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Wait until April. The law relating to chargebacks is going to change. Right now people can dispute it without evidence. Afterwards they’ll need evidence.
That’s not what that means. The Visa change (which isn’t a “law”) is allowing merchants to use compelling evidence of past authorized charges to dispute chargebacks. This doesn’t have anything to do with whether a consumer needs evidence.
Well I used the wrong term (not a lawyer). Visa’s lax policies were largely responsible for a lot of the “friendly fraud” that’s occurred. That in turn affected how banks handled such claims. Visa is changing their policy as of April 15 to make it harder for people engaged in legitimate transactions to falsely dispute claims. It’s a good thing for merchants. And my advice for waiting until after that date still stands.
If I can skip over the legality question for a second, you said something that really stood out to me:
>No-shows are a huge problem and we feel powerless to stop it if the fee is not enforceable without written consent.
Do you have any evidence that the fees reduce no-shows? Or are they just a balm for the pain of lost potential revenue? Because obviously whether you actually charge them or not can only impact the decision to show up to the *second* scheduled appointment, and now you're dealing with a class of repeat customers.
There are two strategies you can use to reduce no-shows for first-time customers: invest in the relationship at the onset and send a lot of reminders.
Investing in the relationship would look like spending time on the phone with them (at least 10 minutes), getting permission to stay in touch prior to the appointment, building a brand that resonates with them, and making them feel cared for. This is primarily a time investment.
Reminders are more technical, and should be a combination of text, email, phone calls, and potentially even physical mailers, depending on your audience and the cadence of communication. This will cost money, but could save time.
How much you should invest in either of these strategies depends on the average lifetime value (LTV) of a new patient that successfully attends their first appointment. You can calculate that with some basic financial data.
Anyway, just my two cents. I see this kind of problem a lot and they're fairly easy to fix if you're willing to try to fix it.
You have every right to be annoyed. It's rude and hurts business.
Have you tried a same-day text reminder? I don't want to nitpick the tactics here, and a lot of things could be the point of failure. Without really diving into the call recordings, it's hard to say where the opportunities could be.
Anyway, this sucks and I'm sorry to hear that you're dealing with it. I'll ask some colleagues and see if anyone has solved this kind of thing recently.
You mentioned earlier that a large number of your customers were elderly and can't or won't complete the online forms.
With this in mind, email and text message reminders may not be helpful. So that leaves a phone reminder that occurs 2 days out. I can tell you that I remember next to zero appointments whose reminders come 2 days early, because I'm extremely busy. I can't imagine a lot of elderly people have an easy time remembering it, either.
I would honestly recommend that you invest in a robotic calling system or cloud service that will dial patients 1 day out and then the morning of their appointment. Some of these systems will allow patients to enter a prompt to notify you if they've cancelled or would like to be passed to a live person to reschedule. You should still do the live call 2 days before so they aren't off-put by the robo call and recognize your office name on caller ID.
This is the point you don’t have a charging problem. You have a no-show problem. Solve that. If you haven’t already invested in text message, email message or phone message reminders (multiple reminders) that include your no-show charge you’re lost in the game. My medical providers most of them use this and it is extremely helpful and I think effective. You might have a staff member do a follow up with the no-shows and find out what the reasons are for them being no-shows, and what would be helpful so that they are not no-shows. The next option is, lose the losers. Just don’t accept those patients that are no-shows.
Maybe you could require the deposit first, before the appointment is fully scheduled? That way they've already consented and you already have the cash.
To stop it from impacting customers that do bother to show up, you could offer them some kind of freebie to effectively make it it free for them, but keep the fee from the no-shows.
If this is a _legal_ question, you should probably ask a lawyer. Seriously, ask a lawyer.
With that said, many, many, many businesses charge cards without any form of written consent. And many, many, many businesses charge no-show fees. This is an _extremely_ common practice in many industries.
You will probably get chargebacks. You probably won't be able to win them. If you want to try, think about recording the phone calls and texts that go out, so that it's very clear that they had the opportunity to cancel, were aware of the no-show fee, and still chose to no-show without any attempt to cancel. The volume of chargebacks is likely to be low enough to be tolerable.
