30 Day Non Compliant Letters for Ortho- Discontinuing Patients
I. Introduction
● Brief introduction to Dr. Amanda and StraightSmile Solutions.
● Purpose of the article: Understanding non-compliant patients (PITA patients) and strategies to manage them effectively in orthodontic practice.
● Importance of compliance in patient care and legal protection for the practice.

II. What is a PITA Patient?
● Definition and explanation:
○ Acronym for “Pain in the A**” patient, a term often found in the Urban Dictionary.
○ Refers to patients who are non-compliant with treatment protocols.
● Examples of non-compliance:
○ Missed appointments or poor attendance.
○ Not wearing aligners, braces, or retainers as prescribed.
○ Poor oral hygiene leading to decay or caries.
● Impact of non-compliance on treatment outcomes and practice management.

III. Strategies for Managing Non-Compliant Patients
1. Proactive Communication
○ Importance of clear instructions for patients at the start of treatment.
○ Setting expectations for appointment frequency and hygiene standards.
○ Use of multiple channels for reminders: phone calls, emails, texts.
2. Regular Monitoring
○ Leveraging practice management systems to track patient compliance.
○ Running monthly reports for active orthodontic cases (codes like D8090, D8080, etc.).
○ Identifying and addressing lapses in attendance or treatment adherence promptly.
3. Documentation and Follow-Up
○ Keeping detailed records of all communications and attempts to reach the patient.
○ Initiating follow-ups through calls, emails, and texts.
○ Escalating to written notices after repeated non-responsiveness.

IV. The Importance of a Strong Patient Contract
● Key elements of a robust patient contract:
○ Clear terms on compliance and consequences of non-adherence.
○ Financial policies for treatment discontinuation or additional lab fees.
● Role of templates:
○ Dr. Amanda’s document store offers templates for managing non-compliance.
○ Alternatives include free resources online or creating custom documents.

V. Steps to Discontinue Non-Compliant Patients
1. Warning Letters
○ Sending initial and follow-up letters detailing non-compliance issues.
○ Importance of certified mail with return receipt to ensure delivery.
2. 30-Day Notice
○ Giving patients a 30-day window to seek a new provider.
○ Offering to transfer records at no cost.
3. Legal Considerations
○ Reviewing state-specific Dental Practice Acts for compliance.
○ Consulting with liability insurance providers for guidance on templates and processes.

VI. Case Study: Lessons from a Non-Compliant Invisalign Patient
● Scenario:
○ Patient failed to attend appointments for 3–4 years, leading to case expiration.
○ Patient expected continuation without additional charges, claiming abandonment.
● Resolution:
○ Doctor obligated to complete treatment due to lack of proper documentation and recall attempts.
○ Lessons learned:
■ Importance of proactive recall systems and certified communication.
■ Legal and financial risks of not managing non-compliance effectively.

VII. Resources and Support from StreetM Solutions
● Dr. Amanda’s templates and resources:
○ Discontinuance for non-compliance letter template.
○ Access through membership plans or course purchases.
● Benefits of leveraging external tools:
○ Saves time and ensures compliance with legal standards.
○ Avoids costly errors and misunderstandings with patients.

VIII. Conclusion
● Emphasizing the need for a structured approach to manage non-compliant patients.
● Balancing patient care with legal and financial protections for the practice.
● Encouraging orthodontic professionals to invest in resources and systems for better management.
Tools and Resources
Dr. Amanda offers practical tools for managing Pita patients:
● Templates for Communication: Discontinuation letters and other essential documents.
● Training and Support: Courses and consulting sessions to improve practice management.
● Free Resources for Members: Premium and VIP members receive free document templates and additional perks.
Practices should also leverage their practice management systems to run monthly reports on active patients and identify potential issues early.