Thomas DeAngelis, MD

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Charged $25 for rescheduling an appointment within 24 hours
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LIVINGSTON, NEW JERSEY -- My OBGYN put a new policy in place in January of 2010 that any cancellation or rescheduling of an appointment would cost the patient $25. He didn't inform any of his patients. The receptionist told me something to the effect that it didn't make financial sense to send letters to all of his patients to inform them of the new policy. I haven't been to the office since before then, so I don't know if it is posted in the office. I had an appointment for June 22 and had to reschedule it because of various reasons. I did call within 24 hours of the appointment, which I normally try to avoid, but sometimes things happen.

Since I was getting charged anyway, I cancelled the appointment since I was afraid something else would come up and I'd get charged another $25. Yesterday, July 28, I got a bill from the doctor! Not for $25, though. For $5. Apparently, I had a $20 credit on my account from my last appointment (around November 2008) that I was not aware of. They went ahead and applied that credit to my cancellation fee and then sent me a bill for $5. Pretty sad that that's what a long time patient is worth, isn't it? It didn't make financial sense to send a letter to me about the new policy, but I guess it makes perfect financial sense to send me a bill for $5.

Now I'm looking for a new doctor who has a little more than just money in mind. Yes, I know that will be difficult, but I can try!
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User Replies:
spiderman2 on 07/29/2010:
I think this is the norm. All of the doctors' offices I go to and take my kids to have this policy. I did have an issue come up recently and had to cancel for one of my kids 2 hours before the appointment. The secretary kindly waived the charge for me since it was really something I couldn't control and the fact that they see us every 2-4 weeks. If you don't show and they don't have time to get someone in for your appointment time, they have lost money.
SaMoore on 07/29/2010:
You typically have to sign an agreement when this policy goes into effect. In both my doctors and my dentist's office I have had to sign an agreement saying that if I do not cancel before the 24-hour point that I will pay a cancellation fee. I question the validity of the fee based on the fact that you were not notified that any fee existed.

I would suspect that you didn't sign a waiver for a cancellation charge, except that you stated the receptionist told you that they did not notify clients of this fee because it would cost too much in postage.

I would suggest writing a formal note to your doctor and letting her know that you were never made aware of this cancellation fee. I would request a re-credit of $20 and the dissolution of the five dollar bill that you received. But I would also note that you have been made aware that the cancellation fee is in effect and you will honor it in the future.
shayen on 07/29/2010:
SaMoore is correct. I ran into this before and I notified the practice's office manager that I never signed an agreement. They removed the fee from my account and started to have current and new patients sign an agreement as to their cancellation policy. I was working at a law office at the time and an attorney there told me that a lot of doctors/dentists have this policy but they need to have it in writing and get the patients' signature in order to enforce it. Most places have you sign to this when you fill out the new patient paperwork. Something else I've learned the hard way is that if I do have to cancel or post-pone an appointment, call first and then followup with an emailor get the employee's name and notate the date and time of call. I started doing this after I once just verbally cancelled an appt. and the the receptionist did not mark it in the system and I was charged a missed appt. fee.
yoke on 07/29/2010:
What is ironic with the OPs' doctors office is the only reason she found out about the credit was because of the cancellation. It has been 2 years that they have been holding onto that $25 getting interest on it (I know not a lot) and they have the nerve to send a bill for $5. If this OB is anything like mine they were probably lucky she cancelled since they are probably overbooked.
momsey on 07/29/2010:
Exactly, yoke!!!
Helpful on 07/29/2010:
I don't think this is necessarily wrong. Some patients make it a practice to cancel and change appointments too easily, not taking into account the time of the physician.

I'm actually surprised that a patient wouldn't understand this and just be more considerate of the appointments that were made. It seems pretty drastic to just drop him as a physician, especially an OBGYN. Out of all the physicians and specialists one may see, most ladies will generally not change their OBGYN because of the intimate nature of the exam. For $5 most ladies, I think, would be quite reluctant to become "acquainted" with a new doctor.
SaMoore on 07/29/2010:
I agree with helpful and not too many patients cancel and change appointments without enough notice. However, it is not technically legal to decide on charges given through to your clients without any notice of such.
yoke on 07/29/2010:
I know in my OB/GYN my doctor admitted to me that her girl double books her 15 min appointments. That mean she see's up to 8 people in one hour. There are times that she is so behind that you wait over an hour to be seen. So if a person does a no show they are not losing any money. I was in the hospital last year and stayed much longer than expected. Before my surgery I had already book my 2 week post op, but since I was still in the hospital and I was aware of the fee I asked my doctor if I should call and cancel the appointment or will she tell the girls in the office for me. She pleaded with me NOT to call that she would look forward to the 7 minute break.
IMO doctor offices that overbook and then make you wait should not expect you to pay a cancellation fee.
Nohandle on 07/29/2010:
I only deal with 3 medical practices in my area. My OB/GYN, Dentist and Dermatologist. I've never cancelled within a 24 hour time frame but have had to call and reschedule, well in advance. One thing to be a no show, without a good reason, but to be charged for changing an appointment within the time allowance? I don't think so.
momsey on 07/29/2010:
Helpful, it is wrong. I'm all for policies, but how can a doctor's office expect someone to follow policies and procedures without knowing what they are? Yes, I understand common courtesy, and as I said, I don't normally try to change my appointments so close to the time. This time, I really just couldn't make it at that time. If I really could have, I would have just gone and saved myself the headache and $25.