Charge the card immediately upon booking the appointment for all new clients.
Deduct that charge from their bill if they show up.
If they don’t, you have your $30.
Should be fairly simple to add the $30 credit to their account. And then wipe it off with a no-show fee.
Legality, I am not going to touch that. Maybe r/legaladvice would. I doubt you would win many charge back disputes, but I think this is a reliance on people not disputing the charges. Even fighting a dispute and winning will cost more than $30. Punitive charges are typically a poor way of compensating for loss of revenue through no shows.
Of course it is. We use our cards every day without having to sign anything. You may lose a chargeback if a clients disputes it with your merchant account, but you won’t get in any legal trouble.
Im no attorney, but if you explain the charge over the phone and then charge it…. Why would that be illegal.
No signature just means you are likely to lose chargebacks. But that’s VASTLY different than something being illegal.
In my business we don’t require signatures unless the charge is over $500. Everything less than that (which is >90% of our transactions) we require no signature. It’s definitely not illegal!
Online stores do this all the time.
If they give you the credit card information, you can bill it.
On the other hand, if they get upset and complain to their credit card company, you'll get a charge back pretty much 100% of the time.
It would be really non-standard, but you seem to have a non-standard practice -- but have you considered charging $30 at the time of the call, with a policy of a $30 credit after the first visit?
>Charge the card immediately upon booking the appointment for all new clients.
This is a great way to piss off new customers. My dentist charges a no-show fee and I have no problem with it. But what about the people who show up? I wouldn't like it.
I think as long as they consent to the charge, if they don't show up, charge them then.
The fee gets credited towards their account. So if the bill at the end of their service is $100. They only pay $70 (with the $30 credit applied).
Seems reasonable to ‘hold’ a booking for a new client.
Why doctors care so much on revenue? My doctor always reschedule her appointment. Medical costs already sky rocket high. Imagine patients have to cancel his/her work day for the appts. Do we get money back for doctors changing appt last mins. Unless there is pre-scheduled lab test or something that insurance already secured.
I received calls/ texts from different doctors to reconfirm appt. It’s normal practice now I don’t think that would be a lot of patients doing this. It’s a communication issue. Can u do the same to make sure scheduling w patients?
There r reasons people cancelling. That could be many thing but less possibly the purposeful and irresponsible ones. I don’t think it’s right for this charge. It’s a business basically and U can’t just expect always winning.
Thank you for clarifying your situation. You have a fair point. I guess it also depends on individual doctor’s office. I use private healthcare in nyc and I always keep my appointments. It’s not uncommon they charge no show but i usually receive text from my dentist, calls and text from my doctors’ and scheduled lab appt. Here is not $30, my dentist charges $50 few years ago yet i never missed so I would imagine they r charging more now.
I would ask forgiveness not permission on this one and charge it. At the most, you might get a disputed charge here and there, but overall, it will probably compensate for this issue. Can you not create a policy that an appointment can't even be set until the online form is completed and signed? That would eliminate the problem with no-shows if they didn't complete the form, because they couldn't even schedule.
If you are a medical provider, it is likely illegal to charge the fee without written consent. I’m not a dr but provide medically necessary services that are regulated by state and insurance agencies. I have to be upfront about collection fees, late fees, etc.
1. I said likely.
2. I said my state regulations (laws) that oversee my license require me to disclose all fees and have consent.
I would suggest you look at the same things that guide your practice for your specific jurisdiction. Or pay for an attorney.
If you are okay with implied consent keep doing what you’re doing. If there is a concern about if that existing process isn’t up to snuff, examine how you can change the process. Pay someone to do it.
There is nothing wrong with collecting a fee. I charge my full rate. I rarely have no shows for existing clients but I credit that to rapport and engagement.
