36% of dentists don’t charge for missed dental appointments — no matter how many times a patient is a “no-show.”

Only 5% charge a fee for the first offense, while 39% charge a fee after the second missed appointment. 20% of dentists charge after the 3rd missed appointment.

With the current economic conditions, The Wealthy Dentist decided to ask dentists if they have been charging for missed appointments.

Boston’s Pilgrim Hospital is in the news this week for reveling that in the first 10 months of 2011 patients failed to attend almost 17,000 appointments. Thats about 49 missed medical appointments for every day of the year.

“Time is money!” complained one dentist, and he is right. A missed appointment is an appointment that can be filled by other patients. Missed appointment fees ranged from $25.00 for the first no-show to $2,500.00 after the third missed appointment. The average fee is $75.00.

The following dentist’s comments were selected to share how dentists are handling missed appointments —

Pre-paying is popular …

“We ask the patient to pre-pay for future appointments.” (Illinois dentist)

“Repeat offenders are put on ‘probation’ where they must pre-pay (the full price, non-refundable) before we will schedule them again. This way we don’t ‘fire’ them, they either pre-pay or leave the practice. They are usually on ‘probation’ until they consistently show up.” (Kentucky dentist)

“We have them pay before the appointment and if they break the appointment, the fee is deducted from their account.” (Missouri dentist)

“After three missed appts we will not reschedule unless they prepay in full for whatever the appointment is for. It works great. We have a great practice and people know the value that they receive here.” (Colorado dentist)

“We ask the patients who no show for 2 appts or more to prepay for further visits.” (General dentist)

“We just charge them little more when they come next. Also if they are entitled for any offers or discounts don’t give them that.” (General dentist)

Confirming helps …

“Confirm. Confirm. Confirm.” (General dentist)

“Have your patients give you the cell number where they receive texts and text them their appointment. Works like a charm.” (California dentist)

“We confirm by phone, email and text message.” (General dentist)

“We double book or call patient the morning of appointment.” (California dentist)

“We send a sms reminder the day before the scheduled appointment.” (General dentist)

Same day or on-call appointments only …

“After the second time we choose the option of putting the patient on our short call list only.” (Georgia dentist)

“We don’t give 3rd time offenders the opportunity to schedule in advance. We put them in our ‘Short Notice Club’ and call them when we have an opening or they can call to see if they can get in that day.” (Oklahoma dentist)

“After 3 missed, the patient must call on a day they would like to come in and see if there is an appointment available.” (Pennsylvania dentist)

“We don’t “fire” them but put them on a VIP list where we call them when we have a same day appointment available.” (New Hampshire dentist)

Fire them …

“My letter to the patient who I am dismissing is actually very nice. It states that our priorities do not match and that they would be better served by another dentist and to please let us know where to forward their records. A lot of times, the patient begs us to let them come back to the practice and they become our best patients ever about being there for their appointments even in bad weather, etc.!” (Alabama dentist)

“We send three letters and then dismiss patient with a 30 day emergency window so they have ample time to find a new dentist that will be more conducive to their schedule.” (Missouri dentist)

“You must get rid of them because you can not afford them. The other thought is to give them a stand-by appt. They may have to wait a while to be seen.” (North Carolina dentist)

“After a new patient reschedules/misses an appointment twice, we fire/do not reschedule. When existing patients break numerous appointments we notify them to call us on a day when they have extra /free time on their schedule and we will see if we can work them in at that time (this way we are not blocking an actual appointment for them). The best approach would be to require a credit card at time of scheduling to hold the appointment.” (General dentist)

How do you handle missed appointments? Have you ever “fired” a patient?