Billing and cancellation complaints: what telehealth brands can flag
"Cancelled and still charged" is the most common sentence on a telehealth Trustpilot profile. These reviews hurt, they repeat, and almost none of them can be removed. This guide explains why, shows the few exceptions, and sets out what regulators already expect of your checkout. We remove the exceptions, and you pay per removal.
By James Tumbucon. Published · Updated . Reviewed against Trustpilot’s guidelines on
100% risk-free. You only pay for the reviews that come down.
Short answer
Billing and cancellation complaints are genuine experiences, so Trustpilot keeps them online, even when the customer has the facts wrong. A billing review can be flagged only if it breaks a rule for another reason, such as naming an agent with contact details or describing a charge from another company. Never offer a refund in exchange for removing a review. Trustpilot bans it, and the FTC cited the same conduct in its NextMed case. The lasting fix is clear renewal terms, easy cancellation and fair review invitations.
Key facts
Billing, renewal and cancellation complaints are genuine experiences under Trustpilot's rules and stay online.
Source: For which reasons can businesses flag service reviews?, Trustpilot Help Center
The FTC said NextMed conditioned refunds on consumers agreeing to remove negative reviews, and treated that as suppressing reviews.
Source: FTC Takes Action Against Telemedicine Firm NextMed (July 14, 2025), Federal Trade Commission
The FTC's final order against NextMed requires clear disclosure of refund and cancellation terms before charging and a simple way to cancel.
Trustpilot bans incentives for writing or editing a review, and its examples include refunds.
A public reply that confirms a charge, a plan or a date can disclose protected health information.
Why this is the largest group
Telehealth is sold as a subscription. A visit, a prescription and a monthly refill are bundled into one recurring charge. Three moments produce most of the reviews.
- The first renewal. The customer thought they bought one month.
- The multi-month charge. A 3-month supply is billed at once and reads as a surprise.
- The cancellation that did not stick. A chat agent said it was done, and the card was charged again.
In the sample audit on our telehealth page, billing is the largest row. That matches what we see when we read real profiles. It is also the group a removal service can do least about.
Why Trustpilot keeps these reviews
Trustpilot removes a review for one of five reasons. A disputed fact is not one of them. Its guidance lists what it will not remove, and that list includes reviews a business disagrees with.
The closest reason is defamation, which sits under "harmful or illegal". Trustpilot describes it as content that harms a reputation and leads to significant financial loss, and it does not act on opinions. "They kept charging me" from a real customer, about a real charge, is not that. Our guide on suing over a bad review explains the legal side.
A flag on a real billing complaint comes back as an invalid case. Invalid cases show on your public Company activity page for 12 months.
The billing reviews that can be flagged
| What the review contains | Trustpilot reason | First step |
|---|---|---|
| A support agent's full name with a direct phone number or email | Personal information | Edit request to the reviewer, 3 days |
| "Cancel and switch to this provider, use my code" | Advertising or promotional | None |
| A charge from a company with a similar name, for a product you do not sell | About a different business | Update request to the reviewer, 3 days |
| "They charged my father's card" written by someone who was not the customer | Not based on a genuine experience | Request information, 3 days |
| Threats against a named agent | Harmful or illegal | None. Hidden while assessed |
In each row the reason is something other than billing. That is the point. We flag the breach, not the complaint.
The refund shortcut, and why it is dangerous
A customer writes: "Refund me and I will delete my review." It sounds like a fair trade. It is the one thing in this guide that can bring a regulator.
In July 2025 the FTC announced its case against the telehealth company NextMed. It said the company suppressed negative reviews on Trustpilot in three ways. One was "conditioning refunds on consumers' agreement to remove negative reviews". The final order in December 2025 included a $150,000 payment.
Trustpilot's Guidelines for Businesses ban incentives for writing or editing reviews and list refunds among the examples. Its Action We Take policy treats offers tied to edits or removal as misuse.
The safe order is simple. Decide the refund on its merits. Pay it if it is owed. Say nothing about the review. Our guide on whether review removal is legal covers the other methods.
What the NextMed order expects of billing
The FTC's final order is about one company, and it still shows what the agency looks for. It requires:
- clear disclosure of refund and cancellation terms before the customer is charged
- informed consent before billing
- a simple way to cancel
- prompt handling of refund and cancellation requests that follow the stated policy
Read that list next to your 1-star reviews. The overlap is usually complete. Your reviewers and the regulator are asking for the same four things.
This is general information, not legal advice. Your counsel should review your billing flow.
Replying to a billing review
A reply that proves you were right usually discloses that the person is a patient. HHS settled a case in 2023 over exactly that kind of reply.
| Do not write | Write |
|---|---|
| "Our records show you agreed to the 3-month plan on April 2." | "Our plans renew on the schedule shown at checkout. We cannot discuss any account here. Please contact our support team so we can review this privately." |
| "You never cancelled." | "Cancellations should be simple. If one did not go through, contact our support team and we will look into it." |
| "We refunded you on May 5, so please update this review." | "We are sorry for the trouble. Our team is glad to help with anything else in private." |
The third row matters. Asking for an update right after a refund looks like the trade Trustpilot bans.
Reducing new billing reviews
- Put the renewal date and amount on the checkout page and in the confirmation email.
- Send a reminder before each renewal, with a one-click way to pause or cancel.
- Let customers cancel in their account, without a call or a chat.
- Confirm every cancellation in writing, at once.
- Give support the power to refund small amounts without escalation. A fast refund often prevents a review.
- Invite every customer to review, the same way, at the same point. Trustpilot requires fair and neutral invitations.
Where removal fits
Removal does not fix a billing problem. It clears the reviews that should not be on the profile at all, so the real complaints can be read, answered and reduced. The main Trustpilot review removal page explains the five reasons and the evidence for each. The free audit sorts your reviews into both lists.
For help with your own profile, start with our Trustpilot review removal service. Our review removal pricing is per confirmed removal, with nothing up front.
Frequently asked questions
No. The customer is describing their experience of your billing, and a dispute about the facts does not make the review fake. Reply in general terms, check the case in private, and refund if one is owed.
Refund them if they are owed a refund. Do not tie it to the review. Trustpilot bans incentives for editing or deleting reviews, and the FTC described refunds conditioned on removal in its NextMed complaint. Sources: Guidelines for Businesses and the FTC announcement.
Not for Trustpilot. A chargeback is between you, the customer and the card network. The review is still a genuine experience. Do not mention the chargeback in a public reply.
Only those that break a rule for another reason. Examples are a named agent with contact details, a rival's discount code and a charge from a company that is not yours. A writer who says it happened to someone else is another. The table in this guide lists them.
No. It reduces the new ones. TrustScore weighs recent reviews more, so the mix improves month by month once fewer new complaints arrive. Source: TrustScore explained.
Primary sources used on this page
- For which reasons can businesses flag service reviews?. Trustpilot Help CenterLast verified
- Transparent Flagging: see how a business is reporting its reviews. Trustpilot Help CenterLast verified
- FTC Takes Action Against Telemedicine Firm NextMed (July 14, 2025). Federal Trade CommissionLast verified
- Guidelines for Businesses. TrustpilotLast verified
- Action We Take. TrustpilotLast verified
- FTC Approves Final Order against Telehealth Provider NextMed (December 3, 2025). Federal Trade CommissionLast verified
- OCR agreement with a provider that disclosed patient information in response to negative online reviews. U.S. Department of Health and Human ServicesLast verified
- TrustScore and star rating explained. Trustpilot Help CenterLast verified
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