Dentist Appointments: No-Shows Must Pay Anyway

Missed dentist appointment fees have recently made headlines, with one Canadian man complaining loudly about a $400 cancellation charge.

Many dentists charge patients missed appointment fees. Typically, these fees tend to be about $25-50 per appointment. But there's a lot more variation than you might expect!

A recent survey we conducted showed that an average of 1 in 10 patients is a no-show. That's a 10% reduction in dental practice profitability, and a serious dental management issue.

The $400 missed appointment fee

Roland Ikporo's son got a toothache last month, but their family dentist was closed. So he took his son instead to Calgary's Expressions Dental clinic.

The dentist there conducted an exam and took x-rays at a cost of $150. He told Ikporo that his son needed 4 teeth removed right away. So Ikporo made another appointment for two days later.

But within an hour, Ikporo cancelled the appointment, realizing that his general dentist would be cheaper. (While Expressions Dental would charge $1,700 to remove the four teeth, the dental work was only $800 from their regular dentist.)

Though called the dentist office to cancel the appointment less than an hour after he made it, his Visa was billed an additional $400 missed dentist appointment fee.

Ikporo had in fact signed a consent form that explained the clinic's cancellation policy: give 72 hours notice or be charged $200 per hour of missed appointment time. So by booking an appointment less than 3 days in the future, Ikporo had no ability to cancel.

Angry, Ikporo has registered a complaint with the Alberta Dental Association and College. They are now investigating.

Just an observation: Even if he pays the $400 fee, Ikporo will still have saved money by having his family dentist perform the extractions… The general dentist's $800 fee plus the $400 cancellation charge is still significantly less than the $1,700 quoted by the dental clinic.

What’s your policy?

Many dentists find that a $20 cancellation charge just doesn't get the job done. How does your practice handle no-shows?

http://www.thevisibledentist.com/ The Visible Dentist

From the looks of all the negative press the dentist has received (137 comments last count), it’s likely he’ll wish he had never listened to that dental marketing consultant’s bright idea of charging 400 bucks for a cancellation.

Personally I think it’s better to charge a modest, non-refundable appointment fee up front, applicable to the eventual bill.

John Barremore, SEO
Houston, TX USA
http://www.drbobdeaver.com Robert Deaver

We send a letter after the 1st no show or last minute cancellation reaffirming the policy of the importance of the appt and the everyone’s time and waive the charge for no shows and last minute cancellations the first time. We call both by person and an electronic calling system and this works but if we use just one system, it does not. Human behavior is certainly interesting but that is an entire volume of books and posts. On the second time, we do charge $75 hr and we are prepared to not see that person if they do not pay
http://fatherandsondentistry.com Wesley Harper, DDS

For years we have charged $50 for a failed appointment defined as a no show or a cancellation with less than 24hrs notice. We waive this charge frequently if there is a reasonable excuse. Our purpose with this fee is to modify patient behavior not to anger them. But they all know if they blow us off there’s a penalty. We’ve never lost a good patient over this. In the case described in the article we would have waived the cancellation fee. Reading between the lines I suspect that the parent felt pressured into making the appointment. Later he had regrets. If you really want to reduce no shows and cancellations the secret is to not pressure people into making appointments in the first place.
http://www.marketingfordentalspecialists.com Marketing for Dental Specialists

$400 is a ridiculous charge for an appointment that was made for 48 hours out and then canceled within an hour. That is just trying to take advantage of the fine print.
http://SanRamonDentalCare Karl J. Muzikar, DDS

My name is Karl J. Muzikar, DDS and I am a practicing dentist of more than 25 years and 5 days a week. For the first missed appointment, I always send the patient a bill for $50 for each 1/2 hour that was scheduled. This is accompanied by a “courtesy for missed appointment”. In this way the patient knows exactly what will happen if he misses another one. If the patient does miss a second appointment, they will not be allowed to schedule a third until they pay for the missed second appointment.

We have a periodontist in town who will charge the entire surgery fee for the missed appointment. He has been doing this for 30 years and NOBODY fails him second time!

As an aside, I find it difficult to take much credence in those in this blog who fail to identify themselves and why they should be taken seriously. Who is “Marketing for Dental Specialists”? Why should I believe them? Perhaps the doctor rearranged a bunch of other people’s appointments and cancelled his personal plans to accomodate the patient. Maybe it is not “trying to take advantage of the fine print”. Maybe the doctor was trying to make sure that this patient did NOT make another appointment in their office. This would be one way to do it.
Gerald Levin

I charge NO fee for a cancellation or a missed appt. I absorb the cost/time. I feel everyone is due a second chance. But it is recorded and if they do it again to me, I’m done. Well done. And will not see the patient again.

