HHS has fined or settled with three dental practices over replies
Remove negative doctor reviews that break platform rules
For physicians, clinics, med spas and therapists, the risk is in the reply: confirming that a reviewer was your patient can break HIPAA. We file all your bad reviews with Google, Yelp and Facebook under each platform’s own policy. The platform decides each one, and you pay for the ones that come down.
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The reviews a medical practice gets.
Your reply can disclose more than the review did
Under HIPAA, health information includes “the provision of health care to an individual” and payment for it. A reply that confirms a visit, a treatment or a balance discloses it. In 2023 a New Jersey psychiatric practice paid HHS $30,000 after its replies to four patients’ Google reviews. In 2018 an allergy practice in Connecticut paid $125,000 after a patient took a dispute to a TV station and the doctor discussed the patient with the reporter.
A relative posts the patient’s diagnosis
A spouse or an adult child may write about a parent’s or partner’s care. What they saw at the front desk is their own experience, and that part usually stays up. A review that names another person’s condition breaks Google’s Personal information policy, which bars posting someone else’s “medical information” without their consent. You still cannot reply to confirm that the patient was seen.
Wait times, bills and outcomes
A one-star about a two-hour wait, a surprise balance or a result the patient did not like usually stays on Google, which says it “doesn’t get involved in conflict between businesses and customers.” Zocdoc is stricter: it does not publish insurance pricing specifics or claims about whether a diagnosis or treatment was accurate. On Google, a review crosses the line when it calls a physician a fraud or a criminal without proof.
Competing clinics and former staff
Med spas and cosmetic clinics in one town compete for the same patients, and a burst of one-stars can come from a rival’s staff. Google bars content based on a conflict of interest and names industry competitors and current or former employment. Naming the doctor is not a breach by itself: the same policy allows the names of public-facing professionals, such as doctors, who work under their own name.
What one star is worth.
In TrustReviews data on 306,017 reviews across 1,106 Google profiles we monitor (October 2026), one-star reviews are 2.6 times longer than five-star reviews (median 315 against 119 characters), so a one-star usually tells the full story of a visit. Owners reply to 45% of one-star reviews. For a medical practice, each of those replies is a HIPAA decision. These profiles belong to businesses that came to a removal company, so they are not a random sample of Google. An illustrative example, not a measured result: a practice that sees 80 new patients a month at $400 of first-year revenue each takes in $32,000 a month from them. If a lower rating cost it 1 new patient in 20, that is 4 patients and $1,600 a month.
What your rating costs a medical practice
Luca’s Harvard Business School study of independent Seattle restaurants on Yelp found that each extra star brought 5 to 9 percent more revenue. Your business may differ. Change the numbers to match yours.
Estimate only. Luca, “Reviews, Reputation, and Revenue: The Case of Yelp.com”, Harvard Business School, 2016. The median rating across the 1,106 Google profiles we monitor is 4.75 (TrustReviews data, October 2026; these businesses came to a removal company, so they are not a random sample).
The sites your customers read.
How removal works, in four steps.
Connect your Google Business Profile in the TrustOS portal: search by name or paste a Google Maps link. Businesses with no public address can connect too. We read every review at once and show you each one rated 3 stars or less.
Every 1-star review is selected by default; add 2 and 3 star reviews if you want, and choose how many removals you want. You see the price and accept the terms in the app before anything is filed. For other sites, send us the links in the chat and your account manager agrees the price with you.
We screenshot each review, then our filing team files it with the platform under its own policy. The platform reads each one and decides. Some removals arrive months after filing, so we follow every filing to an outcome.
A person checks every removal before we count it; our software never marks a review removed by itself. We email you the review and its before-removal screenshot, and we stop when the number of removals you asked for is reached.
We file all your bad reviews.
You pay for the ones that come down. On Google, you see the price and accept the terms in the app before anything is filed. For other sites, your account manager agrees the price with you first. No one can guarantee every review comes down, because the platform makes the final decision on each one.
Medical practices, an example.
Over two weeks, seven one-star Google reviews arrived from accounts the owner linked to a competing clinic’s staff and their friends. None matched a client on the books. The owner could not answer them in detail without saying who was or was not a client, and the rating fell from 4.9 to 4.4.
The owner chose all seven, and our filing team filed each one with Google as a conflict of interest under its Rating manipulation rules. Google removed six of the seven, and the rating rose to 4.8.
Real Google reviews we’ve had removed.
Each one now reads “This review is no longer available.” Business names are blurred for privacy.












Our clients, in their own words.