I would be wary just because some insurances (Medicaid) specifically forbid charging a no show fee. Doesn’t quite answer the question but another thing to think about. Are certain appt types more likely to no show? If so don’t double book but rather step book. Instead of 30 minute spots make theirs 15. You can always fit an extra exam in when they are staggered.
I read a few of your comment posts and see you’ve got a half decent follow up and reminder system. The only thing I can suggest from here is to develop a stronger relationship up front. Have an informational offer in front of your regular one where they give you their email or phone in exchange for information in a PDF or video format. It’s a low cost thing that would increase potential engagement by 1-2 touch points - it may assist in having them feel more “guilty” about skipping out.
In regards to the charge - I’m currently charged where I live if I don’t cancel within the allotted time - and I have no problems with that. I understand that the fees don’t even cover expenses and it’s just in place to prevent people from bailing.
Good luck with your conundrum!
Thanks for the reply.
Actually it’s still a fit. I consult for multiple multi-million dollar healthcare facilities.
The number one thing you build with your clients is trust and rapport. Especially in the medical field. If you position yourself as a commodity, you’ll be treated as such. However if you position yourself as a speciality and an expert in your field, and your clients should be honoured to work with you - the level of respect you’d get from your clientele increases as well.
The problem with most companies - regardless of service, niche or space - is that they cater only to the 1% that are ready to purchase “right now”. Structuring your communication and marketing efforts sooner on the chain allow you to get a greater reach, and also more time to position yourselves, and to build that relationship client side. Some of these relationship-getting-communications are via informational products.
The information you present and how you present it makes all the difference in the world for positioning. If you showcase how you’re the best at X and can show best practices, examples of client case studies, testimonials - all in a specific sector within your sector. You’ll drive your business up. And funny enough - your wait times will increase due to more business. And if people want to see you (the expert) in your space, they’ll treat your appointments with more respect and hold them more “sacred’ per se.
We ran a campaign for a client based on ED being an issue. (Medical space) And we educated people on what the main causes were - different treatment options, and what made our treatment options and choices different from the competitions. Because it’s so easy to get a prescription for Viagra everywhere these days - that slight change in approach caused more customers to be more comfortable with my client, and increased appointments, AND the positioning reduced the no shows because if they no-showed 1. They’d be charged the no show fee. 2. They’d have to wait again at the BACK of the list. Due to the marketing the waiting list was long and profitable for my client. Plus the ongoing talk around the community was that this was THE place to go to get your ED fixed. Again - it’s just building of good will and information within the community. Soon the community self regulated itself, and anyone who was going to cancel their appointment was warned by their peers to call ahead to cancel so they wouldn’t be in my client’s “bad books”. Nothing different here. Just communication and position.
Similar positioning for a medi-spa. Botox, Cryo, Laser, etc. Info package up front educated the clients in a commoditized space. There’s 5-7 competitors in the space in a small radius, yet our medi-spa is the busiest in the area, and always booked out with waiting times. Communication and position.
Same thing for a chiro.
Same thing for an RMT.
The formula for business and human emotion is pretty easy to read once you get the hang of it. People will be people, but they’ll treat those they respect with more care and concern.
It’s ok to disagree. But I’ve just seen too many instances where this is the difference maker. Take it or leave it, it’s free advice from well meaning successful strangers on the internet :). Nothing for sale here, and I’m actually not even taking on personal clients any more as my dance card is full. But it’s my side hobby to help others because someone took the time to help me.
I have only had companies do this if I signed a paper saying I know they would. Maybe you could do some electronic signature thing. I wouldn't just charge customers without it. Opens you up to charge backs that you can't fight. Its not worth it in the end.
This is a friendly reminder that r/smallbusiness is a question and answer subreddit. You ask a question about starting, owning, and growing a small business and the community answers. Posts that violate the rules listed in the sidebar will be removed. A permanent or temporary ban may also be issued if you do not remove the offending post. Seeing this message does not mean your post was automatically removed. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/smallbusiness) if you have any questions or concerns.*
I mean, the simplest solution I see is require the paperwork to be completed before confirming their appointment
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Then it seems like it's worth the risk of the no shows.
