Charging for Consults Without Losing the Lead (Part 1)

Andrea (00:04):
Well, hi there. I am Andrea Watkins, and if you're listening to this while juggling three patient calls, checking in a couple patients, taking a payment, selling skincare, and trying to catch your doctor in between procedures, you might be working in an aesthetic practice.

Blake (00:18):
And I'm Blake Lucus, and this is Practiceland. This is not your doctor's podcast.

Heather (00:27):
Welcome back to Practiceland. I am Heather Hughes Hardy, registered nurse, retired patient care coordinator, and your sometimes host here on the podcast. Today's episode is all about overcoming booking blockers, specifically appointment fees. And this one is for the front desk pros, the individuals in a practice that uniquely act as both the frontline and the last line of defense. And this group of staff, they have the responsibility of working diligently to fill the books, optimize the schedule, initiate and reinforce the patient experience, and act as the administrative extension of the provider team. It's a lot to handle. And from my own experience in that role, I can attest that one of the blockers I consistently ran into was consult fees. But today our guest is Jenna Hennig, registered nurse and aesthetic sales specialist. She has worked in almost every seat in the practice from patient concierge to social media marketing, to clinical nurse, and now an experienced nurse injector.

(01:20):
From her unique perspective, she's walking us through the why behind appointment fees and the exact method that you can use to effortlessly explain their purpose to the prospective patient and ensure that you never lose a lead to the consult fee again. Jenna, thank you so much for being with us here today.

Jenna (01:36):
Yeah, I'm happy to be here. Thanks for having me.

Heather (01:38):
Absolutely. Well, before we get into frameworks or tactics, can you take us back to your experience with this side of aesthetics pre-provider and how your view of the appointment fees has taken shape to your understanding of them now?

Jenna (01:52):
So I came into this field just desperate to get out of the hospital. I started off in labor and delivery nursing, and then I quickly learned that the hospital life was not for me. And so fortunately, I was able to secure a spot at a plastic surgeon's office in the social media realm. At that time, they were a smaller practice. They didn't need any nurses directly, but I was like, "I will clean your toilets. I will do whatever I need to do. Please, I would love to work here and I'm a hard worker, not I can work my way up." And so fortunately they took a chance on me and gave me a position in social media because I had a little bit of background in that. And so I started off filming in the OR. Then we started growing really, really quickly. So then we needed somebody to help with the front desk.

(02:35):
And so I started assisting with that and I started assisting in clinic. And my main roles started to develop into social media filming, helping at the front desk as far as scheduling patients, being patient concierge, and then a little bit of dabbling in the room with consults with direct patient care. And so I really got an in- depth view as far as every different aspect of the practice from start when you take the phone call to actually seeing the patient in the room. And then finally when you get to the procedure of what that whole process looked like. So it gave me a really unique perspective on the entire patient experience and then kind of getting to see the different barriers as they come in each step.

Heather (03:09):
It sounds like you definitely have, you've seen it from full circle now. And so that consult fee or that appointment fee, it probably has a little bit of a different meaning to you. Whether from that time that you were sitting at the front desk, it meant one thing and now you're on the other side of it as a provider. But talk to me a little bit about the purpose of the appointment fee, the consult fee, and why they exist, and what we're really trying to accomplish when we're requiring a prepayment for a visit.

Jenna (03:37):
Yeah, you brought up a really great point. I think it's a very different perspective of what that fee entails when you're in different seats in the practice, because when the front desk, you're like, "Man, this is such a barrier. Can we just get rid of this thing?" But then when you're in the room and it's time on your schedule, you're like, "Man, can we just put something on there so that way I'm not having..." It's a little bit of a more reliable show for patients. But the purpose, and we've done it a lot of different ways. I've had experience where we had no consult fee and there were free consultations. I've had experience where we had a higher consult fee, and I've had experience where we lowered consult fees. We've also done where we have done card on file. So I've experienced quite a few different ways of collecting some sort of commitment from the patient, but I will tell you some pros and cons of each.

