Patient no-shows can be a drain on your facility. Not only does it waste the time of your physicians and other staff, but it also costs you revenue. In the United States, specialty clinics report a nearly 20-percent no-show rate and it could be even higher for primary care providers, costing tens of thousands of dollars each month!
Your facility may be considering charging a no-show fee, but what is the ideal way to do that? How do you keep revenue loss down while minimizing the impact to the overall patient experience? Read on to see how no-show fees work with Medicare and Medicaid, and some best practices to consider before implementing a no-show fee.
Medicare
According to the CMS Medicare Manual, Medicare rules do not prohibit charging a no-show fee. The manual says, “[…] if a physician’s or supplier’s missed appointment policy applies equally to all patients […], then the Medicare law and regulations do not preclude the physician or supplier from charging the Medicare patient directly.”
What that suggests is that there must be a policy in place that treats all patients the same. While it could be argued that a policy does not need to be in writing, the best practice is to have a written policy in place regarding how no-shows will be handled and outline any fees that may be incurred.
Medicaid
In some states there are laws that prohibit charging Medicaid patients for missed appointments. If your state does have laws against charging Medicaid patients a no-show fee, then it could affect charging Medicare patients as you wouldn’t be treating all patients the same. You should seek advice from your legal counsel to see what the Medicaid laws are in your state.
Contract With Your Patients
If federal or state laws like those that govern Medicaid and Medicare do not prohibit charging a no-show fee, then it would come down to the contracts you have with your patients. Basically, a contract does not have to be in writing for an agreement to be valid. It can be verbal or implied if all the elements of a contract are met. Including your no-show fee and the price in documents, like your patient registration form, will help minimize any confusion for your patients which can often lead to a better patient experience and quicker payments.
Best Practice
Overall, the best practice is to have a policy that conspicuously discloses the no-show fee and obtain written acknowledgement of the fee. This could be on your patient registration forms or having the patient acknowledge this written policy in its own document.
The American Medical Association Code of Ethics Opinion 11.3.2 states that physicians should “clearly notify patients in advance of fees charged” and base fees on reasonable costs for “missed appointments or appointments not cancelled in advance in keeping with the published policy of the practice.” As mentioned in the Medicare section, if a provider is going to charge a Medicare patient missed appointment fees, then they need to have a policy in place and, while a policy does not necessarily need to be in writing, it is much easier to prove that your office has a policy if such policy is in writing.
Conclusion
No-show fees can help minimize the revenue lost when a patient does not attend or notify your office that they won’t be able to make their appointment. If your office is considering charging a no-show fee or already has one in place, it is important to follow the best practices and take the advice of your legal department to ensure that you are following the laws in your state. Americollect can help you when speaking to patients to help them understand your policies when it comes to no-show fees.