Fees for Breaking Appointments

I'm an office manager at a dental practice. We handle cancellations on a case by case basis. If we had a policy not to charge for cancellations due to illness, I can guarantee that anytime someone cancelled at the last minute they would tell me they were sick. Is that harsh? Maybe, but it's true. When we have patients who continually cancel and/or miss appointments, we ask them to find a new dentist. What many people don't realize is that when someone cancels an appointment at the last minute, it's almost impossible to fill the time, and staff still needs to be paid.

For next time:
When I've been in this situation (and I have) I don't call to cancel, per se. I call and say "I have an appointment today, and I am able to make it, but I want to let you know ahead of time that I'm sick."

And in my limited experience, they will ask me if it's ok to reschedule.

This way I'm not calling to cancel so there is no question of a fee. I'm calling to give them a heads-up that I'm sick, and then I let them decide if they want to risk catching what I've got.

If there was a stated exception for illness, everyone would call in sick when they cancelled an appointment.

I'm glad that they waived the fee for you and I hope you feel better very soon!

Well said Veruca. You live in a suburb of a major city and have no options?? I find that hard to believe. From what I hear being a dentist is very competitive and many don't make much money. We have so many great dentists to pick from I feel badly for them. But you of course have a choice. Don't go to the dentist. Simple. Oh - you need work done? So they do provide a valuable service that takes years of training and expensive equipment and employees and insurance? Yup. You have to pay for that...And they didn't even charge you!!! No reason to be so mad.

Maybe he hates you, too.

If you don't like the dentist to begin with, find another dentist. Plain and simple. I used to work at a veterinary practice and we had a client who was a chronic complainer, always found something to be unhappy about, and could never be pleased or reasoned with. She was stressful to deal with and a drain on the staff. Thing is, it wasn't like we were the only veterinary clinic in the area - she had an array of vet practices she could have taken her pets to, if she was so unhappy with us. Finally it got to be too much, and the owners of the practice "fired" her as a client - wrote a very professional and polite letter, but essentially asked her to find another vet practice that she could be happy with since we obviously could not meet her expectations. Problem solved.

Like veterinarians and other health professionals, dentists invest a lot of money and time into their education and their careers. Their time and their skills are valuable, just like my time and skills are valuable. I also own my own practice, so I have a business to run on top of everything else. Every time a client cancels or "no shows" for an appointment, that is income for the business that is lost, since someone else potentially could have been booked in that slot who would have shown up. I also get complaints that we charge $42 for an exam/office visit. Apparently there are people who feel that amount of money for 30 minutes or more of my time to examine their pet, determine what is going on, discuss their options, and come up with a plan for diagnostics and/or treatment, is too much. Maybe $20 would make them happier, but then I would not be able to keep the lights on and pay my staff and stay in business very long. I have those expenses to meet before I take anything home for myself. Some people would just like everything to be for free. I wish everything could be.

I don't charge for cancelled appointments, but once I had to have someone pay for their office visit ahead of time after they no-showed 4 separate times, with no phone call and no reasonable excuse given. Most vet practices do NOT charge for appointments that are not kept and your dentist did extend you a one-time courtesy, so I would be grateful for that. You can still look for another dental practice that you will be happier with, but don't expect them to not charge for appointments that get cancelled last minute.

Wait -- there WAS no fee this time. The only thing you had to do was reschedule, by phone, which takes moments. So you were not "fined" that $200 for being sick. The receptionist did not say you were wrong not to give 24 hours' notice, did she? I''m not sure why you're so angry.

I do know that our dentist waives the fee if we cancel suddenly because of illness and I've never gotten the "You must reschedule right now" thing. BUT in your case, this was a big, two-hour hole in their schedule, not a 30-minute cleaning, so I understand why they were a LITTLE bit tougher with the "you need to reschedule right now" requirement. They were not unsympathetic; they were just trying to get their schedule straightened out.

If the office is hard-core about these cancellation charges, find another dentist. Ours would not ever charge us the fee for any illness-based cancellation and doesn't ask for instant rescheduling, so others out there must be the same. But in your case, I think they were not out of line to ask you to reschedule in order to get the fee waived. They do this to prevent "serial cancellers" from messing up their schedules.

Am I missing something here? They didn't charge you! They just stated their policy and told you they weren't charging you because they believed you were sick

How would you feel if your husband's work called him and said don't need you to come in today, and we aren't paying you? Yeah that would suck and that is what happens when people cancel at the last minute, lost revenue. Per your what happened, how about your husband comes in and works all day but they only pay him half because they didn't have enough work for him?