(04:21):
So before, when we had no consult fee, the schedule was full, full, full, full, full, and it was crazy. But the cancellations and the no-shows were also crazy. So then you show up to your schedule and you get there and you're like, "No show, no show, no show, cancel, cancel, cancel." And there's no penalty because there's no commitment from the patient. And sure, there were tons of patients who did show up too, but that's such valuable time in the moment that you can't fill directly right then and there that you've then lost. And so for somebody who's super, super busy and you have a lot of patients who want to get in, if they're no showing you same day, that's just a waste of your time. And it's also important for the patients to, I think in this day and age, I can't even get a hair, I literally booked a hair appointment for next week. I can't even get a hair appointment without a car on file or paying half a deposit. Nothing in life now, very few things in life can you even get without some sort of commitment with the card and file or even a deposit.

Heather (05:15):
You've touched on maybe that there are other things that you could do, but when it boils down to it, do you think that consult fees or appointment fees are a non-negotiable?

Jenna (05:26):
I don't think they're non-negotiable. I think it's just a matter of what are you willing to sacrifice Because if you don't do them, then you sacrifice potentially time on your schedule that you can't get back. You can never give back time. If you do do them, you sacrifice some patients who may not be willing to pay a fee who no matter how good your patient concierge is not going to book. And that's a potential lead that you've lost. But I really do feel like the sweet spot is at least doing a card on file because the one thing, I mean, if you're doing your marketing well and you have really good employees who are reaching out and nurturing these leads, you're going to have a good base to be able to get people into your door. And the last thing you want to do is have the moment where you're sitting there in the room waiting on somebody who's not showing up because that's time that you really can't get back. So I do think for me, they're essential and my preference would be to have them, but it's just a matter of which one are you willing to sacrifice.

Heather (06:21):
So it sounds like the consult fee is pretty much the mainstream tactic here that a lot of practices are employed, but some are choosing not to. And if a practice were to choose not to implement, what could they do in other efforts to still pre-qualify and protect the schedule?

Jenna (06:41):
Yeah, there's lots of other tactics you can use. Having a card on file, so not collecting to deposit, but just having a credit card on file for that, a clear cancellation policy, having a pre-visit nurture sequence and a lot of communication beforehand to make them feel really excited and prepared. And then required pre-visit forms, that's always really, really helpful. And then a pre-call with a seasoned sales consultant can also be super helpful just to kind of really re-secure them and get them committed.

Heather (07:04):
Okay. This is all super helpful and I'm excited to dive into each one, but if I'm being totally transparent, in theory it makes sense. When I was sitting in the seat, I could hear something like this and be like, "Yes, cool. I have a few things in my back pocket that I could do here," but then I might go to implement them and feel just as lost because understanding it myself is step one, but then to go and explain like, "Okay, this is why we do the consult fee or this is why we have the cancellation policy. I needed some help crafting how to actually communicate that confidently." So can we talk through some scenarios to kind of help shape taking this from concept to practice? Would that be okay with you?

Jenna (07:47):
Yeah, let's do it.

Heather (07:48):
Okay, cool. So let's start with simply just communicating the consult or appointment fee. And let's say you're sitting at the front desk and the phone rings and there's a lead inquiring about a surgical consultation maybe for like a rhinoplasty and we're having a great chat and then we're moving into the more logistical piece of the conversation. It's time to bring up the fee. Can you tell me a little bit about when is the best time to do that in the conversation and what exactly do you say? Because I imagine there are a few different points that someone could bring it up.

Jenna (08:21):
Oh, totally. And it kind of makes me laugh remembering this phase of my career because there's definitely a wrong time to bring it up. And so a lot of individuals that I'd work with in the past, one of the first things they would say, you call a lead and you're like, "Hey, thank you for your interest, blah, blah, blah." And then you're like, "Okay, before we get started, I just want to let you know that we charge a $200 consultation fee." And the patient's like, "Okay, yeah, no, thank you. I don't want that click because they have no buy-in, they have no interest." And you're kind of like, "Okay, this one less I have to do. " And instead of the incentive to get them bought in and the driver, it was just a way for them to kind of tick through the schedule. So don't bring it up in the beginning, it's definitely going to shut it down.

