Practice Management Alert

Unpaid bills, difficult patients among possible termination factors. 

No medical office wants to end a relationship with a patient. It hurts the bottom line, and could adversely affect the practice’s reputation among patients.

In short: You don’t want to pull the trigger on a patient termination process until you’re absolutely sure you should end the relationship.

Check out this list of expert advice on warning signs that might lead you to terminate care for a patient. If you have patients who are exhibiting these behaviors, keep an eye on the situation: you might have to consider letting them go at some point.

Failure to Pay, No-Shows Often the Cause of Trouble

According to James P. Bartley, MS, Med, practice administrator for Women’s Healthcare of New England, an OB/GYN practice in Norwalk, Conn., unpaid bills are the primary reason for patient dismissal, followed by failure to follow the physician’s care guidelines.

When a patient is struggling to pay a bill, you shouldn’t just get rid of her. If you make repeated (futile) efforts to get the patient to pay, however, it might be time to think about another course of action.

“We will always work with patients to resolve unpaid bills, but there needs to be point in time when termination is the only recourse,” Bartley explains.

Another reason you might terminate patient care is “non-follow-up,” which is “when the patient constantly terminates their appointments or is a no-show,” explains Steven M. Verno, CMBSI, CHCSI, CMSCS, CEMCS, CPM-MCS, CHM, SSDD, a coding, billing, and practice management consultant in central Florida.

Make your own rules: Every medical practice is different, so you should consider your patient population and practice culture carefully before choosing a cutoff for nonpaying/noncompliant patients.

Abusive Patients Can Also Get the Boot

While it might be a rarer occurrence, Bartley says that his practice has dismissed some patients for rudeness to the staff. “We clearly follow the mantra of ‘the customer is always right’; however, there are occasions when management must take a stand to protect their employees,” he explains.

When the practice defends the staff from abusive patients, it can help create a sense of unity in the practice. At the very least, it will show staffers that the practice will stand up for them when patients are abusive.

Verno agrees, saying that verbal and physical abuse are very likely to get a patient terminated. When the patient “makes threats to the provider and office staff, or uses actions which disrupt the normal office operations,” Verno explains, it might be time for that patient to go.