Instead of being mad at your dentist be mad at the people who don't bother showing up or just changed their minds at the last minute. They are the reason this policy is in place. Think about how many people did that, that doctors didn't get paid, that they started this policy about 15 years ago.

You also may want to check with your other doctors because I don't know of one that doesn't charge if you don't cancel within 24 hours.

Um, Jennifer dear, it is for how long your procedure is scheduled for. So a 30 minute teeth cleaning it is 50 bucks, two hours of major dental work is 200.

It's reasonable and they let you off this time for no fee. I don't see the problem.

I am sorry you feel bad and had to cancel your appointment. Rules are put in place because of what other people have done and this is the way the doctor protects him/herself to stay in business. It's not fair but it is what it is. You should inquire what the costs are to run a medical/dental practice and you will understand the dilemma.

From your SWH it might be a mutual situation where neither likes the other. You said you left for five years and went back. There has got to be more than one dentist in the area or they have you on a list because of your attitude. You know word does get around about patients

I just went to the dentist yesterday and spent 2 hours in the chair on a root canal that is not completely finished. I need another appointment to finish it because of an abscess. I hurt but I did not take it out on the dentist he is helping me.

A reality check is needed by you in how the real world works. I hope you get better soon and make a new dental appointment and find a new dentist to your linking. Otherwise you maybe going to a doctor on the other side of Chicago for treatment and spending a day away from home just to do that. That's extra money on top of the dental fees. So your $200 bill could easily be $500 just because. Sorry.

the other S.

J.,

Do you NOT understand what goes into filling and replacing porcelain inlays??? It's not just filling....there is SO MUCH MORE...You think you can do it? Open wide and do it yourself....or you can fly to Mexico and have it done. It's cheaper down there.

Yes. They have EVERY right to charge you for time they could have otherwise filled with someone else.

If you don't like your dentist? GO TO ANOTHER ONE...really. You're expecting me to believe there is ONLY ONE dentist in Chicago???

Yes. You are over reacting. They are providing you a service. Oral Hygiene is EXTREMELY important.

I'm sorry you are sick, I'm sorry you can't breathe through your nose. However, that's NOT THEIR FAULT NOR IS IT THEIR PROBLEM....they expected you to be there today. They can't fill that chair because you were blocked for it. They have the right to charge you for not coming...sick or not.

I'm sorry you're feeling sick and I hope you feel better soon. I like what another poster said about calling and stating you're sick and asking what they want you to do.

I work at a medical group in scheduling and if you call the day of an appointment and cancel, you are considered a "no show" even if you reschedule. We can't charge you for missed appointments, but the doctor can choose to dismiss you if you have too many no shows on file.

Let's face it, a 2 hour block of time is huge and the dentist probably won't be able to fill that spot all the way so he probably is well within his rights to charge you something.

Of course doctors and dentists know that things come up, but that isn't their fault. Everyone still likes to be paid. Just like if you're late to your appointment, you still expect to be seen.

There's a great Seinfeld episode about this - how doctors or I think it was a massage therapist charge for cancelled appts but then when the doctor or therapist cancels on George, he tries to charge her for his time. Classic bc I think we all feel that way... However as people have said, they do have to discourage last minute cancellations all the time and likely treat them on a case by case, patient by patient basis. And that's what they did here... I'm not sure I've ever actually been charged though that's their policy. I think the policy is typically waived except for repeat offenders.

I would have just taken a Tylenol Sinus/Cold pill 20 minutes before the appointment and I would have been fine for two hours.

The fact is that if they allowed exceptions then everyone would be "sick" if they found they needed to cancel, and appointments canceled last minute can not be filled with other paying customers. While $200 seems steep, that is 2 hours where they will not be making any money today because you had to cancel. It sucks to have to pay when you are sick, but why should they have to pay because you are sick? Just be glad they waved it this time.

I am sorry you do not feel well. I hate being sick in the warm months!

I can totally understand why they do this. People are just awful about appointments as it is, many never call to cancel they just do not show up!

I know that our dentists office would probably, allow us to reschedule, we have been going to him since before he even had his own practice (early 1980's), but I would reschedule with them for the following week right then if they had an opening.

Many times they staff for the day is based on the procedures scheduled. If it is cancelled he still has to pay this staff member. His office is a busy place certain times of the year and he calls in extra staff as needed.

J., this is standard operating procedure and not at all nuts. We do this at my work too...when I do something extra for a client that isn't covered in our contracted services but is a reasonable request for a good client who pays us a ton of money, I'm not going to nickel and dime them over a few hundred or thousand dollars in work (on a contract with hundreds of thousands or millions of dollars) but I will let them know the cost associated with the work and that we are waiving the fee for them. It's about setting expectations and getting people to understand that professional time isn't free. Of course if you're a good customer of a business they'll forgive the occasional need to reschedule an appointment but it's important to set the baseline expectation that you're paying for their time whether or not you're there.

