Comparing Online Appointment Charging Models

Does it matter to your practice whether the fees associated with selecting an online appointment booking solution is free, charged on a per booking basis or charged on a flat subscription fee basis either per practice or practitioner? Which is best? Do any of them have the potential to hurt my practice business?

The good news is that practices within the GP sector are left with a choice of solution options and pricing models. Outside of the GP sector, only two pricing models currently exist (independent of any provided by a Practice Management Solution vendor which is a whole other interesting topic) from two solution providers.

While on the surface of it, it would appear that it’s all about the pricing options and practices should select based on which model they are most comfortable with. The truth is that these pricing models may reveal some very interesting insights into the motivations behind one pricing model over another, as you would rightly expect and some may actually hurt your business if you are not careful. So some homework is important and some key questions should be asked of the vendor.

While I may be accused of writing with a bias, as I am the Managing Director of one of Australia’s leading online healthcare appointment solution providers, I nonetheless feel that the information shared in this article is objective, open and accurate. I don’t mention any specific solution provider as I think this would be inappropriate. Please feel free to share your views or experiences with me directly if you wish, via my email address. I would love to hear from you.

Presently, three pricing models exist in the market, Free (or at least the “claim” of free), Pay per booking and a flat monthly subscription fee (whether by practice or practitioner).


“Free” Pricing? Really?

At first glance, FREE sounds like a great option for your practice doesn’t it? But you know the old saying right “if it’s to good to be true then it probably is”. Nothing comes for free. There must be some benefit to the company who is offering the service for free or why would they do it? But do you know what that is? If not, do your research and find out. I believe there are two hidden truths about “free”. 1) There are hidden costs and charges that you will be paying that you have not been made clear of understood. The proverbial sting in the tail! Or, 2) The motivations of the vendor to be offering free is not immediately obvious? Could it be a Trojan horse? Is it possible that the solution may be aimed at driving your existing patients away from you because they make more money by charging fees for delivering new patients to other practices, or worse, encouraging your existing patients to book with competing practices so they make money? Make sure you check how their system actually works from a patient’s perspective. I am always stunned when I hear that a practice has not checked this or tried to use the service themselves from either the vendors website or mobile app. Obviously when patients come to your website to book they are only presented with appointments for your practice. Unfortunately, your own website will deliver only a small proportion of your bookings.

Bottom line is, be very very careful when being blinded by the offer of “free”. So your homework and ask lots of questions. Changing systems is a bit like changing practice phone numbers so you don’t want to get it wrong.


Per Booking Fee

Success or usage based pricing has it attractions. There is no doubt about. It offers the practice an opportunity to trial a service and only pay when a result is delivered to the practice. Performance based pricing? The trend to date appears to be around two forms of usage pricing models. A flat fee regardless of whether the patient is a new or existing practice, or a smaller fee for existing patients to book and a larger fee (new lead fee) when a new patient books online.

As a minimum, if you are drawn to a per booking fee proposition, whatever you do, go with a flat fee per booking regardless of whether or not an existing or new patient books online, AND, make sure that there is a clear monthly cap per practice or practitioner so that you are not being over charged for your own success in driving patients to book with you online! The benefits of online booking to your practice are massive and if anything is standing in the way of you maximizing the efficiencies and benefits that you can gain (like paying through the nose for the volume you may get), then avoid it or negotiate better terms!

If however you find yourself selecting a solution that charges different fees for new vs existing patient, then be aware that you may find yourself in quicksand very quickly. There are two challenges with this pricing approach. 1) You will end up paying through the nose the more successful you are in driving patients to book with you online, even if they cap the existing patient booking side of things. It won’t take long before you are paying 2-10 times more than other solution options out there and when you are talking about several hundreds of dollars a month to thousands, it becomes a huge financial burden on the practice. Or 2) You will likely end up in dispute with your service provider every month. This will occur because a) you will be charged for no-shows and want to be reimbursed for those and b) existing patients will mistakenly identify themselves as a new patient resulting in your being overcharged for that booking, and again leaving you with a monthly reconciliation headache. And there is nothing worse than that monthly billing nightmare and having to get that fixed with your vendor! I think we have all had the experience of trying to sort out billing mistakes with a Telco and discovered how time consuming and painful that can be as an example.

Be careful also, as sometimes the systems that use these per booking fee arrangements are actually designed to drive your existing patients away from you as they make more money when a new patient books with a practice for the first time. You can easily check that by looking at how their systems are designed and whether or not a patient search result on their website or mobile always delivers competing practice appointments as well, leaving your patient to have to wade through the long list of providers to find you.


Monthly Subscription Fees

This approach provides the practice with the easiest method of pricing and no monthly practice administration overhead as is the case with per booking fee models. The only concern for some practices is that they have to shell out fees each month without any certainty about the booking volumes that they might get and therefore may question the value of the service they have adopted or risk of adoption. Trials or money back guarantee periods are a good way of managing this risk, and to be honest, online appointments will only be successful because of the effort you put into the technology to get the most out of it. It will work, of that I am certain when you make a active effort to make it successful.

The bottom line however is this. Online healthcare appointment booking services are not just for new patient acquisition. It’s not just another form of yellow pages. Significant value will be derived when you consider these solutions as a way of making it easier for your patients to access your services, 24/7, for both new and existing patients. In fact, you are likely to see more business from your existing patients as a result of this easier form of access to make an appointment with your practice. 65% of all Australian’s find the current process of making an appointment by telephone, frustrating and inconvenience and many delay access to healthcare services as a result.

Online appointments will be adopted by your practice in the near future. It is not so much a question of if anymore, but a question of when. It has become an obvious trend and preference of patients and leading practices. As consumers, we do so much online now, why not including booking your healthcare appointment online as well. It just makes sense and is proven already internationally.

At MyHealth1st we care deeply about nurturing the existing doctor/patient relationship and not seeking to actively disrupt that relationship. Dr Google is only ever one click away and it is only a foolish businessperson who thinks they can control their customer’s choices in this online world. Making it easier for your patients to book appointments with you and offering a superior service is your best avenue for patient retention and attraction. Online is clearly the optimal solution for this and it is my prediction that 90% of practices will be offering these types of solutions within the next 5 years. Its transformational and that shift cannot be stopped.

Selecting the right system though is key as the impact on your practice can be significant.

Feel free to drop me a note with any questions that you may have. My team and I would be only to happy to help.

Klaus Bartosch
Managing Director
Email me