Providing Refunds and Releases to Patients: A Risk Management Perspective by Julie Goldberg, DDS from Pharmacists Mutual - May 2026 E NEWS

Providing Refunds and Releases to Patients: A Risk Management Perspective

Issuing refunds and obtaining releases from patients are common strategies used in dental practices to resolve conflicts, maintain goodwill, and mitigate potential claims. Aligning the use of these tools with legal, ethical and risk management best practices to ensure effectiveness can be challenging. This article will explore when and why a practice might consider a refund, the value and limitations of a release, NPDB reporting considerations, when to involve your insurance carrier, litigation risks and considerations for patient dismissal.

When and Why to Consider a Refund

Refunds are typically issued when a patient is dissatisfied with treatment, when the dentist recognizes a service may not meet expectations or standards, or when a patient relationship has deteriorated. Offering a refund is not an admission of guilt; instead, it is often viewed as a customer‑service gesture intended to defuse tension and avoid escalation. Prior to offering a refund, a provider will want to consider the following:

·         Avoid impulsive refunds. Consider when and why to offer a refund and include these details in your office policies and procedures.

·         Evaluate clinical circumstances to assess whether they meet office policies and procedures.

·         Document the rationale for the refund.

·         Ensure the refund does not violate payer or insurance rules.

Obtaining a Release: Value and Limitations

A release, also known as a release of liability or settlement agreement, is a signed document in which the patient agrees not to pursue future claims related to the treatment in exchange for consideration. Releases can be valuable tools, but they are not without challenges. Prior to offering a release, a provider will want to consider the following:

• Understand that a release is voluntary for both the provider and the patient.
• Ensure the release clearly states what the patient is releasing the dentist from.
• Identify the offer of valid consideration.
• Comply with state‑specific laws.
• Avoid any language that attempts to prevent a patient from filing board complaints, which may be prohibited in specific jurisdictions.
• Consult your business attorney.

Even with a well‑drafted release, a patient may still file a complaint with the dental board or pursue litigation. Releases can reduce liability exposure, but they cannot eliminate it entirely. And importantly, no release can block state dental board oversight; regulatory bodies retain the right to investigate concerns regardless of contractual agreements.

NPDB Reporting Considerations

The National Practitioner Data Bank (NPDB) requires reporting of certain “medical malpractice payments,” including settlements made on behalf of licensed practitioners. Whether a refund triggers NPDB reporting depends on structure and intent:

• Ordinary refunds-refunds that simply return fees paid for services, without any allegation of harm or negligence are not typically reportable.
• Payments made to resolve allegations of malpractice, even if no lawsuit has been filed, may be reportable and this typically dependent on the source of payment. For example, payments made by businesses are typically reportable. Check with your business attorney to ensure you have accurate information related to reporting in your state of practice.
• Any payment made by a malpractice insurer on your behalf is almost always reportable.

To limit potential missteps, consult your business attorney and malpractice carrier before issuing any refund connected to a clinical complaint. Reporting obligations can have significant long‑term implications for credentialing, licensure, and professional reputation.

Involving Your Professional Liability Insurance Carrier

Your carrier should be notified early when a patient expresses dissatisfaction, requests a refund tied to clinical issues, or makes statements that suggest potential legal action. Insurance carriers may be able to:

• Assess whether the circumstances indicate a potential claim.
• Provide template release agreements.
• Document an "incident" date; this date may then determine policy coverage.
• Help mediate communication with the patient.

What insurance carriers typically cannot do:

• Determine whether NPDB reporting is required.
• Ensure the risk of litigation is eliminated altogether.
• Offer legal advice.

Failing to notify your carrier can jeopardize coverage if the situation escalates. Even if you believe the complaint is minor, documentation and carrier involvement protect you.

Risk of Litigation

Many dentists hope that issuing a refund or obtaining a signed release will close the matter for good. While these tools often help, they do not eliminate the possibility of:

• State board complaints
• Malpractice litigation
• Insurance audits
• Negative online reviews
• Requests for additional refunds or compensation

A release may be tested in court, and a patient may still attempt to pursue legal remedies. That’s why documentation, carrier involvement, and careful communication remain essential.

Patient Dismissal Considerations

If trust has deteriorated or a patient becomes abusive, dismissing the patient from a practice may be appropriate. When doing so, a provider will want to:

• Provide written notice.
• Avoid dismissing patients in active pain or during critical treatment phases unless necessary.
• Document behavior that led to dismissal.

