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Not all medical and dental procedures are completed in one setting. They are staged.

A common example is a patient needs new teeth. Impressions are taken. Temporaries are placed. The lab fashions the new implants. They are placed down the road.

Patients often pay upfront for the bundled procedures. And the work is front-loaded. The effort expended in the final step is typically the least labor intensive.

What happens if a patient “loses the love” in the middle of the process? They want to go somewhere else. AND they want you to pay for them to start over.

Once you start a treatment plan, you typically need to finish it. Or make sure the patient has an agreed-upon plan to finish the treatment elsewhere. Otherwise, the patient can make a case to the Board they were “abandoned.”

So, how to resolve the impasse?

The patient wants to leave the practice but wants money to leave – to start over elsewhere.

Here’s how one practice handled it  – in my estimation – adeptly.

Dear XXX:

I received a call you want to finish your treatment elsewhere. To recap, you prepaid for a treatment plan. Extensive work was performed over a number of patient visits. You decided you wanted to receive follow-up care from another practitioner. We think it makes the most sense to complete your treatment with us. And we remain ready, willing, and able to do so. But ultimately, that decision is your call, and we respect your right to do so.

You have a credit remaining on our account for $XXX. This represents a sum that would have been allocated to complete the agreed-upon treatment plan. This amount will be sent to you shortly.

As for accounting, the following catalogs what was performed:

And the following itemizes what likely remains to be performed.

While your credit would indeed cover work to finish the treatment plan in our office, I cannot guarantee that amount will allow you (to accommodate your choice) to complete the treatment plan in another practitioner’s office.

I wish you well.

A final note: If a patient prepays for a bundle of procedures and not all of those procedures are performed, you do have an obligation to refund the money for what was not done. Every state treats this differently. But, patients who believe that funds were kept can file a complaint with the state Attorney General. A final, final note: This is different circumstance than a patient who puts a deposit on a scheduled procedure and slot is reserved and supplies ordered. And the patient does not cancel the procedure in a reasonable agreed-upon time frame. In that circumstance, some things were done. A reserved slot kept other patients from accessing that same slot on the surgery schedule. Supplies may have been ordered that cannot be returned or reused.

A practice never wants to be in the cross hairs for a charge of patient abandonment. Handling financial matters properly when a patient wants to go elsewhere will prevent such a charge from being leveled.

What do you think?


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