And, I don't know how much you know about "ladies" because I'm guessing you're not female yourself. I am 35 years old and have one child and have had several gynecological issues that have required me to be seen by different doctors at different times. I'm not squeamish about the exam. I do want someone I feel comfortable with, and I wouldn't go to anyone I haven't gotten a personal reference for, but I'm not terrified to be seen by someone else. The bottom line is I felt that my ten years as a patient with this doctor meant nothing because I didn't reschedule my appointment a few hours sooner.

I'm sure the doctor wasn't out any money because I cancelled. I know for certain that appointments are made in 15 minute increments, and it's probably as yoke said, they double book people. The feeling I got was that I wasn't a valued patient. I don't need that feeling with my OB!
momsey on 07/29/2010:
GermanGirl...I'm fine with signing something and agreeing to policies set forth by the doctor. Of course I won't be signing any sort of contract with a doctor (who signs a contract with a doctor?) but as long as I'm aware of policies and rules, I am happy to either follow the rules or be penalized.
Anonymous on 07/29/2010:
In all fairness, the doctor should have waived the fee the first time. The fee should not be another revenue stream for the doctor. The point of the fee is to encourage people to keep their appointments or at least give ample notice so that the time can be used for someone else. Waiving the fee the first time alerts the patient that it is there, which is the critical thing to do.
Anonymous on 07/29/2010:
Now, when are WE, the patients, going to start charging doctors for missing appointments with us (an hour-plus wait is missing the appointment) or rescheduling them at the last minute?

I was scheduled to give blood for some lab work. My schedule was the first one for the day for them. I was the ONLY person in the waiting room. They still did not get to me until 20 minutes after my scheduled time. That's utterly deplorable.
Helpful on 07/29/2010:
I mean no disrespect momsey. There is an assumption on your part, it seems, that your physician is automatically double booking. One should never assume such and think that it's okay just because "he's probably not out anything anyway".

You are right. Some women are easily open to a new OBGYN where other ladies simply are not. If you like the way the OBGYN handles you in every other way, you may just consider the $5 no big deal. Accept it as notice of the policy and make sure to be considerate of his time for future appoints; not that you're not already. It sounds like a rarity that you would ever cancel an appointment.

I had a similar question about paying a co-op fee on a follow up visit. I kindly asked my physician and he explained that it was not just policy but had something to do with laws. I didn't make a big deal out of it and still continue to see him.
Helpful on 07/29/2010:
Good points LinusOno!
jktshff1 on 07/29/2010:
My Dr charged me a cancellation fee many years ago. Next time I went in and had to sit for 45min-hr after my appointed time, I sent him a bill for what I would normally charge for "consultant" fees for that period of time. Long story short, cancellation fee was refunded and I've not had any problems since.
Nohandle on 07/29/2010:
Linus, you are correct. Let patients start charging for the wait if they are charged for missing an appointment. When I first visited my current OB/GYN, my other doctor had retired, he walked into the room and acknowledged my wait immediately. He then said they were about to order out for lunch and what would I like. You couldn't help but like this person.