Dismissal situations are best handled on a case by case basis; providers will want to consider each scenario in the context of legal and ethical guidelines to avoid potential abandonment claims. 

Navigating refunds, releases, NPDB considerations, and potential patient dismissal requires a careful balance of clinical judgment, legal awareness, and proactive risk management. While these tools can help resolve conflicts and protect the practice, none offer absolute immunity from complaints or litigation. By thoughtfully evaluating each situation, maintaining clear documentation, and involving legal counsel or your malpractice carrier when appropriate, dental providers can address patient concerns effectively while safeguarding both their patients’ well‑being and the long‑term stability of their practice.

 

This article is intended to provide general information only on certain risk management topics and is not intended to provide any coverage determinations or coverage positions, nor is it to be construed as providing legal, medical, or professional advice of any form.

The Power of Google Ads for Dental Practices (Without Wasting Budget) - May 2026 CCDS E NEWS

 

The Digital Chairside

Marketing insights, explained like you’d explain treatment to a patient.

The Power of Google Ads for Dental Practices (Without Wasting Budget)

By Kayla Mauldin, Founder, Firelight Marketing
Former dental professional with 23+ years of industry experience

When dental practices consider advertising online, Google Ads is often one of the first platforms that comes to mind. It promises quick visibility and the ability to reach patients actively searching for care.

But there’s also hesitation—and for good reason. Many practices have tried Google Ads before and felt like they spent money without seeing meaningful results.

The truth is, Google Ads can be incredibly effective for dental practices—but only when it’s approached with the right strategy and expectations.

Why Google Ads Works for Dentistry

Unlike social media, where patients are casually scrolling, Google Ads targets people who are actively searching for a solution.

These are high-intent searches like:

• “Emergency dentist near me”
• “Invisalign consultation”
• “Tooth pain relief dentist today”

This means your practice is showing up at the exact moment a patient is ready to take action.

For dental offices, that level of intent is powerful. It shortens the decision-making process and often leads to higher-quality inquiries.

Where Most Campaigns Go Wrong

The biggest mistake practices make with Google Ads is treating it like a set-it-and-forget-it solution.

Common issues include:

• Targeting too broad of an audience
• Sending traffic to a generic homepage instead of a focused landing page
• Not tracking calls, forms, or conversions
• Running ads without clear messaging or intent

Without proper structure, even a well-funded campaign can produce poor results.

Google Ads is not just about being seen—it’s about being relevant.

The Importance of Targeting the Right Services

Not every service needs to be advertised equally.

High-performing dental campaigns often focus on:

• Emergency dentistry
• High-value procedures (implants, crowns, Invisalign)
• New patient exams or offers

These services align with both patient urgency and practice growth goals.

By narrowing the focus, practices can allocate budget more effectively and avoid spreading resources too thin.

Landing Pages Matter More Than the Ad

Getting a patient to click on your ad is only the first step. What happens next determines whether they convert.

A strong landing page should:

• Clearly match the intent of the search
• Explain the service in simple, patient-friendly language
• Build trust with reviews, visuals, and transparency
• Make it easy to call or request an appointment

If a patient clicks on an ad for “emergency dentist” and lands on a general homepage, there’s a disconnect—and often, a lost opportunity.

Tracking Is What Turns Ads Into Strategy

One of the biggest advantages of Google Ads is the ability to track performance.

Practices can see:

• How many people clicked on an ad
• How many called or filled out a form
• Which services are generating the most interest

This data allows for continuous improvement. Campaigns can be adjusted over time to focus on what’s working and eliminate what’s not.

Without tracking, advertising becomes guesswork. With tracking, it becomes a system.

Google Ads Should Support—Not Replace—Your Marketing

Google Ads works best when it’s part of a larger strategy.

Practices that combine ads with strong SEO, positive reviews, and a well-built website tend to see the best results. Ads can drive immediate traffic, while other efforts build long-term visibility and trust.

Think of Google Ads as a way to fill short-term gaps while your broader digital presence continues to grow.

The Takeaway

Google Ads can be a powerful tool for dental practices—but success comes from clarity, focus, and ongoing refinement.

When campaigns are built around patient intent, supported by strong landing pages, and guided by real data, they can consistently bring in high-quality new patient opportunities—without wasting budget.

