Medical Billing Forum

Payments => Patient Billing => Topic started by: linda carroll on September 14, 2009, 12:03:14 PM

Title: charging for no show appts
Post by: linda carroll on September 14, 2009, 12:03:14 PM
our doctors have decided to charge pt's for no show appts. I explained that might be especially difficult for new pt's who have never even been to our office. do you know if pt's can legally be held responsible to pay if they didn't receive a service? I'm in charge of creating a letter to send and collecting for this new venture!!
Title: Re: charging for no show appts
Post by: Steve Verno CMBS, CEMCS on September 14, 2009, 02:36:56 PM
State law may prohibit charging a patient without informing the patient before being charged, 

One of my doctors has a huge sign at the sign in desk that says they will be charged $X for a missed appointment.
Title: Re: charging for no show appts
Post by: linda carroll on September 14, 2009, 03:18:26 PM
do the patients pay?
Title: Re: charging for no show appts
Post by: PMRNC on September 14, 2009, 04:25:31 PM
The office policy should contain this rule, but the patient would need to read and sign and this way they are notified in advanced. 
Title: Re: charging for no show appts
Post by: lhough on September 14, 2009, 05:00:41 PM
If the new patient has not even come in to do paperwork then how can you expect someone to pay for a no show when they have not signed the agreement stating that if they miss an appointment they will pay XX # of dollars? Now if they come in to complete the paperwork prior to their first appointment then to me you should be able to charge for a no show because they have already signed the office policy stating that they will be responsible.  That is how we handled it at the practice I used to work for.  Sometimes patients will come in prior to the first appointment and do the paperwork, then you have it in writing that they are responsible.
Title: Re: charging for no show appts
Post by: Pay_My_Claims on September 14, 2009, 08:54:06 PM
We always notified the clients prior to scheduling there is a $xx.00 no show fee.
Title: Re: charging for no show appts
Post by: PMRNC on September 15, 2009, 06:10:07 AM
Verbally letting the patient know is really not enough, it should be in the office policy that the patient receives on their first visit so really a doctor will eat that charge for a new patient that does not show. What I advise my clients to do is send out the new patient information for new patients when their appt is within at least 7 days and the office policy is in there. One of my clients will actually put a sickie note on the office policy bringing their attention to the $35 Late fee.
Title: Re: charging for no show appts
Post by: Pay_My_Claims on September 15, 2009, 08:45:36 AM
For me JMO, it is enough. When you have clients that are calling and want an appointment NOW!! and for a new patient appointment you overbook 2 established patient slots to accommodate that patient (no time to mail the office policy) and you state ANY MISSED APPOINTMENT IS A $XX.00 fee, and they don't show up is infuriating. The key is just because you charge it does not mean they will pay!! Any office can have a policy for no-shows, but doesn't mean they will get the money. Clients will change PCP's just to circumvent the accumulated deductible they have incurred at one practice. Many go to ER's just to "meet" the deductible. I am very much into customer service, however there are just some things that are patient responsibility.

I agree with you in the fact that no appointment should be scheduled prior to having the client sign the appropriate forms, however 99% of the clients that I have dealt with, don't mail the new patient forms until they come in. Just because we mail it, doesn't mean they got it.

Title: Re: charging for no show appts
Post by: PMRNC on September 15, 2009, 11:29:22 AM
I should rephrase my original answer.. you can CHARGE the patient, but don't expect to collect it as they will have a legal precedent for not paying it and you won't be able to send it to a collection agency. If the patient wasn't notified in writing they have a clear cut legal basis to which they don't have to pay, so it makes better sense to have them see the office policy. 
Title: Re: charging for no show appts
Post by: Sportsmom on January 11, 2010, 06:48:11 AM
Our office charges for no-show appts. We charge what the insurancs would pay and the co-pay, but only for patients that have signed a consent stating they understand our policy.
You can not charge a patient for a no-show if they have not signed the office policy.
We send a Welcome letter to our new patients that states they have to call and confirm they will be keeping there new appt if they do not then we take them out of the schedule, it works very well.
We send our patients to collects for no show appt. We had one patient get made and take it to his lawyer and he told the patient because we had him sign the consent for treatment and it stated our no-show policy his lawyer told him he had to pay the bill.
Title: Re: charging for no show appts
Post by: Pay_My_Claims on January 11, 2010, 03:42:50 PM
Our office charges for no-show appts. We charge what the insurancs would pay and the co-pay, but only for patients that have signed a consent stating they understand our policy.
You can not charge a patient for a no-show if they have not signed the office policy.
We send a Welcome letter to our new patients that states they have to call and confirm they will be keeping there new appt if they do not then we take them out of the schedule, it works very well.
We send our patients to collects for no show appt. We had one patient get made and take it to his lawyer and he told the patient because we had him sign the consent for treatment and it stated our no-show policy his lawyer told him he had to pay the bill.


