Expert: Dr. Randolph Myerson - 12/28/2009

Question
Hello Dr. Randolph Myerson,

My dentist has recommended I see an orthodontist to improve my bite - my chewing isn't as efficient as I would like. Coincidentally, an orthodontist sees patients at his office once a week and also treats my dentist and several of his staff members. I met the dentist (he seems competent and personable) and he indicated when my dental work was complete I should have Invisalign. My dentist indicated he had completed the work he had to do about a month ago.

My question: the orthodontist wants to be paid in full (about $6,000) for the treatment in advance. He's offering a 5% discount for advance payment (and the dentist's office offers a payment plan but they have made it clear the orthodontist's practice is separate from their own).

Is requiring advance payment in full reasonable and customary? It seems unreasonable to require payment 12-18 months in advance. Most health care payment transactions are pay as you go or pay after the product/service is delivered. When I see my GP or dentist I pay after the consult or treatment.

It makes me uncomfortable to pay in full in advance for any service or product to be delivered months in the future. What if the doctor declares bankruptcy (in this economy a real possibility), leaves town, dies or becomes ill? If I'm unhappy with his treatment (I found a number of patients on boards complaining about their Invisalign doctors handling of their treatment) I have no leverage against the doctor if he's already received my money?

I appreciate any insights you can share.

Elena

Answer
It has been my experience that many orthodontists offer a no interest payment plan which requires a substantial initial payment and regular monthly payments during the course of treatment.  In addition to this, some orthodontists also offer a 5% reduction in the fee if payment is made in full at the start of treatment.  Some orthodontists also offer outside funding through companies like CareCredit.  In our office we offer all three options.