Missed Dental Appointment Fees

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Missed dental appointments: average fee is $50Two out of three dentists charge patients a missed appointment fee… but most of them wait until the second no-show to charge the fee.

In this survey, 30% of respondents said they don’t charge a fee for missed dental appointments or late cancellations. Ten percent do the first time, while 41% wait until the second offense, and 18% wait until the third time.

After three missed dentist appointments, almost half of doctors are ready to let that patient go. Here’s some more info about doctors’ missed appointment policies.

  • 1% fire patients after the first missed appointment
  • 7% fire patients after the second missed appointment
  • 35% fire patients after the third missed appointment
  • 29% do fire patients, but they have more than 3 chances
  • 23% rarely if ever stop seeing a patient
  • 6% never fire their patients

The average fee for dentist appointment no-shows was about $50. However, there’s a tremendous range. More than one doctor charges $100 per hour of missed appointment time. While one doctor bills for half the missed appointment fee, another charges for the full amount of the missed appointment.

No worries if patients pre-pay

  • “We collect $$$ up front when they make appointment (eg. all my sedation dentistry cases) or no appointment is made.” (Florida dentist)
  • “Make them pre pay for appointment time; then there is no need to collect after the fact.”
  • “We never ‘fire’ a patient…we just make them pay in advance for their appointments.” (California dentist)

Miss one appointment, prepay for the next

  • “Patients always miss appointments… After the first failure, we make them prepay ahead of time for their next treatment appt.” (Tennessee dentist)
  • “After the second missed, even though they pay the missed appt fee, these clients have to pre-pay the entire cost of the next appointment before they can be scheduled. Once they pay then are scheduled. this fee is non-refundable so if they do not show, the office does not lose.”
  • “After one missed appt, they must prepay for the next appt.” (Pennsylvania)

Require a credit card to book an appointment

  • “We are starting to require a credit card to make an appointment, the same as if you were making hotel reservations or renting a car. If you break the appointment without 24 hour notice, you will be charged an hourly rate based on the length of the anticipated appointment.” (General dentist)
  • “Broken appointment fees are one way, but reserving the appointment with a Visa/Mastercard may be more positive.” (Kentucky dentist)

Make sure patients know your time is valuable

  • “We emphasize the importance of reserving our time. The policy is posted on signs and on all appointment cards. We are flexible based on the excuse but will charge patients who have bad attitudes.” (New Jersey dentist)
  • “We discuss respect for our time or we don't respect theirs.”
  • “I suggest having a face-to-face discussion with the patient after the first missed appointment. If that doesn't phase the patient, then pre-paying for the appointment will either get them on board, or make them someone else’s problem.” (Tennessee dentist)
  • “The Doctor needs to get eye-to-eye with the new patient and right up front discuss with the patient that the doctor-patient relationship is very important and it is indeed a two-way street. ‘I as your doctor will be here for you but you must show up on time for your appointments.’ We must educate our patients!!" (Alabama dentist)

Have patients sign off on missed appointment fees

  • “We state our no show/last minute cancellation policy in the financial arrangement agreement form filled out by patient at initial visit.”
  • “Patients sign a form stating they will be charged if they miss an appointment." (New York dentist)
  • “If the 1st or 2nd verbal warning doesn't make a difference, send him/her/them a copy of your Cancellation Policy which they signed when they filled up forms during the initial visit.” (California dentist)
  • “In our new patient packet, the patient must sign a MAP letter missed appointment statement of our office policy on missed appointments. Our policy on who we charge depends on who the patient is, and what the excuse is. If they are chronic, they are dismissed from the practice in the
    legally proscribed manner.” (California dentist)

Advance payment for dental care

  • “Paying in advance increases incentive to show.” (Connecticut dentist)
  • "Try to get them to pay when they make and appointment. They will then rarely miss." (General dentist)
  • “Pre pay appointment before appointment is scheduled.” (Colorado dentist)

No-show patients get standby appointments only

  • “I don't ‘fire’ patients, but after 3 missed appointments they are seen only on a stand-by basis.” (Kansas dentist)
  • “Miss one and they get rescheduled out 6 weeks. Miss 2 and they get a fee. Miss 3 and they go on our do not schedule but call for any short notice appt list (VIP) since they are so busy they can't keep long standing appointments and it works better for them to call when they are available and see if we can fit them in.” (Pediatric dentist)
  • “After the second no-show for a confirmed appointment, we will assess a no-show/late cancellation fee, but only after trying to reschedule the patient for the same day if possible. After that, they are seen as a ‘walk-in’ patient.”
  • “Won't reserve an appointment time after 2nd missed appointment. They can only take cancellation spots." (General dentist)

Reminders are part of dental patient marketing
and management

  • "SMS text message to confirm, day, date and time." (General dentist)
  • "After their first missed we send them a reminder letter to reinforce our policy, after the second we send them a stronger letter, we bill them after the third one. If they value our office, they will pay the bill and keep coming. If not, then they don’t come back and they go away for non-payment." (General dentist)
  • “Constantly reconfirm then charge a fee for missed appointments.”
  • "Missed appointments are a fact of life. We make many phone calls to people we think may forget us." (General dentist)

