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malonea21

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We have a workers comp. patient in our office that has had 3 scheduled appointments within the last month and every time the appointment date comes, she never shows up. She doesn't call or give us warning she is not coming in.

The doctor that treats her asked me to bill her because of this. I feel uncomfortable doing so because it does not seem like something legal.

Does anyone know what the guidelines are for this type of occurrence? Can we bill her anything or is this something that we have to deal with in the medical field?
 
I know your scenario is W/C but CMS does have guidance on this. Word of caution: You should be consistent with your "no-show" policy.

Providers may not charge ONLY Medicare beneficiaries for missed appointments; they must also charge non-Medicare patients. The amount the physician/supplier charges Medicare beneficiaries for missed appointments must be the same as the amount that they charge non-Medicare patients.

http://www.cms.gov/MLNMattersArticles/downloads/MM5613.pdf
 
no show

In the office where I work, we instituted a no show policy this year. Too many people would schedule appts and not show up, thus, this is time that could have been offered to a sick pt or someone else. We send a letter the first time with complete details, (this lets them know our office policy--it is also posted in 3 areas in our office in case they have not seen it), the second time they miss, they are charged a $40.00 no show fee, etc....I know it sound high, but it truly is not. If you charge for one, make sure you charge for all. It seems to be working...we have less no shows now then we did before. You can go online and type in "no show" or "cancellation fees in a doctors office" to get a template and then customize it to your specific office. Customize it, save it to your computer so you can fill in the pts info in the appropriate spots, make a copy (scan into their chart) and then mail it to them. If the pt calls to complain, state it is your office policy that is applied to all pts. Believe me, you are not the only office to charge for no shows/cancels. Hope this helps you a bit! :) Good luck!
 
Typically, only state Medicaid patients cannot be charged noshow fees. Medicare, workers comp and all other financial classes should be held responsible for costing you business.


Bill Hale, CPC
 
If you get audited bythe W/C company, they won't pay for those no-shows; they might even terminate her treatments as she obviously doesn't need them - otherwise she would come in.

Lin
CPC
 
Okay, but what about on the date of injury? Not all injuries happen between 9am - 5pm. The employee is injured, comes in for urgent treatment at 6:00 pm. This is a legitimate after hours charge. Most W/C carriers pay this. Perhaps they appreciate that we are open at an hour when most other physicians are not, and all they have to pay extra is this little 99051 charge, rather than paying hospital emergency dept charges.


Bill Hale, CPC
 
losborn said:
If you get audited bythe W/C company, they won't pay for those no-shows; they might even terminate her treatments as she obviously doesn't need them - otherwise she would come in.

Lin
CPC
Click to expand...

You wouldn't bill the WC carrier for the no-shows...you would invoice the patient directly.
 
OOPS, I confused this thread with another re 99051 after hours charges I had replied on. And it's not even Monday! :eek:

Absolutely, I don't believe any carrier will pay a noshow fee. This strictly a patient responsibility.


Bill
 
I agree with the respondent above who described their office's policy on no-shows and I think it is a good one. You may also want to post something in your office notifying your patients of the "new policy" as well as including notification with place for signature in your "new patient" packet of paperwork that patients complete on their first visit and annually.
 
Scheduling Script

And don't forget to make it part of the scheduler's "script" so when a patient calls to make the appointment the patient is notified of the no-show penalty.

F Tessa Bartels, CPC, CEM
 
If the patient is a no show but a family members comes instead and talks with the physician what code do you use:)
 
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