Beyond the Exam Room: How a Top Chicago Cosmetic Surgery Practice Manages Payment for Care

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Most cosmetic surgery practices operate far from primary care’s recurring billing models. Patients come and go and are often one-and-done, creating a practice that’s more transactional than built on repeat business. But, the care these surgeons provide is anything but transactional. It’s highly personal, often reflecting on a patient’s sense of self and worth.

With this in mind, how can cosmetic surgery practices keep payments as personalized as the care they provide while operating a transactional business model?

Lori Pascal is the office manager and patient coordinator for Dr. Thomas Mustoe and Dr. Sammy Sinno, two of Chicago’s most prominent cosmetic surgeons. Having spent over 17 years in patient coordination for cosmetic surgery practices and the past four-plus years managing Mustoe’s and Sinno’s, Pascal offers some insights to help other medical practices add a personal touch to their payment procedures.

“Patients don’t think of medicine as a business, but whether you’re a heart surgeon or a dermatologist, it’s still a business,” says Pascal. “If the practice isn’t well run, patients will pick up on that, and that’s what makes them feel less like a person and more like a transaction.”

Create a Structured Financial Policy

Pascal’s first recommendation for any medical office operating on a transactional billing model is to have a structured financial policy in place. “For our practice, this means having set procedures for how we present financial information, and we present that information in a highly transparent way,” says Pascal.

“Patients don’t get on a surgical schedule without a surgery deposit,” she says. “This policy prevents our surgeons from having gaps in their surgical schedule. The deposit is refundable. To cancel or reschedule, patients need to give us notice no later than four weeks before their surgery date. I’ve found that with windows shorter than four weeks, surgeons have less chance to fill those surgery times and we don’t want our surgeons to have holes in their surgical schedule.”

Without a structured financial policy, practices like the one Pascal runs might quickly be in trouble. “From an office standpoint, we have to think about how we’re going to create an efficient schedule for the physicians. We want to make the surgeons’ time useful, and that includes thinking about how many new patients can be seen on a weekly basis. A transactional practice like ours has people waiting for consults and surgery. If there weren’t any penalties, we’d end up with an empty flight which wouldn’t leave us in business very long. ”

But there always has to be room for leeway, and it’s not all about penalties and cancellations. Discussing financial information may make or break a transactional practice. Here’s how Pascal makes payments personal for patients while maintaining a high level of professionalism.

Making Payments Personal

In practices like the one Pascal manages, procedures typically cost thousands of dollars. Insurance rarely comes into play, which means the burden of payment rests with the patient.

“There has to be an appreciation that this is a lot of money,” says Pascal. “Naturally, having the wrong person discussing finances with patients could make a patient uncomfortable.”

At Pascal’s office, she’s the single point of contact for all financial discussions with patients. As the single point of contact, Pascal may also offer flexibility on a case-by-case basis.

“When people need a little bit of leeway, I’m the only one negotiating that flexibility. Being the single point of contact for finances helps the patient have a smooth surgical and in-office experience. Whether it’s receiving a final payment a few days later than our financial policy dictates or paying cash to save a bit of money, I’m always going to try to accommodate the patient.”

Pascal is committed to keeping a structured financial policy to maintain the human touch in the practice she manages. In Pascal’s office, patients and the practice are equally important.   This allows both to work towards the same goal: incredible outcomes that generate referrals because of the excellent work throughout the patient experience.


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