Kent Burnett, DDS: Serving Organized Dentistry and Providing Family-Friendly Care in Corvallis - Coastal Cascades Dentist Society February 2026 Member Spotlight

 

 

Dr. Burnett is currently a member of the Coastal Cascades Dentist Society council and was integral to the merger of the membership of the Southern Willamette and Lane County Dental Societies.  He also serves on the Oregon Dental Association Board of Trustees. He serves on these boards to express his gratitude for the opportunity to become a dentist and to say thank you.  Why did he decide to become a dentist in the first place? A friend suggested that he should become a dentist. At first, he resisted the idea, but he liked the idea of working with his hands and making a decent living. Most of all, the pursuit of dentistry was a challenging goal for him to achieve.

Dr. Burnett was born in Missoula, lived in Utah while his father worked at Weber State, and he went to dental school at Case Western Reserve University in Cleveland, Ohio. Early in his career, he worked as a dentist with the Confederated Salish and Kootenai Tribes’ Tribal Health Department.

Dr. Burnett ended up in Oregon after he and his wife decided not to move back to Utah due to the high number of dentists there and to avoid snow. After working in Eugene with a friend, he ended up finding a dental practice in Corvallis in 2001. The practice seemed like a good deal, but he struggled to rebuild the practice during economic turndowns associated with 9/11 and 2007.  He recommends that new dentists pay attention to Return On Investment (ROI) before making big purchases. Regardless of the initial challenges, Kent has enjoyed being a dentist. The favorite part of his job is chatting with long-time patients and seeing them through all the many stages of their lives. He thinks this is funny because he generally likes being alone. 

One of  Dr. Burnett’s favorite activities outside of work is taking a quiet scenic drive and continuing his family's tradition of “grey-lining,” which involves traveling on less-used roads to discover unique places. He also enjoys gardening and enjoys the challenge of growing a vast variety of different plants. Once, he grew a 12 foot tall Greenhouse to grow bananas.

Dr. Matthew Collins, DMD: A Young Dentist's Transition to Practice Ownership, Reprinted from CCDS November/December 2025 Newsletter

Dr. Matthew Collins bought his new Springfield practice, Two Rivers Dental Group, in July of this year. Previously, he had worked at Smiles Dental and a couple of Aspen Dental Locations. Although taking on practice ownership involves a lot of hard work, this was made easier due to support from another local dentist. Dr. Terri Baarstad, who has her own full-time practice,  has helped Dr. Collins by providing mentorship regarding business practices, giving advice on navigating insurance issues, and sharing patient pools. 

Dr. Collins was born in Southern California, studied at California State University Channel Islands before going to dental School at the University of Nevada.  He graduated from dental school in 2019. Early on, Matthew had a strong interest in science and anatomy. Although he initially focused on becoming a surgeon, he soon discovered that working in a hospital setting was not a good fit for him. 

Matthew’s mom is a hygienist and invited her son to come watch the dentist at work to see if dentistry would be something he would like. “So I went in there, and then, I was just like, this is pretty cool. I just kind of clicked.” He also liked that as a dentist, he could continue to learn new skills and you get to be a business owner.

Dr. Collins decided to move to Oregon because it promised to be a good place to raise a family. In addition to the slower pace of the Pacific Northwest, Matthew said,” I love the seasons. I love the green and the rain, all the water and mountains.” 

Dr. Tyler Peterschmidt, DDS: Showcases His Art at PNW Dental, Reprinted from CCDS November/December 2025 Newsletter

One of the first things one notices when they walk into Pacific Northwest Dental is the beautiful wall-sized nature photography throughout the office space.  Dr. Tyler Peterschmidt has found that displaying his own artwork, which began as a personal hobby, has grown into a conversation starter with his patients. He started taking pictures about six years ago, teaching himself through YouTube. At first, he was a bit shy about sharing his art. He first hung up a picture and didn’t tell anyone it was his, and let it sit there and waited to see how people responded. Now he is proud of his work and has photos in all the operatories. Now, instead of shying away from sharing his personal interests, he uses his photos as a way to connect with his patients, and some even buy his prints.