(09:00):
You have to build that investment first. So as far as when to bring it up, the most important thing at the start of the call, and I won't go too much into this, but it's getting that emotional buy-in, figuring out why they reached out in the first place, making them feel like you're a little bit invested in them because you want it to be a really positive experience about them, not just about the card that you need to collect. So once you've collected that information and you've made a little bit more of a deeper connection with the patient, then when you start to look at some dates and you've already talked about how great the practice is and the provider that they're going to see and you've gotten them really excited and they really understand the value of what they're about to place that fee for, that's when you kind of solidify it and you say, "I know that provider X is really excited to see you.

(09:40):
In order to get this everything secure to already have X, Y, Z, here's what you can expect. The last item that we will need to secure your appointment will be the appointment deposit of blah, blah, blah." And if you apply that towards their service, you can mention that too, but it's already at the end when you've already gotten them committed, they've got a date, they know everything's working, they're super excited, that's when you mention the fee because they understand what they're actually buying into.

Heather (10:02):
Okay, perfect. And this is great, but then you still have those clients sometimes that you're on the phone with them and then they give you the pushback and you've done the credentialing, you've talked with them, but they're still like, "I wasn't really expecting to have to pay in advance just to get the doctor's advice. I'm not really ready to do that. I'm just going to keep looking around." How would you respond to that?

Jenna (10:27):
Yeah, it can feel really awkward when you get that response because you're like, "You don't want to be pushy, right? Nobody ever wants to be pushy." So a lot of it does depend on some of those questions that you've asked beforehand, but the most important thing too is building the value of what they're going to experience. And then you can ask the question again of like, "Oh, I completely understand. You want to make sure that whatever you're investing into, that it's something that's going to be conducive to the aesthetic goal that you're trying to reach." So then you can kind of follow up with like, "Yeah, I definitely understand there's other options out there and I want you to choose the option that makes the most sense for you. " For our practice, we do require this consultation fee to make sure that we're able to secure the time on our provider's schedule.

(11:04):
They can spend the full amount of time with you. And with our provider's credentials of X, Y, Z, we want to make sure that we're able to have them fully deliver that expert opinion to you in the room. So given their credentials of X, Y, Z, we do require that deposit so we can provide you the best experience and be able to provide all those amenities that really drew your eye to us in the first place.

Heather (11:23):
It comes so natural when you're saying it and you seem so comfortable. How long did it take for that to just become second nature to you?

Jenna (11:32):
It takes a long time. I mean, the biggest thing is just practice. It's so funny, in the beginning you take a phone call and the first time you get the pushback, you're like, "Ugh." And even as I say it, I'm like, "Oh, there's a better way I could say that. " So no matter what, I don't think you ever feel like you're like, "Ooh, I crushed it. " But the more you practice, the more objections you get, each one is like a gold star on your belt. It's like, yes, I got another one. I got more experience with that. And eventually you can literally be typing in their information like you're saying your whole spiel as you're writing out something completely different. It just becomes second nature and you just go into it with the ... Your goal is to truly help them. And if you really believe that your provider, your office, your services can help them, it becomes a lot simpler than you think it would be. So just get out of your head and just focus on what they're telling you they want and how you want to help them, and then practice, practice, practice, and it will just flow.

Heather (12:23):
You've given us some really great verbiage to work with here. And I wonder, I know we kind of touched on it, but maybe we could do a mock call. I can pretend that I'm calling in and you can run it through with me. We'll pretend that I'm calling to book maybe a cellulite treatment with you and you're the front desk person. All right, the phone's ringing. You can go ahead and pick it up.

Jenna (12:44):
Hello, this is Jenna. How can I help you?

Heather (12:47):
Hi, my name's Heather. I was wondering if y'all had any treatments for cellulite. I've seen it on your social media. I was hoping to book an appointment.

