Challenging missed dental appointment charges and refusal of treatment

Bethrezen

hi all

I’m not sure if this is the right board for this so apologies if it’s on the wrong one.

Anyway to my question are there are any grounds under which I can challenge missed appointment charges from my NHS dentist ? at present I live in Scotland I’m unemployed and on job seekers so I get free treatment however I rely on public transport to get around and I live some distance from my dentist (an hour away by bus) so on occasion I will miss appointments the most common cause being that I miss the bus and as there is only 1 every hour this means I can't make my appointment

when this happens I'll do the polite thing and phone them up to let them know what’s happening and get the appointment rescheduled anyway the dentist in question has a policy of charging a penalty of £30 for late canalisation of appointments this is in my opinion is a little steep especially given the fact that I am unemployed now I understand the importance of keeping appointments and I understand why they feel charging penalties like this is necessary however I feel that this is a little unreasonable

I mean its not like I'm deliberately missing appointments just to waste there time I do try my best to be where I'm supposed to be when I'm supposed to be there however due to relying on public transport to get around this is not always possible

anyway I have no intention of paying this charge if I can avoid it because for a start I simply don’t have it as job seekers is barley enough to keep me clothed and fed especially since the VAT rise in January

now the chances are when I tell them I can’t pay the charge there going to start being difficult and refusing to see me until I do should this happen is there anything I can do about it other than moving to another dentist

jugglebug

In Scotland I believe a dentist can still charge for missed or late cancelled NHS appointments. We can't in England, our only option is to refuse treatment.
It is entirely at their discretion.

Toothsmith

How many appointments have you missed?

The way you've written it, it sounds like it's happened a few times?

But this is the first time they've charged you?

Sounds like they've just got fed up with you. Every time you miss an appointment, the chair is empty. That time slot is wasted, plus you need another time slot to get the job done eventually.

If you're a serial offender, it will be costing the practice a lot of wasted time to have you on the books.

Could you not make sure your at the bus stop 20 mins early?

Bethrezen

How many appointments have you missed?

The way you've written it, it sounds like it's happened a few times

over the 5 or 6 years I been seeing this dentist I don’t know maybe a dozen or so times at a guess I do try to show up when I'm supposed to be there the last missed appointment I had was a couple of years back

Sounds like they've just got fed up with you. Every time you miss an appointment, the chair is empty. That time slot is wasted, plus you need another time slot to get the job done eventually

nah this is just standard practice they have a notice up on the bored at the reception saying as much

I get that missed appointments costs them money at least in theory but to be honest missed appointments are a fact of life there going to happen and there is nothing you can do about it so they just need to chalk it up as a business expense and move on I mean if a patient is consistently failing to show for appointments and is deliberately wasting there time then fair enough in that case they would be justified but for occasional missed appointments that’s a little unreasonable

But this is the first time they've charged you?

No I've been charge once before a couple of years back when I had an appointment that I forgot about because it wasn't going to be for like 2 or 3 months because they where so busy at the time that it was the earliest slot they had available

at the time it wasn't a problem paying it because I had actually been working so I had the money and I just paid it but this time I can't hence the problem

GlasweJen

No there is something they can do about it, charge you some of the money that they would have got from the NHS had you turned up which is exactly what they've chosen to do.

They can chase you through courts for this money plus admin costs relating to chasing you for payment and refuse to treat you until you cough up. If you try to move dentist the old dentist can let the new one know of the outstanding charges which might prevent you being added to your new dentists list.

If you rely on a once hourly bus and you miss it regularly then you should be leaving the house earlier to make sure you catch it!

funkymonkey1

I would say that missing 12 appoinments in 5 or 6 years is just rude! How many were you supposed to have?

jugglebug

Bethrezen wrote: »

I get that missed appointments costs them money at least in theory but to be honest missed appointments are a fact of life there going to happen and there is nothing you can do about it so they just need to chalk it up as a business expense and move on I mean if a patient is consistently failing to show for appointments and is deliberately wasting there time then fair enough in that case they would be justified but for occasional missed appointments that’s a little unreasonable

Not in theory, in fact.
However you can't expect them to write it off as a business expense.
If they had a free hand in setting their treatment fees you could perhaps as they could build in a"failure margin", but they have no control over them so the missed appointment fee is their only chance of making up. It also serves to try and deter further missed visits.
Here in england my only option would be to refuse you further treatment, and that would happen after the 2nd missed appointment. Some practices are not so lenient!