One missed appt and a fee charged for that appt is the quickest way to get that patient out of your office. Not my policy.
http://www.LarsonRoelofsFamilyDentistry.com Dr. Renae Roelofs

We make our $50/hr. missed appt. fee known at the start of the dentist/patient relationship and explain that we only schedule 1 patient at a time. We ask for 48 hour notification to change the appt. Everyone is entitled to one mistake so a letter is sent with a courtesy adjustment the first time. The next time the fee applies and patient will not be seen until it is paid. We do not enforce this for acceptable excuses (i.e. illness, death in family, car trouble).
http://www.dental-solutions-europe.com George McKee DDS

Word of mouth and bad press is going to cost that clinic a lot more then $400. Times are bad enough without driving your new patients away from your door due to your bad reputation.
John Walter DDS

I did look into this issue and also took the time to find if there were any postings from the dental office which charged this fee, I could not find any and it also looks like this original posting was made by CBC news which means it had to be made negative. I dont see any facts listed by dentist office. $400 is a little too steep but I think there may have been a reason as to why this would have been done by a dental clinic. I have been in the dental field for a long time and I know how it feels when you have 3 hour bridge prep appointments booked and the patients dont show up. What does it cost a dental office for this? Well….there are a lot of things….salaries…cost of practicing….assistants….receptionists and the most of the advertising costs…..

What I also see in this case is that the gentleman was not able to get in with his own dentist and this dental office may have gotten him in on an emergency bassis and then he makes this appointment and then he decides to to his dentist cuz his dentist might have returned his call finally a day late.

The fact that this guy signed a consent to keep this appointment and later cancelled it was not fair on his part either. Lets take an example of an airline ticket…they will not only charge a change fee but the cost of the difference in fare. Here is another example…what happens when an employee comes to work and works for 3 hours and then there is no work…then the employer should say since you worked only three hours then I should pay you for 3 hours. I have a cancellation charge of $100 now and if the appointment is for 3 hours then I lose on it. I think that if you make a commitment you should keep it and I am sure this dental office must have decided to take such a step after thinking much.
http://www.thevisibledentist.com/ The Visible Dentist

Here’s a few tips for resolving negative complaints.

How To Handle Negative Online Reviews

John Barremore
Houston, TX
melissa miller1

So $706.00 for a missed appointment for only xrays and initial exam is extreme? You may email me.
Joe

I am an attorney and I would represent this guy for free in a lawsuit against the dental clinic. Dentists are too greedy.
Robbie J

Hahahah…an attorney who says we dentists are too greedy! I would love to charge 200 dollars an hour to sit on my but with little overhead and write emails and letters…guess how much we get for intellectual work…hmm nothing.
http://chicagodentists.us chicago dentists

Cancellation is not a good solution in my practise because it means the loosing money, if I charge someone for cancelation I am sure he will never back again, I am using a call solution, kind of reminders, it works good, the cst of it is very low but works excellent.
http://www.insightsfordentists.com Dentis Marketing Solutions

If the policy was on the contract that Ikporo signed, is there any basis for a lawsuit? As unfair as the charge may have been (ridiculously so!), he did sign the consent form.
http://www.RoyalYorkDental.com Toronto Dentist in Etobicoke

I think that father had a right to be angry in this situation. Like George said, the bad press will cost that dental office far more than the $400.

Joe
http://www.torontodentist-smileblog.com Toronto Dentist in Etobicoke

I charge a nominal fee, only on the second strike with no legitimate reason. The fee is more of a warning, as part of training patients to play by the rules and be mutually respectful.

Joe
Jan

We use patientReminder (patientreminder.eu) which greatly helped us to reduce patient no-shows or late arrivals. It sends automatic SMS to patient eg. 2 days before an appointment. We use it also for prophylaxis recalls. Furthermore it is a great service for patients, they like it.
Mzerbarini

Hi,
My 18 year old son blew off his appointment to have his teeth cleaned. I called the office and asked them to send him the fee, and he would be responsible. Two days later, I received a bill for $212. with an itemized bill for flouride, xrays, etc. totalling 212.. This seems exorbitant. I figured they would charge him a cancellation fee, but this seems outrageous. Please advice.