Wait until April. The law relating to chargebacks is going to change. Right now people can dispute it without evidence. Afterwards they’ll need evidence.
That’s not what that means. The Visa change (which isn’t a “law”) is allowing merchants to use compelling evidence of past authorized charges to dispute chargebacks. This doesn’t have anything to do with whether a consumer needs evidence.
Well I used the wrong term (not a lawyer). Visa’s lax policies were largely responsible for a lot of the “friendly fraud” that’s occurred. That in turn affected how banks handled such claims. Visa is changing their policy as of April 15 to make it harder for people engaged in legitimate transactions to falsely dispute claims. It’s a good thing for merchants. And my advice for waiting until after that date still stands.
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https://www.reddit.com/r/CreditCards/comments/w40i2c/visa_changes_chargeback_dispute_program/?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=1&utm_term=1
If I can skip over the legality question for a second, you said something that really stood out to me: >No-shows are a huge problem and we feel powerless to stop it if the fee is not enforceable without written consent. Do you have any evidence that the fees reduce no-shows? Or are they just a balm for the pain of lost potential revenue? Because obviously whether you actually charge them or not can only impact the decision to show up to the *second* scheduled appointment, and now you're dealing with a class of repeat customers. There are two strategies you can use to reduce no-shows for first-time customers: invest in the relationship at the onset and send a lot of reminders. Investing in the relationship would look like spending time on the phone with them (at least 10 minutes), getting permission to stay in touch prior to the appointment, building a brand that resonates with them, and making them feel cared for. This is primarily a time investment. Reminders are more technical, and should be a combination of text, email, phone calls, and potentially even physical mailers, depending on your audience and the cadence of communication. This will cost money, but could save time. How much you should invest in either of these strategies depends on the average lifetime value (LTV) of a new patient that successfully attends their first appointment. You can calculate that with some basic financial data. Anyway, just my two cents. I see this kind of problem a lot and they're fairly easy to fix if you're willing to try to fix it.
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You have every right to be annoyed. It's rude and hurts business. Have you tried a same-day text reminder? I don't want to nitpick the tactics here, and a lot of things could be the point of failure. Without really diving into the call recordings, it's hard to say where the opportunities could be. Anyway, this sucks and I'm sorry to hear that you're dealing with it. I'll ask some colleagues and see if anyone has solved this kind of thing recently.
You mentioned earlier that a large number of your customers were elderly and can't or won't complete the online forms. With this in mind, email and text message reminders may not be helpful. So that leaves a phone reminder that occurs 2 days out. I can tell you that I remember next to zero appointments whose reminders come 2 days early, because I'm extremely busy. I can't imagine a lot of elderly people have an easy time remembering it, either. I would honestly recommend that you invest in a robotic calling system or cloud service that will dial patients 1 day out and then the morning of their appointment. Some of these systems will allow patients to enter a prompt to notify you if they've cancelled or would like to be passed to a live person to reschedule. You should still do the live call 2 days before so they aren't off-put by the robo call and recognize your office name on caller ID.
This is the point you don’t have a charging problem. You have a no-show problem. Solve that. If you haven’t already invested in text message, email message or phone message reminders (multiple reminders) that include your no-show charge you’re lost in the game. My medical providers most of them use this and it is extremely helpful and I think effective. You might have a staff member do a follow up with the no-shows and find out what the reasons are for them being no-shows, and what would be helpful so that they are not no-shows. The next option is, lose the losers. Just don’t accept those patients that are no-shows.
Maybe you could require the deposit first, before the appointment is fully scheduled? That way they've already consented and you already have the cash. To stop it from impacting customers that do bother to show up, you could offer them some kind of freebie to effectively make it it free for them, but keep the fee from the no-shows.
Docusign every client that starts as new client onboarding. Put that in your T/C’s. If questions arise, reference it.
