Practice Management Alert

READER QUESTIONS:

No-Show Charge Rules Vary By Carrier

Question: We are a pediatrics practice that is having problems with no-show appointments. Recently, the problem has gotten so bad that the physician asked staff to review the no-show policy and see whether we can tweak it. What are the rules for collecting on no-show appointments?


North Carolina Subscriber
Answer: While patients who don't show up for scheduled appointments are a thorn in the side for all specialties, the problem seems to rear its head more often in internal medicine and pediatrics.
 
A glut of no-shows can reduce office efficiency and result in lost revenue, so it is often tempting to charge patients for no-shows.

However, before billing a patient for a no-show appointment, you should check with your carrier to see if it is allowed. In general, Medicare frowns on charging for no-shows, but some private payers may allow you to recoup money from the patient under certain circumstances.

For example, a payer that allows billing for no-shows will likely require you to notify patients of that fact in advance of the appointment, preferably in writing. Further, most carriers will not allow you to charge a patient who has canceled her appointment more than 24 hours in advance.

Best bet: Dig up your carrier contract and look for a list of scenarios in which you can charge no-shows (if any).

Remember: Just because you can bill for a no-show does not mean that the carrier will pay the bill. Your contract may allow you to bill the patient directly for a no-show, but the carrier will likely consider it a -noncovered service.-

(For more information on billing patients for no-shows, see the next issue of Medical Office Billing & Collections Alert.)
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