ABSTRACT: Members were from all across North America and included Office Managers, Staff members, Hospital Administrators, and Veterinary Technicians. Practice size ranged from single doctor to large multi doctor practices with huge staffs. It became clear through the chat that several issues concerning client relations (billing, fees, how the staff handles the clients, and so forth) are hot topics on everyone's mind. This will be the first of many discussions!

Heather Howell: How do you want the client relations team in your practice to treat clients?

Anna: We want to make sure clients know that we're there to work with them and to help their pets of course. You want to make sure they clients feel comfortable with you and asking questions, etc. Clients like to see that you like their pets and are interested in them. Building a strong bond that way keeps clients coming back.
Debbie: Educate clients on why we their pets need vaccines, dentals etc., not just 'you should do this'
Kal: We also want to be sure that the client understands the value of the services rendered (helps a lot when fees are high)

Heather Howell: True. Communication up front helps avoid problems later about fee misunderstandings

Anna: yes, CE is very important I think because if clients understand why you recommend certain things, they will be more likely to follow through and appreciate that you take the time to explain to them.

Heather Howell: So, be available, educate, be friendly, etc. What do you do when clients aren't treated those ways? Or when the client is difficult?

Kal: We usually escort difficult clients to a private area (especially if there are other clients present). If unable to resolve the issue, we put them in touch with the DVM.

Heather Howell: What do you say to them once you have them in private?

Kal: something like: "I understand your concerns, however, hospital policy dictates...
Anna: Difficult clients are so hard to deal with sometimes, you really have to know what to say and how to explain things, usually we too, let the DVM handle it if it's the person is being really too much
Beth Ann: Try to avoid "Policy" b/c clients immediately turned off. Try to present it as best interest of client/pet.
Kal: Good point, Beth Ann. We usually try the "best interest of the pet" if applicable, but use the "policy" term to get deposits, etc.

Heather Howell: I agree that it's a good idea to let the client know you're interested in trying to help them solve the issue. So, staying away from policy and making statements about why it's best for the patient is a good idea.

Beth Ann: Money collection is a major problem for us. We hold checks, set up payments and still get burned.
Debbie: policy does work when it comes to deposits, etc because then the clients do not feel that you are saying hey I don't trust you specifically, it's just the way we handle monetary transactions
Anna: Some people are just difficult, and others have a legitimate complaint, it really is an art sometimes to deal with the difficult folks, but you always need to remember that you represent the clinic

Heather Howell: We get paid to remain professional and treat clients with respect regardless of how they behave or whether their complaint is legitimate. Even if they are belligerent and need to be asked to leave, there is no reason for us to lose our professionalism or stoop to their level. It won't improve the situation.

Anna: We have a "no checks" policy for folks who haven't been with us for over 2 yrs. If they are allowed to write checks, they have to have their driver's license # and a VISA or MC # on the back as well. This is posted on the front desk so they cannot miss it. It makes it much easier to enforce the policy when it's written clearly on the front desk.

Heather Howell: Wow. That isn't a problem for you? How do the rest of you handle money? Is billing an issue? Do you accept cash, checks, credit cards, and use CareCredit?

Anna: London ON. We've been doing it for almost 6 months. Our sign says: "due to the # of returned checks, regretfully we can no longer accept checks unless you have been a regular client for the past 2 yrs, blah blah blah.... We have Master Card, Visa, Debit or cash available. That is enough options in my opinion. New clients are told over the phone what payment methods we accept so there's no surprise.
Phyllis: We take cash, credit cards and checks. We get driver's license on all checks. We looked into Care Credit, but we really don't have a problem with clients not paying so it wasn't feasible for us to do. We do not let clients bill out unless they have been real long time clients.
Kal: Cash, checks, all major credit cards. Checks over $150.00 are put through a Guarantee company as well as all checks from new clients (regardless of amount). We do not bill.
Debbie: We do not bill period! We accept cash, check and Visa/MC. My doc feels that we are not a lending institution. His favorite statement is 'if you don't have bank or friend to lend you money why should we?' However, I do find that this sometimes makes it difficult to win or keep clients. Does anyone else have an absolutely no billing policy? How do you handle it?
Kal: Given all the payment options, there shouldn't be a problem. We will, on occasion, with the approval of the senior DVM, bill a long-time client (20+ years)
Anna: Euthanasia's get sent a bill, but this is pretty much the only time we allow the pets to leave w/o payment. We don't offer financing, but have a company we do it through. I wish I could tell clients sometimes that I want to see what grocery store they can walk into and leave with food saying 'bill me'. :)

Beth Ann: Has anyone tried Care Credit? Do you hold hospitalized pet until owner finds money?
Debbie: We had care credit where I used to work and that place had a huge Accounts/Receivable. I was surprised at some of the people who got approved, so definitely think it helped. However we were part of a thirteen practice chain to start with, so got a good deal on signing up with then and were able to keep it after we split form them. One problem we had was that it was the last thing offered. I personally thought that the client should have to try them before leaving a hold check.