Jenna (12:55):
Oh my gosh. Yes. I'm so glad that you called. We have some really great options for cellulite. I hear that you found us online. Tell me how long you've been struggling with this concern and what other options that you've tried to treat it.

Heather (13:07):
Yeah. Honestly, I've had it for a while now, but it's just always bothered me and I didn't realize there was actually anything that you could do that wasn't just creams because I've tried all of that before and it just didn't really work. But I saw this video of this cool device where you just actually cut it and I was like, "Oh my God, I have to go do that".

Jenna (13:26):
Yeah, absolutely. I think I know exactly the treatment you're talking about and it truly is phenomenal. Before we get into the details, because I really want to make sure we get you to a spot where you're able to feel a little bit more confident and comfortable in your skin, I would like to collect a few bits of information just in case we get disconnected and to make sure I can send you any follow-up information that you may need after our call. Is that okay?

Heather (13:45):
Sure. Yeah.

Jenna (13:46):
And then we proceed to collect all the information, put it on the CRM. The key to this is really not if you get disconnected, it's really to make sure that you can nurture them and follow up, collect it all moving forward. Okay, perfect. Thank you so much. Okay. Now to get into the details, I know that you mentioned a treatment. It sounds like our Aveli treatment. Does that sound familiar?

Heather (14:04):
It does, yes.

Jenna (14:06):
So our practice is very, very experienced in the Aveli treatment. It's actually our provider is one of their favorite treatments. And the reason why is because it is one of the only treatments that actually addresses the true cause of cellulite. So you're able to go in there and fully cut and release those bands, which is really, really neat. Now, because our providers are so experienced in treating cellulite, they'll be able to walk you through all of your concerns and be able to create the best treatment plan for you. I'll go ahead and make a note in here that you saw the Aveli video. Is there anything else that you're noticing that you'd like to discuss with your provider at that appointment?

Heather (14:39):
I mean, while I'm in there, I would be curious to hear about other things. I typically go somewhere else for Botox, but I guess I could totally fit that in too.

Jenna (14:49):
Yeah, absolutely. Yeah. I mean, you'll have a full 30 minutes with your provider, so they'd be happy to talk about any concerns you have, and then they can create your customized treatment plan to address each one of those. I know you had mentioned that you had tried some creams and things in the past. Is this your first time looking into an actual medical procedure to address your cellulite?

Heather (15:06):
It is, and mostly just because I didn't realize there was one.

Jenna (15:09):
Okay, perfect. When you were doing your research online, did you have any questions as far as the downtime or pricing or anything that you feel like you may need going into the appointment just to make sure you're fully prepared?

Heather (15:20):
Oh, for sure. I mean, I would love more information on what it's going to cost because I didn't really see that there. Yeah, I think that would probably be a big one for me.

Jenna (15:32):
Cost. You got it. Is there a set amount that you're hoping to spend on your procedure? Are you kind of open or is there a monthly budget that feels comfortable for you just so I can make sure I give you all your options?

Heather (15:42):
I'm not really sure, honestly. I mean, I'm not looking to spend 10 grand or anything, but I mean, if it's really going to work, I think I can be flexible.

Jenna (15:53):
Okay, perfect. The great news is that when you meet with your provider, they're going to give you that custom treatment plan with all the information with the pricing of the treatments that you decide to build together. I am going to go ahead and send you some information as far as different options for financing and pricing. It's what a lot of our patients use in order to build their total treatment plans together and be able to phase it out into something that works really well for their budget. So I will send you that. And then what you can expect from your appointment is you're going to meet with one of our expert providers who specialize in cellulite. Do you have a preferred provider that you've seen online or is there a day of the week that works best for you?

Heather (16:26):
I think the video that I saw was nurse Jenna, so I would love to be with her and day of the week doesn't really matter as long as it's probably like two weeks out just so I can get time off of work.

