Hi Bert,
I didn't read all the replies, but I have a tip about dismissed patients getting appointments. We don't dismiss patients for owing, but we do dismiss fairly often for multiple no shows. We mail 1 certified letter and 1 regular mail letter to the parent. At that point, I inactivate the patient right away and put a note that they are dismissed in the yellow note in demographics. The letter does say we will see the patient for "emergency" visits for 30 days. If they call within 30 days, staff will not find patient in the active patient list. If not found, they know to search under "all patients," so if they are found, the note about being dismissed is very clear, and the appointment won't be made unless it's a sick visit. (And staff will also tell them they have been dismissed.)
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