Dentist Missed Appointment Policies

Dentist missed appointment feesLast week I told you about the $400 missed dental appointment fee that’s made headlines. While most would agree that’s excessive, lots of practices have policies designed to discourage no-shows.

This week, let’s review some of the ways dentists handle patients who skip dental appointments.

A multi-tiered approach

Many dental practices treat the first missed appointment quite differently than the fifth. Some offices do not charge until the third missed appointment. Others charge an increasing amount for repeat offenders.

“After school appointments, Saturday appointments, and school vacation appointments are considered to be ‘prime time appointments’ and are in very high demand,” read one pediatric dentist‘s appointment policies. “If a prime time appointment is missed we will no longer be able to schedule your child during that time.”

And the rest of the family is at risk once one misses an appointment. “We reserve the right to cancel appointments for family members who have upcoming appointments, once a fee of $100 has been charged to another family member.”

Other dental practices simply “fire” patients who have missed too many appointments, asking them not to return. (Not surprisingly, some patients become irate upon being fired.)

Raising prices

Some dentists find that a $20 or $40 missed appointment fee either doesn’t cover their costs or doesn’t prevent future missed appointments. As a result, more dentists are charging $75 for no-shows, and some charge up to $150.

Sometimes it isn’t a flat fee, but related to the cost of dental work. “Our fee is 50% of the scheduled service,” said one dental worker. “It has cut down on no-shows quite a bit, but it still happens occasionally.” Other practices charge by the hour of missed appointment time.

Some practices even charge interest on missed appointment fees.

Patient contracts

The Internet is rife with inquiries from patients who don’t want to pay their fee, asking questions like, “Can my dentist charge me for missing an appointment if I didn’t even know there was a fee?”

Some practices get around this possible objection by having all patients sign an actual contract outlining their financial policies. “A new patient fills out paperwork,” said one dentist office. “Like with any contract, it clearly states that they understand that if they do not give the required 3 business days notice, there will be a charge of $50.”

Other practices simply post their policies on their dental website and/or in their waiting room.

Patients just don’t want to pay

One patient offered this advice to others looking to get out of paying fees: “Whenever I get charged some sort of ‘late fee’ for a utility bill, I just call and ask if they would consider redacting the charge. I’ve never had anyone say no.”

“It also is with great discretion that we dole out cancellation charges,” said one dentist. “We know that by law they are uncollectable, but it prevents the bad apples from making future appointments and wasting more of our time.”

Cutting down on missed appointments

Calling patients to remind them of upcoming appointments can dramatically reduce no-shows. Multiple calls can be time-consuming but effective.

“We call our patients who have upcoming appointments 30 days prior to the appointed date to allow them ample time to make other arrangements,” said one practice. “We call again 2 weeks before the appointment, 5 days before the appointment and again 24 hours before the appointment. It takes a long time to make these calls but we find it is worth it in the long run because we usually see about 200 patients per week and have approximately 10 no shows or late cancels out of that number.”

What’s your policy?

How do you maintain profitability without alienating patients who have missed appointments? If you haven’t yet taken our survey on missed appointment policies, I encourage you to do so now!

Dental Marketing Gone Bad: Dentist Threatens Lawsuit for Negative Review

Dental Marketing Gone Bad: Dentist Threatens Lawsuit for Negative ReviewThe most costly dental marketing mistake could be threatening to sue your dental patients.  And once again, a dentist is making front-page news with her challenge against a negative dental review on Yelp.

ABC News is reporting that Stacy Makhnevich, DDS, threatened to sue dental patient Robert Allen Lee for posting critical comments about Dr. Makhnevich on Yelp and DoctorBase.

According to ABC News the problem began in 2010, when Robert Lee went into Dr. Makhnevich’s office for a scheduled dentist’s appointment. Lee claims he was in excruciating pain when he was told he had to sign a Mutual Agreement to Maintain Privacy form, before being treated. The privacy form required that Lee agree not to publish any commentary or write anything disparaging about his experience online.

Lee further states that although he was hesitant to sign this form, he was desperate to receive treatment and gave in to agreeing to sign the form.

Lee became unhappy when there was a mishap with billing his insurance company and he couldn’t get Dr. Makhnevich’s office to rectify the situation to his satisfaction, Lee wrote negative reviews about Dr. Makhnevich and her practice on Yelp and DoctorBase.

