Picture this: A patient comes into the practice for the first time in years and presents with numerous dental issues. The treatment plan involves 5 different procedures, totaling $5000. The first few steps are the cheapest, and the patient (who doesn’t have insurance) only accepts the first 2 recommendations because they cannot afford the entire treatment plan, then you never hear from them again.
This scenario happens in dental practices every day. The biggest barrier to treatment acceptance is cost, particularly for uninsured and fee-for-service patients. In 2021, approximately 74 million Americans did not have dental coverage.1
Not having dental coverage means paying out of pocket, which many people are unable to do. In 2015, a study by ORC International found that 39% of patients had delayed or limited dental care because of finances.2 By 2018, that number had risen to 55%.3 These rates are expected to continue to climb, as an estimated 6 million Americans lost dental coverage in the past 2 years because of a lost job from the COVID-19 pandemic.1
“Nearly 6 of 10 Americans do not have enough savings to cover an unplanned expense of $1000,” Jay Letwat, vice president of dental at Sunbit, says. “The average dental treatment is [approximately] $1200, so there’s obviously a disconnect.”
What patients unfortunately do, Letwat says, is deny treatment. “[Patients typically] approach it like a fancy French restaurant. They say, ‘OK, I’ll get the first couple things on the list, but the rest is out of reach. I’m going to hold off until it’s really painful, then I’ll somehow come up with the money.’ But then they don’t have the money, so they skip the last few items on the treatment plan and don’t get the full care they need.”
Financial Barriers to Care
Treatment should be more accessible to all patients, regardless of insurance status or income. But historically, this hasn’t been the case. Options have been limited to insurance, out-of-pocket, or financing solutions that are often intimidating or even unobtainable. “We’ve found that there hasn’t been any innovation in the past 30 years—literally the same solutions that were available then are the ones that are out there today,” Letwat says.
The programs today often exclude a large portion of the population, according to Letwat. In traditional dental financing models, only 35% to 40% of patients are approved for financing, he says. “Many of the players in the financing field are only approving patients with prime credit,” Letwat says. “But only [approximately] 40% of people in the US fall into that category. The problem is that 60% of people are considered subprime, and they aren’t getting approved, so those 60% aren’t getting the treatment they need.”
Money can be a taboo topic, and these low approval ratings make offering financing solutions to patients an uncomfortable process for the dental team, as they don’t know whether the patient will even be approved. “It’s an incredibly awkward conversation,” Letwat says. “Even outside the dental office setting, it’s very uncomfortable to talk about finances to anyone. If there’s a $1200 procedure, the treatment coordinator doesn’t want to ask you [whether] you need help because it’s uncomfortable. It’s uncomfortable to ask because you’re not sure what the answer is going to be or even [whether] financing can help.”
Letwat believes the key to success with financing is a transparent, respectful solution with competitive rates that makes both the patient and the office team comfortable. “More and more practices are seeking out easy, transparent, pay-over-time solutions,” Letwat says. “They know it’s critical to offer this type of solution to their patients so the patients [can] receive the care they need. The whole concept of buying something now and paying over time is catching fire. [However], on the dental side, they’ve been slow to adopt technology…”
Simplifying Financing
Three years ago, Sunbit, a financial technology company, entered the dental field. Using artificial intelligence (AI) and machine learning (ML) technology, Sunbit can offer more patients financing for their dental treatment. Sunbit’s AI/ML approach streamlines the approval process so it’s quick, simple, and most importantly, accessible to most patients. On average, Sunbit approves over 85% of patients for financing, which is double the traditional average. “With the advanced machine learning and other technologies we’re using, Sunbit is reducing the barriers for everyday [patients] to get the financing they need,” Letwat says. “That’s the mission of the company.”
Applying for other financing options can be a cumbersome process, much like a credit card application that asks invasive questions and requires a hard credit check. “The same questions on that 1968 credit card application are the same ones on the dental application today,” Letwat says. “[Patients] are very much unsatisfied with the product, [which is] something we can disrupt with our technology. The process is incredibly quick and easy—it takes 30 seconds.”
Sunbit can expedite the application process because it doesn’t require a hard credit check to apply. Instead, they implement a soft inquiry, even if the patient decides to take the loan. This puts patients at ease because it prevents hard credit checks, even if they aren’t approved.
“We don’t want this to feel like an intimidating financing transaction,” Letwat says. “It doesn’t feel like an overwhelming commitment, like a typical financing transaction, [which] is what we want for the patient.”
Participating practices are provided with an iPad, which they can hand directly to the patient to complete the process themselves. Patients scan the barcode on the back of their driver’s license, and the software automatically pulls the patient’s information from the patient’s state issued ID. Patients are then presented with 3 to 6 different payment plan options.
“Ultimately, we want the patient to select the option that’s best for them,” Letwat says. “With us, treatment coordinators can say, ‘You don’t have to pay everything today. We have a payment plan so you can pay over time. Let’s get you qualified in 30 seconds and find a monthly payment you’re comfortable with.’”
For example, say a patient is presented with a $2100 treatment plan. The patient doesn’t need to panic; they’ll see multiple options for payment plans, even as low as $56 a month over 48 months to finish treatment. Payment schedules are clearly spelled out and illustrate that the same amount will be auto-debited monthly, because Sunbit doesn’t apply deferred interest.
In addition, Sunbit doesn’t charge any extraneous fees. The plan the patient sees is what they get. “Because there aren’t any other penalties or origination or maintenance fees, the patient feels like they understand what they’re signing on for and they end up opting for much more treatment than they typically would,” Letwat says. “So, we’re seeing much higher treatment acceptance and much higher-dollar treatments being accepted.”
Practice Benefits
While the main goal is always to provide accessible financing options to patients, these benefits of successful financing for practices—higher treatment and higher-dollar treatment acceptance—are added perks. The application process can be easily integrated into the practice. Sunbit can be added to the practice management software as a tender type—no extra software is needed. “It’s a form of payment that essentially becomes a receivable,” Letwat says. “When a practice closes out their books at the end of the day, they know they can expect a payment from us within 2 business days. We provide real-time reports, so everything is at their fingertips in real time.”
To expedite the onboarding process for staff, Sunbit provides full training for every new practice offering the service. “We have a full onboarding and logistics team, with [staff] all over the country,” Letwat says.
In 2½ years, Sunbit has staggeringly not had a single practice cancellation. They’re now in approximately 6500 to 7000 dental locations nationwide (in DSOs, multilocation practices and single private practices).
“[Ultimately], we want to help everyday patients get the dentistry they need. That’s the bottom line,” Letwat says. “We always say, ‘Be good to the patient, be good to the practice.’ That is how we operate.”
References
Download Issue: Dental Products Report October 2022