Jenna (16:38):
Absolutely. I will see if I can squeeze you in on your strength schedule here in a couple of weeks. She does book up pretty fast, but I do know that cellulite is one of her favorite conditions to treat, so she'll be super excited to see you. It does look like she has availability two weeks from now on X day at X time, or her next availability would be the next week at X day at X time. How would either of those options work for you?

Heather (17:00):
Ooh, let's do that first one.

Jenna (17:02):
Okay, perfect. I'm going to go ahead and secure that date for you. Now there's going to be a few items just to make sure that Jenna's able to provide you with the most comprehensive assessment and make the most out of your time and give you the best overall plan. I'm going to send you some forms that are just going to go over some of your history, some of your concerns and what you're hoping to achieve. And I'm also going to send you some other links to our app, blah, blah, blah, blah, blah. Okay, perfect. Now, do you have any further questions for me or anything else that you feel like you want to address on our phone call that we haven't already gone over just to make sure that you feel like you're fully prepared for your consultation?

Heather (17:37):
Will we be able to treat same day or is it just going to be the consult?

Jenna (17:41):
Yes. So for the appointment that we are securing, it's going to be a 30-minute appointment. For this procedure specifically, unlikely because the audi appointment is about two hours in total and there may be other treatments that you both discuss and who knows, this may not even be the treatment that they suggest overall, depending on your concerns. So this appointment is going to be focused on building your custom treatment plan after they're able to fully look at your body and see exactly what's causing those concerns. And then we can definitely find a time that works well for your schedule to do the treatment. What is your hope as far as your treatment timeline?

Heather (18:14):
I mean, summer is literally here, so the sooner the better, but maybe within the next month or so.

Jenna (18:22):
Okay, perfect. Well, I'm really glad that we got you in on Jenna's next availability here in a couple of weeks because that's going to be key to getting you an early treatment date. I am going to make a high priority note on your account, just so that way she knows going into the appointment that you are going to want to be treated sooner rather than later. So we'll go ahead and do that. And then any other questions or concerns that you had before we move on to the next phase of booking your appointment?

Heather (18:43):
No, I think you've answered all my questions.

Jenna (18:46):
Okay, perfect. Alrighty. So I'm going to go ahead and secure this appointment with Nurse Jenna, one of our cellulite experts at X date at X time. Again, I have a high priority note on your account, so that way she knows that you want to get this treatment done as soon as possible so you can feel good for summer. And then the last step for booking that appointment is just collecting our consultation fee, which would be a fee of $100. And the great news is that this fee does go towards your treatment plan that you will build with Jenna in that appointment.

Heather (19:12):
Oh, there's a fee for even just the consult?

Jenna (19:15):
Yes, we do charge a consultation fee for that custom treatment plan that you are going to receive with Nurse Jenna. Again, since you're already planning on treating, that fee will go towards a treatment that you book with her at that appointment date, so that way by the summer you can feel really confident in your skin. So it is an initial investment that will go towards your overall treatment package.

Heather (19:34):
Okay. And I thought I wanted the cellulite treatment, but if I decide to do something else, can it be used towards that maybe?

Jenna (19:42):
Absolutely. That's the beautiful thing is this appointment is fully built around your concerns. So whether you guys build a treatment plan around cellulite or whether it's a facial rejuvenation plan or whatever it is that you guys decide would be the best process for moving forward, that fee will go towards that treatment plan.

Heather (19:58):
Okay. Yeah, That makes sense.

Jenna (20:00):
Okay, perfect. So I'm going to go ahead and collect this fee. As a reminder, this is a consultation fee that is non-refundable and non-transferable. So this fee goes towards the treatment plan that you do build with Jenna in the room. It will go towards your overall treatment plan and it will be held to our cancellation policy of a 48-hour notice for appointment changes or cancellations.

Heather (20:21):
Okay. So if I have to cancel within 48 hours, I don't get it back.

Jenna (20:26):
Exactly. We do ask for a 48-hour notice, which is a pretty good window if you need to make any adjustments.

Heather (20:31):
Okay. But if it's before then, I can just call and let y'all know?

Jenna (20:34):
Exactly. Exactly.