There's no wait at my dental office period. Dermatologist, yes.. quite often. I've grown to accept it but I don't think I would ever be charged for a last minute change at any of the offices.
yoke on 07/29/2010:
helpful, the $5 came after a credit that the doctor had the nerve to keep on the books for 2 years without letting the patient know. Two years ago the $25 should have been sent back to the OP. The OP was still charged $25 since there was a $20 credit on the books that belonged to the OP.
Today went to the dentist with my son. Appointment was at 11. At 11:30 I asked how much longer before we would be seen, told soon. At 11:40 I informed them unless they could take him now we would have to reschedule as we had someplace else to be. He was seen a few minutes later. No I am sorry was said. The dentist is new to us, I may change. I know if I were 40 minutes late they would have cancelled the appointment and probably charged me for being a no show. Doctors/Dentists can't have it both ways. If they are going to charge for cancellations or noshows then we have a right to charge them $25 if we are left waiting. Bet doctors would stop double booking appointments if they were charged every time the patients had to wait.
Venice09 on 07/29/2010:
I have to agree with momsey and yoke on this. When you consistently have to wait 30 minutes or more for an appointment, it's fair to assume that the doctor, dentist, etc. overbooks. My dentist admitted this to me years ago. As yoke said, they can't have it both ways. It's also interesting that you had a credit in your account, momsey, but were never notified or refunded. I'd be annoyed too. And I would never sign a contract with a doctor either. That's where I would draw the line.

I don't understand why a male would know so much about women's relationships with their OBGYN, or why they would even care. To each his own, I guess.

Lots of good information and advice here. If I ever go the doctor, I'll keep it in mind!
raven2010 on 07/29/2010:
My obgyn, internist and eye doc all charge cancellation/reschedule fees fees. I have never signed an agreement with any of them.

if I call to cancel/reschedule, I am told of the policy at the time and asked if I still wish to cancel/reschedule.

leet60 on 07/29/2010:
I can relate to the OP's frustration. It is ludicrous to be charged for an appointment you weren't able to go to when the Doctor has no respect for your time whatsoever. It is typical to be given a 10:00 am appointment, be told to arrive 15 minutes early, only to be finally taken to an examination room 20 minutes AFTER your appointment time and left to wait another 20 minutes before the doctor sees you.

I have always wanted to send the doctor a bill for wasting my time, if my appointment is at 10, I am to arrive early to be ready to be seen by that time, I fully expect the doctor to come into the room at 10!

I am NOT responsible for you overbooking.
Starlord on 07/29/2010:
Doctor's offices are like airlines anymore. They overbook, figuring a certain percentage of patients will fail to show up. I once read about a guy who sent his doctor a bill for the time spent in the waiting room. He had an appontment for a certain time and showed up, but the doctor made him sit for 45 minutes past his appoinment time, so he billed the doctor for his time. He won in court.
Anonymous on 07/29/2010:
that's ridiculous. I would look for another doctor if I was the OP. I agree with starlord. Doctors aren't like doctors used to be. Its not about the patient anymore, its about the bottom line and how much money they can rake in in once day. Now if the DOCTOR had to cancel, so he can go on the golf trip he needs, its all fine and dandy! If call him up and tell HIM/HER they owe me 25 dollars for cancelling! Lets see what they would say about THAT! Reminds me of that seinfeld episode where George tried cancelling his appointment and hey still charged him, and when she tried cancelling on him, he said the same thing. I LOVE that part!
olie on 07/30/2010:
It's easy to complain about waiting for the doctor. But think of all those times you spend the entire night holding your child with an ear infection, praying that you will be able to get in that day. Or the times when you make an appointment for one kid, and offhandedly mention that the other one seems to have a cough, too. Or the times when you go in for what you think will be a simple office visit, and the doctor orders a strep test or X-ray; you have to see the doctor again before you leave. Or the times when the doctor spends a lot of time on your case. Or the times you plead for the staff to "squeeze you in".

I'm not a doctor, and I don't work in the medical profession. But there are two sides to the cancellation/waiting room story.
Venice09 on 07/30/2010:
Olie, your point about pediatricians is well taken. I used the same office for both kids and was never once turned away. My kids didn't get sick often, but when they did it was always on a weekend or holiday, and they were always taken care of. On the other hand, I don't recall there ever being a fee for canceled appointments. I think the reason was because the waiting room was always packed, and the staff was probably relieved when someone didn't show up. It worked two ways. I was willing to put up with the wait when I did have an appointment because I understood how accommodating they were to emergencies. And when you're dealing with kids, there are always emergencies.
yoke on 07/30/2010:
olie, I understand what you are saying, but it still should not give the right for the doctor to make money off of a patient that needs to reschedule within a 24 hour period or actually forgets about the appointment, 1 time. How many times have someone made an appointment with the doctor well in advance and you go and hire a babysitter and then the day before the doctors office will call and say they are rescheduling the appointment. I don't know about you, but I would still have to pay the sitter if I were cancelling the day before. Should a patient be allowed to say to the doctors office well if you reschedule you will have to pay the fee I have to pay my babysitter who I can not cancel and not pay? WE all know doctors offices overbook and for them to now have a fee in place if you cancel within 24 hours is absurd. Wonder if there is a website that warns patients of doctors that overbook and make you wait to be seen.
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