Wiki Cancellation Policies

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phippsrachel

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Hi,

I work at a newly established Physicians office. We are trying to establish a cancellation policy. It was my understanding that as long as everyone was billed equally for no-shows/cancellations that we were able to bill ALL patient types for not calling to either cancel or reschedule appointments. However, we have been told by other sources that we may not be able to bill Medicaid patients for missed appointments.

Can anyone shed some light on this situation. We would really like to be able to establish a cancellation policy and to be able to enforce it straight across the board to all patients. Otherwise, we feel that it is discrimination and will not be establishing a cancellation policy.

Thank you in advance for your help
 
NC does not allow the practice to invoice the patient for a "no-show" fee. Below are some FAQ's. This is addressed with question 169.

169. How does DMA address or their plans in the future regarding: 1)co-payments owed to providers 2) high no-show rate, no-show fee for Medicaid and Health Choice recipients? This is the responsibility of the clinician to address these issues but please note that Medicaid recipients may not be charged "no show" fees.

http://www.ncdhhs.gov/dma/outpatient/QAFINAL.pdf
 
Is this link the same for TN Medicaid? I'm not familiar with TN.

“In my office, we bill patients who don't show up for their appointments. Is that a problem if the patient is on TennCare?”

Yes. TennCare providers are prohibited from billing enrollees or MCCs for missed appointments.

See TennCare Rules 1200-13-13-.08(6)(h) and 1200-13-14-.08(6)(h).

http://www.tn.gov/tenncare/forms/pro08001.pdf

http://www.tn.gov/tenncare/
 
Rebecca,

Thank you so much for all of your help and patience with me. I am new to billing and coding and have been searching for links etc with no luck. This answers my question perfectly.
 
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