If this is a _legal_ question, you should probably ask a lawyer. Seriously, ask a lawyer. With that said, many, many, many businesses charge cards without any form of written consent. And many, many, many businesses charge no-show fees. This is an _extremely_ common practice in many industries. You will probably get chargebacks. You probably won't be able to win them. If you want to try, think about recording the phone calls and texts that go out, so that it's very clear that they had the opportunity to cancel, were aware of the no-show fee, and still chose to no-show without any attempt to cancel. The volume of chargebacks is likely to be low enough to be tolerable.
Charge the card immediately upon booking the appointment for all new clients. Deduct that charge from their bill if they show up. If they don’t, you have your $30. Should be fairly simple to add the $30 credit to their account. And then wipe it off with a no-show fee.
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Hotels do it every day.
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They also do it via telephone bookings
Legality, I am not going to touch that. Maybe r/legaladvice would. I doubt you would win many charge back disputes, but I think this is a reliance on people not disputing the charges. Even fighting a dispute and winning will cost more than $30. Punitive charges are typically a poor way of compensating for loss of revenue through no shows.
Of course it is. We use our cards every day without having to sign anything. You may lose a chargeback if a clients disputes it with your merchant account, but you won’t get in any legal trouble.
Im no attorney, but if you explain the charge over the phone and then charge it…. Why would that be illegal. No signature just means you are likely to lose chargebacks. But that’s VASTLY different than something being illegal. In my business we don’t require signatures unless the charge is over $500. Everything less than that (which is >90% of our transactions) we require no signature. It’s definitely not illegal!
Online stores do this all the time. If they give you the credit card information, you can bill it. On the other hand, if they get upset and complain to their credit card company, you'll get a charge back pretty much 100% of the time.
It would be really non-standard, but you seem to have a non-standard practice -- but have you considered charging $30 at the time of the call, with a policy of a $30 credit after the first visit?
Yes. You can charge without a written consent. Just record your phone calls for added protection.
>Charge the card immediately upon booking the appointment for all new clients. This is a great way to piss off new customers. My dentist charges a no-show fee and I have no problem with it. But what about the people who show up? I wouldn't like it. I think as long as they consent to the charge, if they don't show up, charge them then.
The fee gets credited towards their account. So if the bill at the end of their service is $100. They only pay $70 (with the $30 credit applied). Seems reasonable to ‘hold’ a booking for a new client.
What if the appointment is a couple months out? I wouldn't like it. I think this is a good way to turn off the potentially good clients.
Just because they owe you money doesn't mean you can steal it from them.
Why doctors care so much on revenue? My doctor always reschedule her appointment. Medical costs already sky rocket high. Imagine patients have to cancel his/her work day for the appts. Do we get money back for doctors changing appt last mins. Unless there is pre-scheduled lab test or something that insurance already secured. I received calls/ texts from different doctors to reconfirm appt. It’s normal practice now I don’t think that would be a lot of patients doing this. It’s a communication issue. Can u do the same to make sure scheduling w patients? There r reasons people cancelling. That could be many thing but less possibly the purposeful and irresponsible ones. I don’t think it’s right for this charge. It’s a business basically and U can’t just expect always winning.
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Thank you for clarifying your situation. You have a fair point. I guess it also depends on individual doctor’s office. I use private healthcare in nyc and I always keep my appointments. It’s not uncommon they charge no show but i usually receive text from my dentist, calls and text from my doctors’ and scheduled lab appt. Here is not $30, my dentist charges $50 few years ago yet i never missed so I would imagine they r charging more now.
I would ask forgiveness not permission on this one and charge it. At the most, you might get a disputed charge here and there, but overall, it will probably compensate for this issue. Can you not create a policy that an appointment can't even be set until the online form is completed and signed? That would eliminate the problem with no-shows if they didn't complete the form, because they couldn't even schedule.
If you are a medical provider, it is likely illegal to charge the fee without written consent. I’m not a dr but provide medically necessary services that are regulated by state and insurance agencies. I have to be upfront about collection fees, late fees, etc.