Both ABC News and Public Citizen are reporting that Makhnevich sent a letter to Lee demanding that he delete the negative posts, warning him that he violated the agreement he signed and threatened to sue him for breach of contract. Dr. Makhnevich also contacted the review sites and asked for Lee’s negative comments to be removed.

Both Yelp.com and DoctorBase refused to take down the negative reviews, but Makhneich reportedly claimed that a copyright clause gave her ownership of the negative comments. She then went on to send Lee an invoice for $100 for each day the negative remarks remained online.

Lee has now taken legal action against the doctor by filing a lawsuit in the US District Court of the Southern District of New York, accusing Stacy Makhnevich, DDS, of violating his rights as a patient by threatening him with a lawsuit for posting negative comments online.

As we have reported here on The Wealthy Dentist in the past, dentists have not been successful in court when suing patients directly for their negative online reviews. Recently in California a dentist who sued a patient now has to pay $80,000 in legal fees, not just to the patient who posted the review, but also to Yelp itself.

In the article, Dental Marketing: A Guide for Avoiding Negative Online Reviews, The Wealthy Dentist has offered dentists advice on how to handle a negative online review — and threatening to sue the patient was not listed as a viable dental marketing option.

What are your thoughts on negative online reviews and the sites that allow them?

For more on this story see: Dentist Threatens to Sue Patient for Negative Yelp Review and Doc Sued Over Attempts to Prohibit Patients From Writing Online Reviews.

General Dental Patients Are the Most Profitable For Dentists

General Dental Patients Are the Most Profitable For DentistsFor most dental practices, a certain percentage of dental patients drive the majority of profits.

But you might be surprised to learn that the more extensive dental treatment patients may not necessarily be the best profit-drivers.

It’s important for dentists to know what type of dental patients are the most profitable to their dental practice. In studying what makes this group profitable, dentists can apply what they discover to other dental patients.

The Wealthy Dentist conducted a survey asking dentists which type of dental patients they find are the most profitable for their dental practice.

34% of dentists responded, “General dental patients are always the core (profits)!”

Here’s a breakdown of the rest of the dentist’s responses —

24% Dental implant patients
18% Cosmetic dentistry patients
11% Sedation dentistry patients
09% Braces patients
02% Dentures patients
02% Other

Here are some comments from our dentists:

“Our most profitable patients are those that pay in full before treatment begins.” (Texas dentist)

“Dental implant patients seem to always pay on time.” (Ohio prosthodontist)

“Patients who pay in full and refer other patients.” (General dentist)

“Sedation patients are the most profitable.” (California dentist)

“Cosmetic patients who want to replace amalgam with a more esthetic composite.” (Arizona dentist)

General dental patients have long been the most profitable type of dental patient for dentists, is this true of your dental practice?

Dental Patients Willing to Travel for Treatment

Dental Survey ResultsDental Patients and How Far They Travel

When we asked dentists how far their average patient travels for treatment, most said about 5-10 miles. However, anecdotes abound of patients who have kept their dentists even after moving hundreds or thousands of miles away. Not surprisingly, rural patients are more likely to travel farther for treatment than do urban or suburban residents.

  • “I have both an active local clientele and an international clientele.” (Urban New York prosthodontist)
  • “Not enough patients come from far away.” (Suburban New York oral surgeon)
  • “Many of our patients travel up to 4 hours by car for their treatment.” (Urban California implantologist)
  • “We have a handful of patients who have moved out of state but continue their care at our office when they are in the area.” (Suburban Colorado dentist)
  • “We advertise on radio for sedation and complex dental services. People drive well over one hundred miles, or as far out as they receive the radio’s signal.” (Suburban California dentist)
  • “We have patients who fly in every year or less from over a thousand miles away. If patients know you’re honest and have their best interest at heart, they will come from anywhere, no matter the distance.” (Urban Minnesota dentist)

Read the complete patient travel distance survey results or post your own comments

Funniest Dental Patient Excuses (VIDEO)

Dentists offered up the funniest excuses they’ve heard from patients for missing appointments in response to a recent poll by dental practice marketing resource The Wealthy Dentist.

The clear winner was the toothache defense: “My tooth hurts too bad to get out of bed,” complained one patient.

Read more: Missed Appointments: Patients’ Funniest Excuses

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