Bethrezen

They can chase you through courts for this money plus admin costs relating to chasing you for payment and refuse to treat you until you cough up. If you try to move dentist the old dentist can let the new one know of the outstanding charges which might prevent you being added to your new dentists list.

not that doing that would do them any good because I cant give them what I don’t have

If you rely on a once hourly bus and you miss it regularly then you should be leaving the house earlier to make sure you catch it!

that's an overly simplistic view point isn't it ? you know as well as i do that reality just doesn't work that way and things are never that simple

I would say that missing 12 appointments in 5 or 6 years is just rude! How many were you supposed to have?

that depends entirely on your perspective and is entirely besides the point and not relevant to my question

as for the number of appointments I have a year usually between 2 and 6 depending on what treatment I need if any and of them normal I'll only miss 1 or maybe 2 at most depending on circumstances sometimes i don't miss any at all

Not in theory, in fact.
However you can't expect them to write it off as a business expense.
If they had a free hand in setting their treatment fees you could perhaps as they could build in a"failure margin", but they have no control over them so the missed appointment fee is their only chance of making up. It also serves to try and deter further missed visits.
Here in england my only option would be to refuse you further treatment, and that would happen after the 2nd missed appointment. Some practices are not so lenient!

maybe so but there is one slight flaw in thinking like that it doesn't work and only servers to alienate patients and cause trouble for both parties

i mean take a look for example at the number of people a year who get caught and fined for speeding or who get caught drink driving yet year on year people still do it so obviously fining them doesn't work ok that's a slightly different kettle of fish but the underlying principle is the same penalizing people for an honest mistake only serves to cause animosity and does nothing to actually fix the issue any way thats totaly off topic and besides the point

like i said i understand why dentists feel it is necessary to penalize people for not showing for appointments and I'm not disputing that and if i had the money to pay it i would but i don't and to someone who only gets £65 a week to live on £30 is a lot of money

so justified or not it is in my opinion unreasonable to charge someone like that when they have so little income

hence my question is there any grounds on which i can challenge this should they decide to try and be difficult based on the fact i have such a small income and am unable to pay it

as a slightly off topic side note to though who are obviously siding with the dentist here and trying to slam me for missing appointments consider this

you all know as well as I do that this stuff goes both ways and on occasion regrettable as it is your appointments are going to get messed with by the practice or there are going to be unavoidable delays getting treatment for one reason or another now as patients we accept this as being par for the course as annoying, inconvenient and disruptive as this may be for us and in my opinion health care professionals need to do the same when there busy punishing people for missing appointments

one also has to be careful about losing sight of the fundamental principle of care in favor of punishing a patient's because all health case professionals take an oath to do no harm and penalising people and refusing treatment when its needed is contrary to this fundamental principal and is in my opinion even worse and more irresponsible that patients not showing for appointments for what ever reason because people who work in these professions should know better and shouldn’t be so petty and vindictive regardless of whether its costing them money or not because they chose to be a health care professional to help people not to make money if your prime concern is making money become a stock trader or a banker and if you want to punish people for wrong doing become a police officer

jugglebug

Bethrezen wrote: »

maybe so but there is one slight flaw in thinking like that it doesn't work and only servers to alienate patients and cause trouble for both parties



like i said i understand why dentists feel it is necessary to penalize people for not showing for appointments and I'm not disputing that and if i had the money to pay it i would but i don't and to someone who only gets £65 a week to live on £30 is a lot of money

so justified or not it is in my opinion unreasonable to charge someone like that when they have so little income

hence my question is there any grounds on which i can challenge this should they decide to try and be difficult based on the fact i have such a small income and am unable to pay it

As others have said.
No you can't challenge it.
You can write a polite letter and appeal to their generosity but that's it.
If a practice has this sort of policy they would find it very difficult to apply it in a variable manner, ie one rate for someone on low income, and one for someone perceived as better off. Indeed it could be viewed as unethical to discriminate in that manner. You know your circumstances but you cannot expect us to go into your financial background (nor would you really want us to I guess)
For example I had a lift home recently given by a friend of a friend. Lovely car, Jaguar, leather seats and a personalised plate. He asked me what I did and when he discovered I was a dentist he began to tell me how he was unhappy as he had recently had to change dentists to get NHS care as he was exempt from charges! We cannot go from looks alone or even from the exempt status. This is a chap who is by no means badly off but from the info he would have given the dentist he would appear just the same as you.

Your point about alienation is an interesting one. For what it's worth I don't think the dentist would chase you for the money. I don't think they would inform another Dentist either. If you are a serial "Fail to attender" I think they would just be happy to see you go elsewhere.

dtaylor84

Bethrezen wrote: »

I mean if a patient is consistently failing to show for appointments and is deliberately wasting there time then fair enough in that case they would be justified but for occasional missed appointments that’s a little unreasonable

A dozen times in 6 years is consistently missing appointments.

DevilsAdvocate1

Bethrezen wrote: »

over the 5 or 6 years I been seeing this dentist I don’t know maybe a dozen or so times at a guess I do try to show up when I'm supposed to be there the last missed appointment I had was a couple of years back

I can't believe you think this is acceptable. You have excuse upon excuse. How about taking responsibility for your actions. I have been going to dentists as an adult for 25 years and in all that time I think I only missed an appointment once. I'm very busy too, working and bringing up 3 children.

If there was only one bus an hour, I would be aiming to get the bus before the one I needed and would take a book to read.

We all have busy lives, but we don't all miss appointments, let alone 6-12 in 5 years.

D.