how are you going to charge them for a visit??  They didn't have a good lawyer, those are def UNETHICAL practices.
Title: Re: charging for no show appts
Post by: Sportsmom on January 11, 2010, 06:42:15 PM
We dont charge for new patient no show, since they have not signed the consent. But other wise they do charge. I don't like it but that is the office policy.
Title: Re: charging for no show appts
Post by: Pay_My_Claims on January 12, 2010, 11:43:21 AM
So you have a different charge for a no show fee? See that is my issue. Some offices have ridiculous fees to prevent no-shows, and they are specialist. Some Cardiologist charge 250.00, where most general practice charge a basic 25.00 no show fee. I'm just trying to figure out how much you can charge based on what insurance would pay, if you haven't seen the client. I can come in with pain in my foot, and find out I have gangrene so my level of care changes
Title: Re: charging for no show appts
Post by: oneround on January 12, 2010, 12:13:11 PM
I have to agree with Charlene on this one.  Our standard No-Show fee is 25.00 for GP and most of our specialists.   I believe charging what the payer would pay is ridiculous.  Not sure how a M.D. could keep a patient with that type of policy.  To me it also seems like an easy case of fraud.  Pt calls in for a headache ends up being a no-show so the M.D. can easily upcode to an higher level.  And where is the documentation?  You have not seen the pt. so there is no documentation.  No way I'd sign any COR like that.  Things happen and a GP charging a pt.  that large amount is ridiculous.
Title: Re: charging for no show appts
Post by: Sportsmom on January 12, 2010, 07:13:34 PM
I work for a LCSW and they feel if they have a no show that is a hour of there time. 
Title: Re: charging for no show appts
Post by: Pay_My_Claims on January 12, 2010, 09:51:55 PM
http://www.medscape.com/viewarticle/705520

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5613.pdf
Title: Re: charging for no show appts
Post by: PMRNC on January 20, 2010, 10:28:07 AM
I see both angles to this but I also see reality.  A no-show is billing for services NOT rendered.. insurance companies don't pay them and patients that are billed these have recourse for legally NOT paying it. These basically are there to "defer" the patient, but providers should be warned that if push comes to shove they won't be successful at getting these reported to credit bureau's.
Title: Re: charging for no show appts
Post by: Sportsmom on January 21, 2010, 08:07:11 PM
When I read the below stmt I  take it as you can bill for missed appts but we can't bill a BCBS client
$ 55.00 and a medicare client $70.11.
I hate that we bill for missed appts fee. I had to bill a client today $ 92.00 for her missed appt fee becuase she got suck at work and could not make her appt. But that is what the provider would have been paid if she made her appt.

CMS policy allows physicians, providers, and suppliers to charge Medicare beneficiaries for missed appointments, provided that they do not discriminate against Medicare beneficiaries but also charge non-Medicare patients for missed appointments and the charges for Medicare and non-Medicare patient are the same. The charge for a missed appointment is not a charge for a service itself (to which the assignment and limiting charge provisions

I have billed for 10 years, but now at the office I work at we have a biller that has taken a class and calls her self a bill. I think she is a data inputer not a biller. She will not bill secondary ins with out me getting very mad, has the office manager. 
Thanks for listen to me tonight.
 
Title: Re: charging for no show appts
Post by: Pay_My_Claims on January 21, 2010, 09:37:16 PM
When I read the below stmt I  take it as you can bill for missed appts but we can't bill a BCBS client
$ 55.00 and a medicare client $70.11.
I hate that we bill for missed appts fee. I had to bill a client today $ 92.00 for her missed appt fee becuase she got suck at work and could not make her appt. But that is what the provider would have been paid if she made her appt.

CMS policy allows physicians, providers, and suppliers to charge Medicare beneficiaries for missed appointments, provided that they do not discriminate against Medicare beneficiaries but also charge non-Medicare patients for missed appointments and the charges for Medicare and non-Medicare patient are the same. The charge for a missed appointment is not a charge for a service itself (to which the assignment and limiting charge provisions

I have billed for 10 years, but now at the office I work at we have a biller that has taken a class and calls her self a bill. I think she is a data inputer not a biller. She will not bill secondary ins with out me getting very mad, has the office manager. 
Thanks for listen to me tonight.
 

Like I said previously, and Linda confirmed (thanks) You can't bill for services you DIDN'T  receive. A no-show is a no-show. It is a set fee to prevent no-show appts.  If I could find out who this provider is, he would be in SERIOUS trouble!! There is no way I would get a bill for a service I didn't receive and pay for it. I would LOVE for him to take me to court over it. ............
Title: Re: charging for no show appts
Post by: Meli on January 22, 2010, 09:57:50 AM
I wonder how the patients feel about this provider or what the patient turn over rate is at this office.  This does not show patient goodwill to me.  Is there a discount given when the office overbooks appointments and the patients have to wait past their appointment time or when the doctor hasn't even arrived at the office yet to begin seeing the patients?  I doubt it.  I think some things should be water under the bridge.

Melissa
Title: Re: charging for no show appts
Post by: PMRNC on January 26, 2010, 12:49:20 PM
Bottom line is you can charge the patient a missed appointment fee. However the ones that don't pay you will end up writing them off, credit bureau's are choosing not to report these because of the wasted time since a patient can dispute this on their credit report VERY easily. I advise my clients who do charge it, not to stop doing it but we write it off if we have sent 3 statements.