Some patients are welcome to find a dentist
other than you

  • "They need to find a dentist with a more convenient dentist office." (General dentist)
  • “Usually if they pay the fee, they come on time, or they get mad and leave.” (Wisconsin dentist)
  • “They fire themselves.”
  • “You charge them, you lose them… but sometimes that's okay.” (New Jersey dentist)
  • “When I charge for the missed appt, it is basically our way to change their ways or encourage them to go elsewhere. After this point they become work-in only; we will no longer schedule time for them.” (Arkansas dentist)
  • “I let go only those that I do not like for some other reason. It is two way street after all. Patients that I don’t like … we schedule them with others at the same time and let them wait!”
  • “Some people are just going to miss appointments no matter what you say to them. Each office needs to decide how to handle it! Try to be as friendly as possible, knowing full well that you are going to cause unfriendly feelings. If a patient is costing you a fortune with failed appointments, is it worth keeping them? Sometimes it is… mostly it isn't.” (General dentist)

Non-refundable appointment booking fees

  • “If they miss 2 appointments, then they have to put down a deposit of the amount of their portion of the work that was scheduled to be re-appointed, This is not refundable. If they don't like this, then they are fired as patients.”
  • "We have them secure their appointment with a non-refundable fee if they want to return to our practice." (General dentist)

Waive the fee the first time

  • “After the first missed appointment, the charge goes on their statement, and then is credited. If they miss a second time they are informed of the fee. Depending on circumstances, we go from there. Often a patient will cancel an appointment the day of and offer to pay the fee outright.” (California dentist)
  • "Explain the policy up front or when they cancel the appointment. However, if we are able to reschedule within the week, the first time this can be waived. After that initial broken appointment, they are aware. We also include this information at the bottom of all forms they are signing making them aware. We also include this at the bottom of our appointment cards. The large fee of $150 generally prevents them from cancelling.” (Illinois dental office worker)
  • "We call 10 minutes after the appointment. If we have to leave a message, the fee is $25 and is required to be paid upon rescheduling. If we reach them and they have a real reason for missing, we inform them of the fee but waive it."

Don’t let it get you down

  • “We never admonish them because people are so busy. We request down payment on larger blocks of appointment time. 90% of the time, this solidifies appointment. Dental hygiene is tricky with so much churning due to meetings called at work. We are upbeat and positive when this occurs. We use email and text reminders to keep things moving forward. Contests work too because people like to win free items and care. Presently, we have a Zoom tooth whitening offer and a monthly drawing for a massage. We're always giving a reason to smile!” (Dental office worker)

One dentist’s system

  • “We have what I believe is the best possible answer to this problem. No one wants to pay for a missed appointment after the fact. Many say they didn't know about the fee, etc. So, we give them grace after the first one, and after the second missed appointment we ‘have the talk’ with them. But if they ever miss a third appointment, these patients must pay in full for the next appointment at the time that they schedule it, even if they call in on the phone to schedule. We tell them that this is a non-refundable reservation fee which will pay for the appointment if they keep it, but if they
    don't show, they forfeit the entire amount of ‘deposit’. This separates the flakes from the well-intentioned very fast. If they know they are undependable, they will not pay the reservation fee and we don't have to see a flaky patient again. The fact that their money is riding on their showing up makes them extremely reliable. We seldom if ever have any more problem with missed appointments, and we've been doing this for over 5 years.” (General dentist)

Separate the good no-shows from the bad

  • “Theoretically, we charge for missed appointments. However, in practice, if it comes to the point of billing for a missed appointment, it means we and this patient aren't a good match. If they fail or cancel short notice 2 appointments in a row, we invite them to either be on our ‘Priority Call List’, or we invite them to find another office. The priority call list patients do not get appointments scheduled in advance. These are usually ‘top 50’ patients who have valid reasons for cancelling short notice: fluctuating work schedules, work that requires that they work on good weather days, patients caring for an elderly or ill relative (this is becoming more common place for the baby boomer crowd). We will call them that day of or the day prior to an opening in the schedule to see if they are available. A win/win for both of us. If we simply don't want the patient in the practice, we do fire them.” (Maine dentist)

Patients need to value your time

  • “We stress each time there is a cancellation or missed appointment that it is time lost forever. Had we had enough advance notice, we could have possibly filled the appointment time. We keep track of the ‘excuse’ if given one, and we know your mother can only die one time. We do understand that emergencies do come up. After the second missed appt, we remind them how busy we are and schedule them out a month or two months and stress that if they don't keep this appointment it may be a longer wait, especially on the dental hygiene schedule with appointments booked six months in advance because hygiene is on a regular schedule. What really bugs me is mothers that insist that ALL the children have appointments back to back, taking up an entire morning or afternoon, and then cancel all appointments the day of, because one child is sick, or has a practice she forgot about. When we try to reschedule say 2 at a time, she gets all huffy, ‘we'll if you can't accommodate me and my many children doctor, I'll go to a new dentist.'” (Tennessee dentist)


Note: Survey sample included 156 respondents. Posted 4/6/2010.

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