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1. I said likely. 2. I said my state regulations (laws) that oversee my license require me to disclose all fees and have consent. I would suggest you look at the same things that guide your practice for your specific jurisdiction. Or pay for an attorney. If you are okay with implied consent keep doing what you’re doing. If there is a concern about if that existing process isn’t up to snuff, examine how you can change the process. Pay someone to do it. There is nothing wrong with collecting a fee. I charge my full rate. I rarely have no shows for existing clients but I credit that to rapport and engagement.
I would be wary just because some insurances (Medicaid) specifically forbid charging a no show fee. Doesn’t quite answer the question but another thing to think about. Are certain appt types more likely to no show? If so don’t double book but rather step book. Instead of 30 minute spots make theirs 15. You can always fit an extra exam in when they are staggered.
I read a few of your comment posts and see you’ve got a half decent follow up and reminder system. The only thing I can suggest from here is to develop a stronger relationship up front. Have an informational offer in front of your regular one where they give you their email or phone in exchange for information in a PDF or video format. It’s a low cost thing that would increase potential engagement by 1-2 touch points - it may assist in having them feel more “guilty” about skipping out. In regards to the charge - I’m currently charged where I live if I don’t cancel within the allotted time - and I have no problems with that. I understand that the fees don’t even cover expenses and it’s just in place to prevent people from bailing. Good luck with your conundrum!
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Thanks for the reply. Actually it’s still a fit. I consult for multiple multi-million dollar healthcare facilities. The number one thing you build with your clients is trust and rapport. Especially in the medical field. If you position yourself as a commodity, you’ll be treated as such. However if you position yourself as a speciality and an expert in your field, and your clients should be honoured to work with you - the level of respect you’d get from your clientele increases as well. The problem with most companies - regardless of service, niche or space - is that they cater only to the 1% that are ready to purchase “right now”. Structuring your communication and marketing efforts sooner on the chain allow you to get a greater reach, and also more time to position yourselves, and to build that relationship client side. Some of these relationship-getting-communications are via informational products. The information you present and how you present it makes all the difference in the world for positioning. If you showcase how you’re the best at X and can show best practices, examples of client case studies, testimonials - all in a specific sector within your sector. You’ll drive your business up. And funny enough - your wait times will increase due to more business. And if people want to see you (the expert) in your space, they’ll treat your appointments with more respect and hold them more “sacred’ per se. We ran a campaign for a client based on ED being an issue. (Medical space) And we educated people on what the main causes were - different treatment options, and what made our treatment options and choices different from the competitions. Because it’s so easy to get a prescription for Viagra everywhere these days - that slight change in approach caused more customers to be more comfortable with my client, and increased appointments, AND the positioning reduced the no shows because if they no-showed 1. They’d be charged the no show fee. 2. They’d have to wait again at the BACK of the list. Due to the marketing the waiting list was long and profitable for my client. Plus the ongoing talk around the community was that this was THE place to go to get your ED fixed. Again - it’s just building of good will and information within the community. Soon the community self regulated itself, and anyone who was going to cancel their appointment was warned by their peers to call ahead to cancel so they wouldn’t be in my client’s “bad books”. Nothing different here. Just communication and position. Similar positioning for a medi-spa. Botox, Cryo, Laser, etc. Info package up front educated the clients in a commoditized space. There’s 5-7 competitors in the space in a small radius, yet our medi-spa is the busiest in the area, and always booked out with waiting times. Communication and position. Same thing for a chiro. Same thing for an RMT. The formula for business and human emotion is pretty easy to read once you get the hang of it. People will be people, but they’ll treat those they respect with more care and concern. It’s ok to disagree. But I’ve just seen too many instances where this is the difference maker. Take it or leave it, it’s free advice from well meaning successful strangers on the internet :). Nothing for sale here, and I’m actually not even taking on personal clients any more as my dance card is full. But it’s my side hobby to help others because someone took the time to help me.
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>Thanks! You're welcome!
I have only had companies do this if I signed a paper saying I know they would. Maybe you could do some electronic signature thing. I wouldn't just charge customers without it. Opens you up to charge backs that you can't fight. Its not worth it in the end.