Practice Management Alert

Question: Our office has taken a financial hit since we’ve drastically reduced our hours due to the coronavirus pandemic. While reviewing ways to bring in more money, we decided to consider charging insurers for no-show visits. How do we do this?

Maryland Subscriber

Answer: You can institute a no-show fee to offset some losses you’ve incurred recently, but you should never bill these no-show chargers to payers. Instead, you’ll bill the patient for the missed visit.

You must first make sure patients are aware of the policy, however. This typically happens when patients first join your practice and sign the financial contract with your office, but if you didn’t have the no-show policy in there then, tell patients about it before you institute any charges.

Payers may only be charged for rendered medical services and/or supplies utilized on the patient. “No-show” appointments mean that no patient showed up and no medical services were performed — therefore, you cannot bill the payer.

Watch out: Some coders believe they can use CPT® code 99199 (Unlisted special service, procedure or report) to bill payers for no-shows, but this is not true. The code descriptor’s vagueness has allowed this myth to be perpetuated over the years; offices that have used it often set up an internal charge code with a description of the charge that generates on the patient’s bill.

No one likes to lose patients. However, patients who consistently miss appointments can result in practice financial liability. If the problem reaches a significant percentage of your patient base, it may be in the practice’s best interest to terminate the relationship. If the etiquette is clearly outlined in the policy, an office can decide to refuse a patient after a certain number of no-shows.

Potential plan: Some practices opt to send letters to the patient and set a limit for missed visits (such as three no-shows) before dismissing the patient from the practice. If the patient was never seen by the practice, don’t make any more appointments and notify the referring provider (if there is one).