CATEGORY 106 AUSTRALASIAN DENTIST BEYOND CLINICAL In-house payment plans can transform treatment uptake – but only when they’re managed properly. Here’s what most practices are quietly getting wrong, and what’s about to change. More Australian dental practices than ever are offering in-house payment plans. The motivations are clear: improved treatment uptake, stronger patient relationships, and a point of difference in a competitive market. For many patients, the gap between accepting a treatment plan and walking out the door comes down to one thing – whether they can afford to say yes today. But there’s a version of this story playing out across the country that nobody’s talking about. The spreadsheet that started as three patients and now has forty. The receptionist chasing overdue accounts between appointments. The principal who wrote off $8,000 last financial year and quietly filed it under ‘the cost of doing business.’ Managed well, in-house payment plans are a genuine competitive advantage. Managed poorly, they’re a liability that erodes revenue, consumes staff time, and creates patient relationship friction. Why managing plans yourself costs more than you think The default approach is DIY. A simple arrangement is documented – sometimes formally, often not – and the practice takes responsibility for billing, follow-up, and collections. This works when volume is low and patients are known and reliable. But practices rarely plan for the failure cases. They don’t document what happens at 30 days overdue versus 60. They have no formal escalation process. And they almost never have a clear picture of their actual default rate, because write-offs happen gradually and get absorbed into operating costs. The real cost isn’t just the money not collected. It’s the opportunity cost of every staff hour spent on accounts rather than patient care, and the relationship cost of an uncomfortable conversation with a patient who hasn’t paid. These patterns aren’t the result of bad management. They’re the result of practices doing their best with a structure that was never designed to scale. The three most common mistakes 1. Incomplete or inconsistent documentation. A payment plan is a financial arrangement and needs the same rigour as a clinical consent form – what’s owed, when it’s due, the consequences of non-payment, and what the patient has agreed to. Many plans are recorded as a note in the patient management system, with no signed agreement and no formal terms. This matters when accounts go overdue: without proper documentation, practices have limited recourse – and patients know it. 2. No escalation process. Most practices have an implicit threshold at which they stop chasing a debt. What they don’t have is a defined process: a specific action at 30 days, a different action at 60, and a clear referral pathway at 90. Without it, overdue accounts drift. Staff become reluctant to chase patients they’ll see again in the chair, and the debt grows stale. 3. Fee structures that don’t account for risk. Extending a payment plan is effectively providing credit, and credit carries risk. Most DIY arrangements don’t price for this – the plan is offered at face value, with no fee to offset administrative cost, the time-value of money, or default risk. Professionally managed arrangements build these factors in transparently. What a professionally managed arrangement looks like A well-structured external arrangement does several things a DIY approach can’t easily replicate: u Formal documentation and signed patient agreements as standard u Defined escalation processes with specialist collections backing u Transparent, predictable fee structures u Administrative separation, so staff focus on clinical care, not accounts u A dedicated payment specialist for patients, rather than their clinician, when issues arise The hidden cost of DIY payment plans: What Australian dental practices are getting wrong By Marlé Ambrose About the author: Marlé Ambrose is the founder of SafePay Smiles, a Gold Coast-based dental payment plan management company operating under COLLECT4U, an experienced debt collection business. With over 20 years in payments and receivables, SafePay Smiles works with dental and orthodontic practices across Australia. safepaysmiles.com. The question to ask any provider isn’t just ‘what does it cost?’ It’s: what happens when a patient doesn’t pay? What’s your escalation process? How are patient relationships protected? The answers tell you whether you’re dealing with a billing facilitator or a genuine partner. What’s changing in October 2026 From 1 October 2026, the Reserve Bank of Australia will effectively ban the passing of card payment surcharges to consumers. For dental practices – and the payment plan providers who serve them – this is a material change. Practices using providers that pass card surcharges through to patients will need to revisit their arrangements before the deadline. Those best positioned are already working with providers who charge a transparent, flat fee rather than layering costs through variable surcharges. For principals evaluating options this financial year, the fee structure question isn’t just about today’s cost. It’s about which provider has already adapted to where regulation is heading. u
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