Heather (20:35):
Perfect. Okay. Yeah, I think let's go ahead and do it.

Jenna (20:38):
Wonderful. I have you all set with Nurse Jenna at X time on next date. I know she's going to be really excited to meet you. I've documented everything that we've discussed here in our conversation, so she will be walking into the room ready to meet you and ready to create your custom plan, and I cannot wait to hear what you guys come up with together.

Heather (20:54):
Oh, that was so good. Okay, cool. You've given us some really good, like I said, great verbiage here and a great example. I think it's nice to put it into a full conversation because you can hear one great piece and then sit down and go to do it and you feel like, dang, I didn't have all the stuff that I didn't even know I needed. So I really appreciate you kind of running that through with us. I think it's going to be really helpful to our listeners. I am curious though, as we're wrapping up here, and you and I have talked about this before, but is there anything you should absolutely avoid saying? Because I think there are a few things that people unintentionally say when they're bringing up the consult fee that can really quickly kill it and they didn't even realize it.

Jenna (21:34):
Anything that puts somebody on a defense, and I think it's easy to get defensive when you get that pushback and it's scary to know how to handle it. So the biggest thing is for any sort of objection you get, it's yes and building value instead of just being like, you get, "Oh, you guys charge a consult fee?" Yeah. Okay. And they're like, "Okay, well, I don't want to pay something." So yes, we do and this is why. And you're just really building the value back. And because any of us, you have to understand where that resistance is coming from immediately. Anytime someone tries to collect a deposit, take money, there's a little bit of a resistance and that's normal, that's human nature. So just making them understand the value of what they're going to get and having that be in your mind the whole time, value, value, value instead of defensiveness of, "Well, our providers are really great or well, we have to charge for our providers time." And they're like, "Okay, well, I get that, but what if they're not the provider for me?

(22:29):
What then?" And they have all these worries in their mind. So it's building the value so that way it alleviates that worry instead of feeding it.

Heather (22:36):
That makes so much sense. The other one that comes to my mind that I often heard, and even I did it myself just because I'm a people pleaser, I'd be like, "So that'll be $200 to book today. Is that okay?" I would turn it into a question and then they're like, "Well, maybe it's not okay."

Jenna (22:53):
Yeah. I say the same thing about my kids. I'm like, "Never ask that question to an answer where no is not okay because there is no option of no." The option of no is, "Well, then find somebody and then I can't book you. " So instead of saying, "Is that okay?" Which is such a natural response, you just ended up, and now we're going to do this and it's that assumptive language. It's not a question, it's this is our next step in order to get you to where you want to be.

Heather (23:18):
I love that. Jenna, thank you so much. This would've been so helpful for me when I was struggling with this day in and day out at the front desk. We absolutely have to have you back for a part two to just go through all of the other tactics that you touched on to help pre-qualify leads, protect the schedule and reduce no-shows and cancellations. Would you be open to joining us again next week to maybe talk about that, the cancellation policy, all of those fun things? Oh my gosh, I would love to. Okay, amazing. Well, if you found this episode helpful and you want the 411 on all the Jenna breaking down all of the blockers to booking, join us again next week and you can get more of her expert tips. Jenna, thank you so, so much for joining us. Where can we follow you online for more?

Jenna (24:02):
Yeah, I am on Instagram and TikTok at Austinbeautyboss, and so you can find me on both those platforms. And then LinkedIn is Jenna Hennig, H-E-N-N-I-G.

Heather (24:14):
Amazing. Well, thank you so much for joining us today. We really, really appreciate it.

Jenna (24:19):
Of course, thank you so much for having me.

Blake (24:22):
Got a wild customer service story or a sticky patient situation? Send us a message or voicemail. If your tale makes it into our "She did what?" segment, we'll send a thank you gift you'll actually love. Promise, no cheap swag here.

Andrea (24:34):
Are you one of us? Subscribe for new episode notifications and more at practicelandpodcast.com. New episodes drop weekly on YouTube and everywhere you can listen to podcasts.