Dr. Peterschmidt’s mother recognized his potential for dental work when he was given a kit of dirty old Roman coins to restore. Tyler enjoyed the fine detail work coin restoration took, and his mom associated his talent with the work that dentists do.  Since he has an aunt who is a dentist,  Tyler was able to shadow her and he also benefited from clinical volunteer opportunities and soon decided that dentistry is the career he wanted to pursue. In addition to enjoying dental work, he found being your own boss and the ability to build your own culture and work environment appealing. 

Dr. Peterschmidt partnered with Dr. Watkins when Dr. Joe Jensen retired. Their partnership is based on shared values and complementary skills. Dr. Peterschmidt has been drawn to oral surgery, participating in advanced training on implants, bone grafting, soft tissue surgery, and periodontics. Whereas Dr. Watkins has done training on sleep apnea devices. Dr. Peterschmidt said that they mesh well in terms of our business relationship and their easy-going personality style. They also have both embraced in house technology, such as doing their own scanning and 3D printing.

In Memoriam: Dr. Stanley Clawson Promoted Comradery While Bringing Laughter and Joy to Our Dental Community (June 11, 1933 – March 8, 2025) Reposted from May/June Newsletter 2025

 

Dr. Stanley Clawson and Dr. Robert Carmichael share a laugh while celebrating Stanley's 91st birthday at the 2024 retiree luncheon.

Dr. Stanley Clawson, who passed away on March 8, 2025, at the age of 91, leaves behind a legacy of laughter and community in the dental world.  

Dr. Clawson practiced dentistry for 30 years and was known for his sense of humor. Dr. Bob Carmichael says that he never saw any of his patients because they stayed with them. Stanley would joke that he did not need antiseptic because he numbed his patients with humor: “They were laughing the whole time he was working with them!” 

In a time when lawyers and doctors were creating group practices with professional partnerships, Dr. Stanley Clawson formed a group practice with doctors Minser & Day, thereby contributing to elevating dental practices in the Eugene area to the same level of professionalism as other types of practices.

At dental society meetings, Dr. Clawson would tell everyone to turn off their cellphones and get to know the people around them. He would also remind dentists that they were not competitors, saying that he did not want their patients as he had enough for himself. He encouraged dentists who had extra patients to give them to the newer dentists.

Dr. Clawson also partnered with Dr. Brinkman and Dr. Hanson to create a store: Grape and Grain. This venture allowed Stanley to travel Europe to find items to sell in their store. He also traveled to Tibet with his wife, collecting yak butter and wine made by Monks.

During the time Grape and Grain was in business, Dr. Clawson would organize Christmas parties for the dental society, which included fancy attire and a big dinner. Grape and Grain would donate various gifts from all over the world. Dr. Clawson would emcee the event, and Dr. Burr and Dr. Carmicheal would dress up as gift-giving elves.

Outside of his dentist office, Stanley enjoyed many outdoor activities, such as helicopter skiing, windsurfing, sailing, and tennis. Later in life, he honed his skills as a woodworking craftsman.

(Information from interview with Dr. Bob Carmichael and Register Guard Obituary)

Member Spotlight: Dr. Rachel Meek Serving Tribal Members at Siletz Community Health Clinic Repreinted from CCDS March/April 2025 Newsletter

Coastal Cascades Dentist Society welcomes Dr. Rachel Meek to its council. Her position on the council reflects our efforts to have wider representation throughout our new, larger geographical area, as she is currently working for the Confederated Tribes of Siletz Indians near Newport. Dr. Meek is a member of the Cherokee Nation of Oklahoma, and she actively seeks opportunities to use advocacy and her work as a clinical dentist to address the need for care in native populations, particularly children. 

Dr. Meek is also actively involved as a leader at the State association level. Her involvement began as an ODA liaison while she was a student studying dentistry at Oregon Health and Science University. She is currently serving on the ODA’s Legislative Task Force and its Regulatory Advisory Council. 

Although Dr. Meek did not initially think she would pursue a career in the medical field, after working as an orthodontic assistant and volunteering on service trips, she decided that dentistry offered a way for her to truly help others’ health. She also discovered that there are not that many native dentists, which led her to work at the Siletz Community Health Clinic after graduating. Plus, she wanted to stay in Oregon. 

In addition to dentistry, the health services encompass all health services on the reservation, including medical, pharmacy, and laboratory services. There is also a natural health area featuring various herbs and spices to help alleviate common ailments. This holistic approach to health facilitates collaboration between dentists and other medical professionals, enabling them to refer patients to one another for specialized care.