. Rosenthal. “You do need a good practice management system. To minimize the risk of employee theft—something that happens more often than you would think—your reporting systems should reconcile quotes and payments, and guard against unauthorized changes. It should also give you a history of who used the files and when they accessed them.”

Policies governing payment for surgery are the most consistent. “When I came into the industry in 1978, surgeons were already requesting deposits—a booking fee based on the total cost of the planned surgery—and, in many cases, patients were asked to pay the full fee at least 10 working days before going into the OR,” says Karen Zupko, a practice management specialist working primarily with plastic surgeons.

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