What do you suppose is the greatest single source of serious (60 day+) orthodontic and dental patient delinquency?  What is the greatest source of failed appointments?  What is the greatest source of excessive emergencies and patients in treatment longer than diagnosed, bad debt write off, dismissed patients, etc?

Many reading this will probably assume I am talking about our credit grading and credit granting recommendations and will say that granting “A” credit to “C” patients is greatest source of these problems.  But that’s not the case!

The greatest single source of all those problems I mentioned is improper financial arrangements on divorce cases and improper handling of delinquency issues when parents become divorced during treatment.

Notice that I did not say that divorce itself is the problem.  Divorce cases are easy to handle and need not cause any of the problems I listed above.  The problem is that these cases, in order to avoid conflict and to “be nice” are consistently mishandled, only to blow up later into what often become unsolvable social, financial, and clinical problems later on.  Even our active clients continue to have these issues as more than half of all support calls to our office concern problems making financial arrangements with divorced parents and problems with delinquency caused by divorce.

To handle divorce, you must first understand divorce law.  But you do not have to understand it all, just the most important part, which is: A divorce decree has authority and power only between the two parties to the divorce.  A divorce court and the resulting divorce decree has no authority, no power, no control whatsoever, over how an orthodontic practice chooses to treat and/or handle financially an orthodontic patient or parent.

Because divorce cases cause the majority of all patient related financial and administrative problems, and because we guarantee our clients that their delinquency will be kept under perfect control, we have a set of “rules” that, when followed, keep divorce related delinquency, along with all of the accompanying problems, at a level so low as to be insignificant to the practice well-being.  Those rules are:

• Understand that there is no Federal law, and no law in any State, that requires a doctor/practice to make a financial arrangement with a non-custodial parent.
• Never split a financial arrangement (contract) between any parties, responsible or not, not for any reason.  Remember that any split contract is releasing both parties of total responsibility for your entire case fee.
• Never allow a non-custodial parent to be listed as a responsible party in your accounting/computer system.
• Remember that neither a non-custodial parent nor a step-parent can give you the authority or “permission” to do an exam on a minor child.  That authority can only be granted by a custodial parent.
• Step-parents (married to the custodial parent) can be listed and used as financially responsible parties, but you must have their direct agreement to be responsible (without that you cannot obtain a credit report on a step-parent!).
• While we are prudent and careful regarding whom we allow to be financially responsible, we are not foolish.  Therefore, you should always be happy to accept payments from any source, even from non-custodial parents, grandparents, etc., but such people will not be allowed to be listed in your computer or listed in any way as responsible parties.

To follow most of these rules you must agree on the definition of “custodial.”  For the purpose of this document, the custodial parent is the parent with whom the child lives 50.001%, or more, of the time.  Remember that a divorce decree granting joint 50/50 custody has no power in your office.  In determining custody for the purpose of identifying financial responsibility, the parent the child lives with the most is always 100% responsible for the account.