Neurology & Pain Management Coding Alert

Most offices give patients 1 -free- no-show visit before charging

When a patient does not show up for a scheduled appointment, you lose time and money, but deciding how much to collect for a no-show and when to start charging can be confusing.

See what the experts have to say about developing a fair no-show payment policy.

Remind Patients of Charge Early and Often

You should note your office's no-show charge in the new patient paperwork, says Jennifer Darling, owner of BBC Medical Management Services LLC in Dallas.

-The no-show policy can be stated in the practice brochure, which is given to the patient. This is the best way to inform patients -- in writing,- says Catherine Brink, CMM, CPC, president of HealthCare Resource Inc. in Spring Lake, N.J.

For instance, Brink says, you might try this script in your new patient paperwork or brochure: -Our practice has a policy to charge a no-show fee of $XXX for the second time a patient has a no-show for his appointment.-

Cover your bases: After receiving the written notice, -patients can be reminded of the no-show fee again when you call to remind them of their appointment,- Brink says. That way, you-ve already told the patient in writing and over the phone about your no-show policy, so there should be no misunderstandings if you levy a charge.

Consider Charging After 1 Free No-Show

When a patient fails to show up for an appointment, don't charge for the no-show until someone from the office calls the patient, Darling says. -Try to find out why the patient did not come, and then ask to reschedule him. If the patient reschedules, I would not bill [for the no-show],- she says.

Exception: -If the patient does not reschedule or you cannot contact a patient to find the reason for the no-show, then the first offense needs to be billed,- Darling says.

Why? -If the patient begins to consistently schedule and no-show, then you have the right to discharge him as a patient after a handful of these offenses,- she says. Brink agrees, recommending that medical offices begin charging after allowing each patient one free no-show. 

-The second time [a no-show] happens, you should charge,- she says -- unless the patient has a really good reason for not calling. For example, if a patient does not show for an appointment because his son was in a car crash, you should not bill for the no-show.

No-Show Fee May Vary for Different Services

Every medical office must decide for itself how much to collect from patients for no-shows. Darling proposes a no-show fee on par with a typical copay amount, in the $20 to $40 range. -This [amount] is small enough for the patient to pay, and large enough to compensate the physician for the time the patient took in the schedule,- she says.

Alternative: You might also consider charging different no-show amounts for different types of services. -If the visit was for a big-money service, say, a $1,000 procedure, then you should charge more, maybe $250. Some practices charge the fee of the service that was scheduled,- Brink says.