Patient Left Without Paying for the Service: How to Prevent It

It’s an uncomfortable situation that almost every clinic or med spa runs into at some point. A new patient comes in for Botox or another cosmetic procedure that isn’t covered by insurance. Everything goes smoothly — until checkout. Suddenly, the patient says, “Oh, I left my credit card in the car, I’ll be right back.”

And then… they never come back.

If this happens, the chances of collecting payment later are very close to zero. Chasing them down usually takes more time and energy than it’s worth. That’s why the best solution is not to fight for payment afterward, but to set up systems that prevent nonpayment before treatment begins.

Here are 6 proven ways to protect your practice from these “dine-and-dash” patients.

1. Charge for a Consultation

If a patient is interested in Botox, fillers, LASIK, ICL, or another elective service, charge a consultation fee ($150–$200).

This fee can be applied toward the procedure if they move forward. It helps filter out people who are only “shopping around” or trying to get a free exam.

2. Collect a Minimum Amount at Check-In

When patients schedule Botox or fillers, set a policy that a minimum number of units will be charged upfront.

For example: payment for 20 units is collected at check-in. If the patient ends up using more, the remainder is collected at checkout.

This way, you know the treatment won’t be a complete loss if the patient disappears.

3. Keep a Card on File with Consent

During scheduling, explain that payment information will be collected at check-in. Patients sign a consent form allowing the clinic to charge their card for services received.

This prevents uncomfortable surprises and creates a safety net for your staff.

4. Train Staff in Payment Conversations

Talking about money can feel awkward, but it doesn’t have to. Train your team with simple scripts, like:

“For all new cosmetic patients, we collect payment before treatment. Would you like to use a card or HSA account today?”

Confidence and consistency matter. If everyone communicates the same message, patients will quickly understand this is the norm.

5. No Payment, No Procedure (for New Patients)

Make it a clear policy: elective procedures for new patients must be prepaid or paid before treatment starts.

Once staff have this as a written policy, they won’t feel pressured to “make exceptions.”

6. Use Electronic Pre-Authorization Holds

Just like hotels and car rentals do, run a pre-authorization hold on the patient’s card at check-in.

The funds are reserved for the estimated cost of the procedure, and the final charge is adjusted afterward. Patients are familiar with this process, so it usually feels natural.

Final Thoughts

When a patient leaves without paying for a service, it can feel frustrating, unfair, and discouraging for your staff. But the reality is simple: once it happens, the chance of recovering the payment is slim. That’s why the focus should always be on prevention, not reaction.