Veterinary fees: Find the balance

Providing estimates on veterinary procedures can often tip the scales on acceptance or anger about fees.

But you should not be put on the defensive about charging appropriatelyfor your time and experience, says Owen E. McCafferty, CPA, who runs anaccounting firm focused on veterinarians in North Olmsted, Ohio.

Last month, DVM Newsmagazine reported on a panel discussion addressingpet owner complaints about escalating costs of veterinary services ("Petowners moan about fees; experts say it signals a need for communication").McCafferty was asked about the presentation of a veterinary billing statementand what veterinarians could do to improve client communications about fees.

No magic solutions

There is no magical solution to wiping out complaints about fees, butthere are strategies that will help.

McCafferty explains, "Clients, by their very nature, want the bestat little or no cost. This attitude toward consumerism has been broughtabout not by interaction with professions, but rather the relationship thatthe American public has with consumer-based activities, such as Wal-Mart,K-Mart, Home Depot."

The trick on not getting clients miffed is to take away any surprisesabout veterinary fees by presenting a detailed estimate.

"There are two sides to a bill; there is the estimate and the actualpresentation of the fee for service. The biggest mistake practitioners makeis they don't do the estimate," he says.

Without some understanding of costs associated with a veterinary procedure,it becomes understandable that some clients will walk away with stickershock simply because costs were not addressed right up front.

"The proper time to do the discussion about a bill is in the estimate,before the service is rendered," he adds.

In the details

When a client is presented with an estimate, a detailed, itemized accountingof costs of services is very much warranted. It is followed-up with an oralpresentation that provides the overview of the bill.

While he doesn't recommend estimates for general examinations, a work-upon sick animals is completely different.

How detailed do you want to get in the estimate? Assign costs all theway down to the sutures, McCafferty says. You want to show the client thetrue costs, he says, and allow a client to make choices before proceduresare performed.

He also says that veterinarians, especially surgeons, are starting toassign costs based on the amount of time spent with a patient, which hethinks is very positive. Another positive is that even seasoned practitionersare charging more for their time as opposed to younger practitioners withless experience.

Keep it understandable

The hazard in providing so much detail is that a bill can become confusingto clients.

McCafferty explains, "Delineation of specific elements of servicerenders a communication, providing that communication is understandableby the client. The balance between too little and too much detail then becomesthe point where minutiae becomes not a communication but confusion,"he says. "At what point does the invoice that is generated by the practitionernot be a way to show the client what was provided, but rather confuse theclient? Does the invoice communicate why things are being charged? Is theclient experiencing angst and then, sometimes, anger for not fully comprehendingthe doctor's level of competency in providing the service?" he asks.

Practitioners will have to answer these questions and come up with aworkable solution that clients will accept and understand.

If you are getting complaints, consider making changes to the way billingis handled.

"The level of details in a bill is an age-old debate that goes onin all professions," McCafferty adds.

Make the presentation

Who presents the estimate? Typically, it could be the job of a doctoror a technician who has excellent client communication abilities.

"In some practices, they have people who are trained to presentthese estimates. They know enough about the procedures that they can answerquestions, and it works out very well."

McCafferty says, "The biggest mistake practitioners make is thatthey hire an entire army of introverts, and as a result of that they neverare able to give the right kind of narrative that people can understandcosts associated with these fees."

McCafferty says that problems with fees develop when the client is unawareof what is going on and what kind of fees they will be charged.

Through healthy communication before procedures are performed, and adetailing of the procedures and costs, most clients will not balk at thebill. After all, they went into the transaction knowing costs upfront, headds. M