FWIW, the only medical people I've dealt with who absolutely always charge for a broken appointment are mental health professionals. For whatever reason, there is not grace for a missed appointment in that field. When I have to re-schedule a dentist appt for one of my kids, they send me a bill noting the missed appointment fee and show a credit for it so I owe nothing but it's a reminder that they take this seriously. Now with 4 kids who all routinely need fillings and orthodontics we're pretty much a cash cow to them and they're not going to want me to take my business elsewhere so I don't expect they'll ever enforce the fee, but I know it's there.

Well, I think it is surprising to see how much the bottom line of these practices are impacted by people blowing off appointment (which I am not accusing you of). I think it is sad that flaky people who make appointments and then don't remember/care keep track cost businesses money and make a ligit cancelation like yours cost a fee.
Overall, I do agree with fees for cancelations but it sounds like they didn't charge you once they realized you were actually sick. They probably also realized you have been a normally reliable client.
I'm sure you know their time is valuable and that you being sick probably lost them a significant amount of money.

Dental practices in the area that we have gone to/do go to, and I love:

Lisle Dental Center (my current provider) - downtown Lisle
Naperville Dental Specialists (both kids and adults) - downtown Naperville in the Promenade building. We had trouble with 1 dentist there several years ago, but she no longer works there.
Dr. Kurt Wagner (Pediatric Dental-my kids' current provider) - downtown Naperville, adjacent to the Barnes & Nobel

I'm sure they all have cancellation fees as well, but we have received great care from them all.

With Lisle Dental they can sit down with you and discuss your insurance coverage beforehand. They bring me an itemized list before treatment even begins.

Why don't you have other options? Is your insurance very restrictive?

By the way, just because a dentist/doctor isn't at their office doesn't mean that they're on vacation. My husband's taken less than 2 weeks of vacation time in the past year, including for the birth of our son, the wedding of his cousin, and our 3 day "vacation" to FL in April. The other days he has been unavailable to his patients have all been CME (Continuing Medical Education ) conferences, for which he pays thousands of dollars to attend, hundreds of miles away from his family.

Usually the fees are for chronic appointment breakers.
($20 usually maybe $50 for a specialist - $200 is unreasonable)
Most offices will understand if an emergency comes up and you have to break an appointment once in awhile.
But if it happens all the time their office/practice will be in chaos so they need to have a way to discourage the behavior.

At the same time, if I have to repeatedly wait an unusually long time when I've made an appointment and I don't have the time to wait around all day for the doctor to show up - I feel I should be able to charge THEM for their casual disregard for wasting MY TIME.
I can be understanding if it's not something that happens all the time but there have been times when I've been plunked into an examine room and almost been forgotten.
I've fired doctors/practices for that sort of thing.

I think most dentists are ok with it if you cancel due to sickness and are happy to reschedule you.

Our dentist (who is fantastic; we love him) has always been great about cancellations. My husband is horrible about keeping appointments (Mr. ADHD never puts anything on his calendar, and then forgets), but even with all of his nonsense, they've never charged us (even though I wouldn't have objected if they did, because it was clearly my husband's fault each time). I think this is because they always keep a list of folks who want to get in sooner rather than later for an appointment, and when someone is a no-show, they call someone on the wait list and tell them to come in. In this way, they never have an empty chair. It's also kind of nice because you never, ever have to wait past your appointment time. If you arrive early for your appointment, more often than not they can take you back right away.

I think if you're unhappy with your dentist, surely there must be some other option?? It can be tricky with out-of-network dentists, but sometimes you can ask a dentist to sign up with your insurance (or just suck it up and pay the out-of-network fees). To me, a good dentist is worth paying a little bit more. You only have one set of teeth, and they have to last you forever! No sense in sticking with a dentist you can't stand.

She offered to waive the fee if you rescheduled right away. Did you? Or did you refuse to reschedule AND expect them not to charge you?
They probably offer this "one-time" courtesy anytime patients who are usually good about making their appointments. Stuff happens, without 24 hours notice, and doctors offices are usually understanding. Frankly, I'm surprised you're so up in arms about this. You knew the rules, you broke them, they offered you an out. Take it, go back to sleep, and get a grip.
No, you shouldn't go in sick, but since they aren't asking for proof of illness with a doctor's note, there's also nothing stopping people from using "sick" as an excuse just to avoid the cancellation fees.

It's one of those generalized things that some businesses must do. They don't make exceptions, because everyone is positive he/she is an exception!