Heather Howell: Do any of you use estimates up front or collect deposits when the animal is left at the hospital?

Kal: If someone comes in without enough money, we will usually hold lab work and meds until the balance is brought in. We do make estimates for hospitalized patients and take 50% up-front.
Beth Ann: We do estimates and get signature. Hospital pet needs deposit - only stabilize until deposit comes in.
Lisa: Care Credit is fabulous. Also you need one person, practice mgr, responsible for A/R not entire staff, certainly not DVM's. Estimates for all major work.

Heather Howell: I have heard good things about Care Credit and other programs like it when used as a first option.

Beth Ann: We are trying 3-month deposits incentive to encourage staff to get payments. We reach deposit goal and staff gets bonus.
Debbie: How do you handle A/R request when the OM is not available? I think that was part of the problem at that hospital the rules were never written down on how to handle A/R
Beth Ann: We have standard form and protocol for staff to follow. I still get calls at home if weird case.
Lisa: Debbie, always have one person on duty that can make a financial decision. Designate a backup to practice mgr.
Kal: Nobody in our practice, except an owner, can leave a balance on an account
Phyllis: We have all clients sign estimates on surgeries and hospitalized patients. We have brand new clients leave a deposit, which is about 75% of what we think the total bill will be. Here's another thought. At this clinic, employees are only allowed to bill out until the next pay period.

Lisa: Anybody figured out how to take a deposit against a Care Credit extended payment plan?
Heather Howell: Wouldn't the company be able to help you with that? We use a local company that extends credit but it's a line of credit that they get approved for before any work is done so the deposit isn't really an issue.

Heather Howell: So, we've strayed to money issues, which is under the umbrella of client relations. But let's get back to how to treat clients, particularly difficult clients. Besides money misunderstandings, what other issues cause client difficulties?

Debbie: What other problems do you have difficulty handling with patient besides $, what about euthanasia?
Phyllis: The first thing to do with difficult clients is to get them out of the waiting room so you can have a private discussion without causing a scene. Then, listen to their complaints before you jump to conclusions.

Debbie: What about if you don't have a separate area to take the clients to? I don't have a separate place unless the exam room is open.
Anna: That's always a good way to go, removing the client from the reception area. I think that a lot of problems stem from misunderstandings as well.
Heather Howell: I walk them outside the hospital if necessary, but usually there is an office, break room, treatment area or some where you can go.
Kal: I tell my staff that the client must be helped first, whether in person or on the phone. Paperwork can be done later.

Beth Ann: How to handle staff that treats clients like an interruption to the staff member's day?
Phyllis: I have one of those employees also who treats clients like an inconvenience. It is a tough situation for me to handle because she has been here longer then me.
Lisa: Beth, what other things does that employee do so exceptionally well that he or she should be kept on staff?

Heather Howell: Good question. What behavior excuses the client relations team from being available to clients and treating them like a priority?

Beth Ann: Daily roller coaster with any staff member, good 1 day, lousy the next. Tried to move them to other areas of the hospital.
Lisa: People like that not only ruin client relations, they "beat up" the rest of the staff. Best to dismiss, the whole staff will be better off being short handed than stifled by this person.

Heather Howell: I think it's important to set expectations as a manager and have the team set them together regarding what is acceptable behavior. If a member doesn't treat clients how they should then the team and manager should address it and they should improve immediately or not be on the team.

Beth Ann: Problem is one of the doctors who won't see new client or inconvenient emergency at end of day.
Heather Howell: Is the doctor an owner?
Beth Ann: No
Heather Howell: Then, that's up to the owners to establish expected behavior of the associates as far as clients go.
Beth Ann: Good advice, now I know I'm not crazy when I tell the owner the same thing. Thanks
Phyllis: I have a veterinarian like that also, who won't stay two minutes past closing time.

Heather Howell: That can be difficult if the owner won't set expectations and let every one know how clients are to be treated.

Heather Howell: We can have a part 2 on this subject and maybe ones specifically dealing with billing, euthanasia, focusing on the staff members, etc. Good night all and thanks so much for your input and for coming.

***** Logging stopped: 7/16/2001 7:58:24 PM
Participants: Anna, Beth, Debbie, Kal, Lisa, Lydia, Phyllis, Shawn, William