Patient Refunds and Discounts

Guidelines for Practice Success | Managing Patients | Patient Relations

It’s up to you to determine if and when a patient should be given a refund for service provided. Some dentists follow the philosophy that the patient is always right. Others might honor a request for a refund because it’s easier than trying to convince the patient that the care provided was appropriate and that the patient was aware of the potential risks. Ultimately, each decision regarding refund requests is based on a number of factors and will vary depending upon the circumstances and, sometimes, will depend upon the patient involved.
  • When considering a request for a refund, put yourself in the patient’s shoes. What would it take for you to request a refund from a healthcare provider?
    • Sometimes, it’s not a matter of money but an issue related to poor communication. Maybe the patient would be satisfied with an attentive ear, an apology, a more detailed explanation, or the promise to provide more information earlier in the process.
  • Some dentists also take into consideration their personal feelings about the dissatisfied patient. Are they generally a reliable, dependable patient? Are they a nice person? While that might sound unprofessional, it’s human nature to consider such things. Many dentists find it easier to give a refund to a patient who has been a pleasure to treat rather than to one who has been noncompliant and unappreciative.
  • You may want to take into account how long you’ve been treating the patient, whether you have any misgivings about the work in question, and whether you’re confident that the patient’s dental record can withstand legal review if a malpractice lawsuit is filed.
  • If you do agree to provide a refund, have the patient sign a release or fee waiver form. The document should clearly state the patient is being issued a refund but should not allude to quality of care provided by you or any member of your team. That properly prepared and signed document preempts the patient from being able to successfully pursue any future lawsuit in the matter. Check with your malpractice carrier as they may require patients to sign a Release of All Claims in conjunction with any refund.
  • If the patient requests a refund because a better and cheaper treatment option should have been used, it’s up to you to decide how to proceed. Your response may vary depending on how long you’ve been treating that individual. While you may believe that some patients might be satisfied with a simple apology, make sure that you’re familiar with any state law that might apply. Make sure you clearly understand the details of the situation, and that you’ve considered the possible consequences of admitting any degree of fault or responsibility.
    • Check with your personal attorney and malpractice carrier for more information about the possible legal ramifications of any apologies or similar statements made to patients and others.
    • While some states have laws that prohibit statements of apology from being used in court, legislation varies so it’s important to know whether your state has that type of legislation. Some states that prohibit the use of apologies in court enacted those laws on the theory that an apology can enhance patient/provider communications and resolve claims without litigation.
  • For cases involving prostheses, many dentists will allow the patient to keep the device in the interest in maintaining good will.
  • Remember that you may have to report settlements, refunds or similar payments made to patients to the National Practitioner’s Data Bank (NPDB). A written demand claiming malpractice, and payment made through the practice’s account, may trigger the requirement to report.  This may not be the case if the payment is made through your personal funds. Check with your attorney or malpractice carrier for their advice on when a report must be made, what needs to be included in the report, and any filing deadlines.

Additional Resources:

National Practitioner Data Bank Website