I've run into this time and time again. It isn't my doing that such rules have to be in place (any more than it is yours), because I'm not negligent about appointments either, but I have to acknowledge the rules.

I hope you went ahead and rescheduled. That's a favor you should jump on.

Hope you're feeling better very soon.

Please do not take this personally. I am sure everyone and their grandmother has phoned in with an illness. Unfortunately, this has also been abused and the reaction has been cancelation fees. I know you were trying to be proactive, and this infection sounds miserable :-(.

Also, think of all the equipment that is needed for your procedure, if he had to order it, and the proper care of that equipment. This is not something you want skimped on to save costs. Think of the dentist that was caught not sterilizing his equipment and exposed many to HIV.

It might be time for you and this dentist to part ways. I go to a dentist that is two towns away. I pay out of network fees, actually my whole family does, to see him. He has reasonable fees and keeps his cost low for his patients because he manages his practice so well.

He is starting to plan his retirement. It is already freaking me out. He knows I plan to move where he retires, and find him on the golf coarse if needed ( I have dental anxiety, not a stalker, he is aware of that too, LOL)

I would not feel comfortable with someone working on my mouth, especially when I need a lot of work done, who I didn't trust. It is not good for either of you.

If you want to continue to use this dentist, reschedule and then let this issue go. Sickness happens. This is really the only way he can protect himself, and leave it at that.

Otherwise it might be time to move on.

I hope you feel better soon :-).

I think that rules like that are made for repeat offenders. Since you were sick, they let it go. No need to get upset. They were simply stating the rule.

Now, what makes me angry is that they can cancel on you no problem. But they won't give you $50 for taking of of work, hiring a sitter, etc.

Feel better!

Find another dentist. It is your responsibility to find out what insurance pays.

Two hours is a long appointment so I could understand the charge.

So say you cancelled 23.5 hours in advance, you'd have a $2350 fee... Yeah, I'd like to see them attempt to collect that! Did you sign anything agreeing to their outrageous(and prob not legally collectible) cancellation fees? Either way, you're off the hook today, but I wouldn't do business there. A certain percentage of cancellations is to be expected, part of the business. Will they sign something agreeing to pay you $2 per minute you wait past your scheduled time? Idk, unless you have repeatedly cancelled and rescheduled, she was out of line to even bring that up. Find a new dentist, cancel the new appointment, and if you get a fee in the mail - tell them to bill your insurance and see what they say.

It sounds like you have lots of issues with this dentist. The cancellation fees are perhaps something you can take up with the insurance company. In general, however, I believe the request to reschedule is not unreasonable. It's just how they did it. A more accommodating practice would have called you and asked if you would like to reschedule now or call them to reschedule when you're feeling better. My take: there are plenty of good dentists out there, I would bet, sooner or later, that you can find one.

My kids' dentist charges a fee as well. They do actually expect you to call at 2 in the morning!
I had to call and cancel an appointment because one of my kids woke up in the wee hours throwing up. By the time we got things cleaned up and his settled back down I went right back to bed. Called them first thing in the morning to cancel a late afternoon apt. Because we were long time patients in good standing they waved it that one time. I was still livid. I even said flat out, so you expect me to even thing or remember to call and leave a message on your machine at O'Dark 30 in the morning while dealing with bedding covered in vomit. She said yes. Next time something like that happened I called at 3 in the morning and expressed how angry I was at 3 in the morning, having to remember to call them while dealing with everything else.
I think it's a stupid policy! I know at our practice it wouldn't be hard for them to fill that appointment very easily with someone needing a last minute appointment. It's a very busy office.

it sounds like he's a horrid man altogether, but next time I would retort with "so I would like a refund of that same amount for the appointments on the following dates that he has cancelled on me" - then come out with a list of the times

I think it's just awful that nowadays, professionals think more of their pocketbook than of the patients. So what if you had to cancel, not your fault. If I were them, I'd be grateful that you called in sick for your appt rather than coming in anyway & possibly getting their staff (and/or) the dentist sick too. That's the same as a co-worker coming in sick & getting everyone else sick stating that they came in b/c they don't get paid for staying home. You did the right thing. If it were me, I'd find a new dentist that doesn't charge for cancellations, period. Simply rediculous & thoughtless of the patients as well. I'd NEVER charge a patient for calling in, even if it was close to appt time. I'd understand if they charged for NOT calling in & just not showing up for your appt but for a call ahead of time, there shouldn't be a charge.

I imagine if they have such a thriving practice they were able to call some people and move them up. I bet there are some happy people from your not going today.

Business can do what they want. I'm sure it's not to stick it to every sick person, but to make people think twice about cancelling. If it happens again, go in sick. Once they see you, they may offer to reschedule.