Reacting to erroneous estimates

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A patient complained that my office manager quoted a fee of $250 for a procedure, but he was billed $300. It turns out the procedure was done a few days after our new fees went into effect. Should we refund the difference?

A patient complained that my office manager quoted a fee of $250 for a procedure, but he was billed $300. It turns out the procedure was done a few days after our new fees went into effect. Should we refund the difference?

Don Dooley

"Yes, refund anything over the estimate," says advisory board member Don Dooley. "If you charge more than the estimate, your estimate has no meaning."

To keep this from happening again, Dooley, a practice management consultant in Los Gatos, Calif., recommends quoting a price range to clients. For example, your office manager could quote $250 to $315. But anytime your fees might exceed the estimate, you must let the client know before performing the procedure.

"As a practice manager, the most I've ever given back is $2,100," he says. The doctor at the practice argued that something unexpected caused the bill to go up. "But the client wasn't called, so we refunded the money," says Dooley. "It stung."

The next time the unexpected happened, a team member called the client for approval before going further. "If you want to keep clients, I think you need to keep them informed," Dooley says.

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