NEW PATIENT - 3 Simple Tweaks to Increase Case Acceptance

As we rebuild our practices to pre-pandemic levels, we need every advantage to start more patients.  And sometimes small things can make a big difference.

Here are 3 simple suggestions that require little effort on our part but may be just enough to tip the balance for someone to say “yes” to treatment with us.  Even if only a few additional patients start, it would add tens of thousands of dollars to the bottom line. 

#1 – How to use the “Acceptable Numbers Principle”

 One simple way to increase our conversion rate is to use the "acceptable numbers principle".  It’s the reason why a patient may accept a fee of $5780 more readily than $5750 even though it’s higher.

Many years ago, a research group examined EVERY fee quoted by more than 30 dental practices over the lifetime of each practice (Bellavia, 1991).  To discover which fees quoted were most acceptable, only ONE CRITERION was used - whether the fee was accepted or rejected by the patient. 

Knowing WHY certain numbers are more acceptable than others is not important.  What IS important is to take advantage of the natural human reaction to numbers.

Quoting fees using the “Acceptable Numbers Principle”

From that study, we can draw the following conclusions about which orthodontic fees will be most acceptable to patients.

Between $10 and $99 – (end in 15, 35, 45, 55, 65, 85)

• AVOID - Fees ending in 1, 2, 3, 4, 6, 7, 8, and 9 & multiples of 25 (25, 50, 75)
• BETTER - Multiples of 10 (20, 30, 40, etc.)
• BEST – fees ending with multiples of 5 (use 15, 35, 45, 55, 65, 85)

For example, a retainer check (e.g. $65, $85)

Between $100 and $500, (end in 15, 20, 30, 35, 40, 45, 60, 65, 70, 80, or 85)

• AVOID - multiples of 100 & 250
• BETTER - multiples of 50 except 250
• BEST – Fees ending with 15, 20, 30, 35, 40, 45, 60, 65, 70, 80, or 85

For example, a Records fee or new retainer fee (e.g., $215, $230, $360, $485).

Between $500 and $1,000 (end in 20, 30, 40, 60, 70, or 80)

• AVOID - multiples of 100 & 250
• BETTER - multiples of 50 (150, 350, 450, 550, 650, 850, 950)
• BEST – fees ending with 20, 30, 40, 60, 70, or 80 (with 80 & 30 having a slight edge)

For example, a LLA or Quad helix (e.g., $880, $530, $620, $940, $760).

Between $1,000 and $9,000, (end in 30 or 80)

• Fees greater than $1,000 should end only with a 0; any other ending seems contrived, and the patient probably wonders, "Who are they trying to fool?"
• AVOID - multiples of 500 & 1,000
• OK – fees ending with 10 or 50
• BETTER – fees ending with 20, 40, 60, 70
• BEST – fees ending with 30 and 80 (with 80 being the most preferred)

For example, Phase I & Phase II fees (e.g., $2,230, $5,780)

Giving “discounts” using the “Acceptable Numbers Principle”

• First, use the term “courtesy” rather than “discount”, as in “family courtesy”.

As a professional, we are extending a courtesy for the second child, not “discounting” our services.

• Give the reason for the courtesy

“We find that treating a second child goes so much more smoothly because the family has a greater understanding of what to expect.”  It makes it seem less arbitrary.

• Use the amount of the courtesy rather than a percentage for orthodontic fees

When we give a fee courtesy, we want to maximize its perceived size. That way, our patients feel as if we’re being more generous.  Jonah Berger (2013) suggests that we follow the “Rule of 100”:

- Give PERCENTAGE discounts when your price is under $100

- And give ABSOLUTE discounts when your price is over $100.

Which sounds better? 

“Because this is your second child with us, we offer a “family courtesy” which reduces our current fee for treatment by $300.”

“Because this is your second child with us, we offer a “family courtesy” which reduces our current fee for treatment by 5%.”

• Finally, use the “Acceptable Numbers Principle” to make the courtesy sound much greater by rounding it up to an “unacceptable” number.

For example, “We are reducing your fee by $300” (instead of $280).  It’s only $20, but it seems significantly more.

#2 - How to say and print the fee

Our patients perceive that our fee is lower when they contain fewer syllables and are not displayed with a comma (Coulter, Choi, and Monroe, 2012).

• So, instead of saying, "The fee for your orthodontic treatment is five thousand, five hundred and eighty dollars" ask your Treatment Coordinator to say, "The fee for your orthodontic treatment is fifty-five eighty."
• Similarly, fees written without the comma are more acceptable than those with the comma. So, the fee should be printed as $5780 instead of $5,780.

#3 – How to make everyone’s fee seem the “same”

Some New Patients may be making their decision based on the numbers that they heard from their friends and may hesitate to start if they think that we’re charging them more. 

So, in addition to following the “acceptable numbers principle”, consider making all of the initial fees and monthly payments virtually the same for every patient despite the total fee being different.

Think about it this way: How much did you pay for your car?  Ok, here’s an easier question?  What’s the monthly payment?

If you’re like most people, we remember the current monthly payment more readily than the total cost from a year or so ago.  It’s also true with our patients.  When talking with their friends, they probably can recall their initial or monthly orthodontic payment but may be vague about the total fee from many months ago.

Here’s how it works:

1.  Quote fees based on the “degree of complexity” and give a 6-month range for completion to be able to account for patient cooperation. For example, 15-21 months for an “18 month” case

2.  Each higher fee level is based on 3 months increments:

12-18 months

15-21 months

18-24 months

21-27 months

24-30 months

 3.  Each monthly fee should be about 3% of the total fee. Therefore, each 3-month increment will be 9% or approximately $450 – $550 depending on the total fee.

4.  Add 2-4 months to the payment arrangements as we move up the 3-month increments, keeping each monthly payment approximately the same. Vary the initial payment slightly to make up any difference.

Here’s how to convert the present payment arrangements to this system:

To calculate a new fee structure:

1. Take your “middle” fee - the one you quote the most. (Say the 18-24-month fee)

For example: $5880 (remember to use the “acceptable numbers principle”)

2. Multiply it by the percentage of your standard initial payment (15-25%)

20% = $1176

3. Adjust it to make the initial payment more “acceptable”

$1180 (4-digit fees ending in 30 or 80 are BEST)

4. Take the remaining balance and divide it so the payments end near the months anticipated

(18-24 m) $4700/24 = $195.83

5. Then round up so the final payment is less than the monthly ones (remember, fees sound less with fewer syllables so drop the “cents”)

$196 X 23 months plus $192 X 1 month

6. Adjust all other fees to have similar initial payments and monthly payments

18-24 months          $5880             $1180 (20%)             $196 x 23m / $192 x 1m

15-21 months          $5380             $1130 (21%)             $194 x 21m / $176 X 1m

It may take a little time the first year to convert, but after that, fee increases are simple by using increments of $50 or multiples of $100 to keep the total fees similar and “acceptable” (i.e. ending in 30 or 80).

 Final Thoughts

How much does all this matter?  Don’t really know.  But what I DO know is that parents share our fee information with friends and neighbors a lot more than we suspect.  And when we present our financial arrangements to a New Patient and the numbers are "acceptable" and match their expectations, case acceptance goes up! 

Even if that only matters to a few more New Patients, production can increase by tens of thousands of dollars.  And that, as they say, gets to be real money.  And it's certainly worth the little time it would take.