Screenshots of messages clients sent us. We keep every client’s work confidential.
























Questions from medical practices
Can a doctor respond to a negative review without violating HIPAA?
Yes, if the reply does not confirm that the reviewer is or was a patient. HIPAA treats the fact that a person received care from you, and what they paid, as protected health information. A general reply speaks only about the practice, for example: “We take every concern seriously. Please call our practice manager at the main number.” Leave out any visit, date, diagnosis or balance. HIPAA binds covered entities, such as a provider that bills insurance electronically, so a cash-only med spa should ask its counsel whether it is one. Addiction treatment has a stricter rule: under 42 CFR Part 2, a facility publicly known for providing only substance use disorder care may acknowledge that someone is a patient only with written consent or a court order.
How do I remove a Healthgrades review?
Healthgrades is not one of the platforms on our site, so this answer describes Healthgrades’ own process. Flag the review on Healthgrades, and its team checks it again against the Community Review Guidelines. Those guidelines bar personal attacks and name-calling, misleading or fraudulent content, impersonation, personal information such as a full name or phone number, and any mention of legal matters or proceedings. Healthgrades says doctors cannot pay to remove a negative review. You can also reply from a Healthgrades Pro account in up to 500 characters, and Healthgrades checks the reply before it goes live.
How do reviews work on Zocdoc, WebMD and Vitals?
Zocdoc posts reviews only from patients who booked through it and whom the practice marked as attended, up to 120 days after the appointment. A provider disputes a review by email to Zocdoc’s trust and safety team, up to one year after the review was approved. WebMD and Vitals.com show the same provider directory. Providers cannot remove or edit reviews there; a review concern goes to WebMD Customer Care with your NPI, your profile link and the review date, and WebMD removes only reviews that go against its guidelines.
Can a state medical board act over an online review or my reply?
A review is not a board complaint; a patient who wants the board to act files a complaint with that state’s board. Your reply is a different matter. The Federation of State Medical Boards’ 2019 policy on social media lists “online violations of patient confidentiality” and “online derogatory remarks regarding a patient” among conduct boards can discipline, from a letter of concern up to license revocation. The same policy says reviews on sites such as Healthgrades “can contain inaccuracies” and advises against defensive or uncivil replies. Rules differ by state. This is general information, not legal advice.
What does medical practice reputation management include at TrustReviews?
Removal and monitoring, not marketing. We file the reviews you choose with the platform under its own policy, and the platform decides each one. Each Google Business Profile you connect is read about once a day, and one daily email lists new 1 and 2 star reviews. You do not send us patient records; the work uses the public review and your profile. We do not write, buy or collect reviews, contact reviewers, or ask a platform who a reviewer is. If your new-patient forms bar patients from posting reviews, the Consumer Review Fairness Act makes that clause illegal.
What if nothing comes down?
You pay for the ones that come down. The platform decides on each review, and a review it keeps up shows as Could not be removed in your TrustOS portal.
What if nothing comes down?Guides on reviews and removal.
Sources
- 45 CFR 160.103, definitions of health information and protected health information
- HHS OCR: Manasa Health Center settlement over replies to online reviews (June 2023)
- HHS OCR: Manasa Health Center resolution agreement (four Google review replies)
- HHS OCR: Allergy Associates of Hartford, doctor’s disclosure to a reporter (2018)
- HHS OCR: 2018 HIPAA enforcement summary (Allergy Associates facts)
- 42 CFR 2.13, acknowledging the presence of patients (substance use disorder records)
- Federation of State Medical Boards: Social Media and Electronic Communications (2019)
- Google: Maps user-generated content policy, prohibited and restricted content
- Google: Report inappropriate reviews on your Business Profile
- Healthgrades: Community Review Guidelines
- Healthgrades: Patient reviews
- Healthgrades Help Center: How to respond to a review
- Zocdoc: Patient reviews (provider help)
- Zocdoc: Getting started with reviews (disputing a review)
- Zocdoc: Reviews FAQs (what Zocdoc will not post)
- WebMD Customer Care: Directory listing or review concern (WebMD and Vitals)
- WebMD Care: Data transparency and reviews
- FTC: Consumer Review Fairness Act, what businesses need to know
Other businesses we work with.
Pile-ons after a viral post or the news
A customer who disputes the quote
The final bill was higher than the estimate
Reviews from the other side of a case
Reviews that name a stylist
Tenants reviewing a property manager over a deposit or eviction
Guests who threaten a review for a refund
Send us the review that is hurting you.
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