Should you take a booking advance? The ₹200 question
Prepayment is the strongest no-show lever available. It is also the easiest to set wrong, in both directions.
A patient who has paid something has made a decision. A patient who has not has made an intention. That difference is most of the gap between a 20% no-show rate and a 5% one, and no amount of reminder tuning closes it.
Getting the amount right
The common mistake is charging the full consultation fee, on the reasoning that you may as well collect it. This suppresses bookings — a first-time patient comparing three clinics will pick the one that does not ask for ₹500 before they have met you.
The opposite mistake is ₹20, which is not a commitment and only adds friction. A token somewhere around ₹100 to ₹300 is high enough to matter and low enough that nobody abandons the form. It should be adjusted against the final bill so an attending patient pays nothing extra.
Three settings, not one
| Setting | When it fits |
|---|---|
| Prepayment required | High-demand slots, cosmetic consultations, a practice with a real no-show problem |
| Prepayment optional | Most practices most of the time — the patient chooses, and many do |
| Pay at the practice | Established patients, follow-ups, anywhere the relationship already exists |
The right answer often differs by appointment type within one clinic. A returning patient booking a review does not need a token; a first-time cosmetic consultation probably does.
The refund window is the part that causes arguments
Decide it before you need it, state it on the booking page, and automate it. "Cancel more than 24 hours ahead and the advance is refunded automatically" is a rule the front desk can apply without judgement — and judgement at the counter is how a ₹200 dispute becomes a bad review.
Where the money must land
Into your account, not your software vendor's, and recorded against both the appointment and the eventual invoice so your collection sheet balances. An advance that sits in a separate system is an advance that gets forgotten and charged twice.
When not to charge it
- Emergency or pain appointments. Never put a payment step between somebody in pain and a chair.
- Patients you have treated for years, who will read it as distrust.
- Slots you struggle to fill anyway — friction is the wrong tool for an empty Tuesday.
GullyMed makes this a per-practice setting with a configurable token and refund window. The advance goes to the practice's own account and lands on the invoice as a credit line.