Begging To Come Back To Dental Office

Thursday Troubleshooter: Should practice take back patient they once terminated?

July 24, 2014
A former patient wants back into this dental practice, even though the last contact he had with them was a termination letter. He claims his lack of payment was an oversight on his part. What should they do?

QUESTION: We have a patient who has emailed us asking if we can reinstate him as a patient. He said his balance of $43 that was not paid was an oversight on his part and he would like to come back. He paid the $43 after receiving a certified mail return receipt Termination Letter a few weeks ago. We have never had a request from a patient to come back after receiving a termination letter, but then again we have gotten proactive in handling lingering accounts just this year. If we do let him come back, is there a specific process?

ANSWER FROM JAN KELLER,Jan Keller and Associates: Was this a good patient before this “oversight?” Did he normally keep his appointments? Was there a reason he felt he did not owe the $43, or was he experiencing financial issues that he was embarrassed to discuss with the practice? A review of your office financial and scheduling policy might be in order as well. Are signatures expected? Do you have updated signatures? Have policies changed since this patient signed the original one?

My advice is to let him return to the practice on a trial basis, which means until he proves to be reliable, pays his bills on time, and keeps his appointments, I would expect payment in full at the time of service. If the patient has dental insurance and your practice is participating, ask that he pay his estimated portion at the time of service, and have a credit card authorization on file for any balances after the insurance pays.

Congratulations on being proactive with your accounts. I have a few questions regarding this patient – Was he a frequent pay problem? Is there untreated dental work that can be scheduled? Is he a longtime patient with your practice? – If you feel that this patient is a good risk, then I would suggest letting him know that you will be happy to keep him active, but from now on he must pay in full at the time of service. If he has a dental benefit plan, you can always not assign benefits, and then the patient will be reimbursed directly.

It’s good to clean up the accounts receivable, but we must treat each case individually when it comes to dismissing patients. We are never fully aware of a patient's circumstances, and it is always good practice to give people a second chance if they have been good patients in the past. Hope this helps, and keep up the great work!

The fact that this patient wants to come back indicates that he values your practice, and also values your financial policy. Providing that he is a good patient otherwise (keeps appointments, is pleasant to the staff, is fairly compliant, etc.) I would accept him back. I would look at this as an opportunity to turn this patient into a star patient and raving fan. However, I would be clear with the practice expectations and protocols. I would send a really nice “welcome back” letter, thanking him for his interest in the practice. I would then kindly remind him of your office expectations (i.e., attach your practice financial policy and any information he should know about your practice). I would treat him like a new patient with all the kind generosity and expectations you have for new patients. If your foundational protocols are in place (and it sounds like you are on your way) then these things typically resolve themselves. If you follow this, I suspect that this patient will return grateful, and will become a raving fan (referring others!) that you will want to brag about. Good luck!

ANSWER FROM WAYNE KERR, DDS, MAGD, Gowasack Family Dentistry
Thanks for your question. Absolutely invite him back! After owning a private practice for more than 36 years, I must admit that a number of patients left my practice for a variety of reasons. I always called them when I received their request for a transfer of records, and found that the majority left because they (1) moved out of the area, (2) felt compelled to leave the practice due to a change in their employer provided insurance - PPO - coverage, or (3) wanted a closer drive.

Each time we transferred records to the new provider, I sent a letter of thanks and acknowledgment to the individual/family leaving the practice. In that letter, I thanked them for the privilege of caring for them, and invited them to return to the practice anytime (unless there was some very specific reason not to). Many returned to my practice after leaving for a PPO because they became acutely aware of just how much they had lost (service, quality, compassion, gentle hygienists, on-time appointments, relationships, listening skills, communication, customized appointments, consistency in care and team members, and much more) by leaving us.

Unless you have a very strong reason not to invite someone to return (they’re unpleasant, can't be satisfied, are very difficult to care for, litigious, always late, a frequent no-show, do not appreciate your services) always take them back. This is usually a win-win situation. Good luck and best wishes for your continuing success!

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