If you’re among the practices that still don’t have a no show policy in place yet, you’re probably losing thousands every year. No-shows have an estimated $150 billion annual industry impact, and the average practice loses $200 per every unused time slot. This means if one patient misses an appointment every day, you lose $52,000 a year.
Because you’re bound to deal with no-shows no matter what, your best bet is to create an ironclad no show policy so patients have to pay you for the timeslot they missed. First, however, you must get your no show policy in writing — and that policy must include a few key provisions.
Be sure to include these three essential features in your no show policy to make sure patients understand it, staff can implement it, and you don’t run afoul of compliance rules.
1. Outline the No-Show Fee
Your policy should include easy-to-understand language that patients will be able to comprehend it. It should clearly state the charge and what it’s covering (your lost business opportunity).
You should check all insurer policies to ensure that they don’t outline limitations to your ability to charge patients for missed appointments, or if they have any maximum dollar amounts you can charge. Once you have that information, set your fee accordingly, and make it uniform across your entire patient base. Every patient’s no-show fee must be the same.
Example: Insurer A allows you to charge up to $40 for a missed visit, but Insurer B caps these charges at $35. In this case, you would charge every patient $35 or less. That way, your charge will be uniform across your patient base but won’t violate any payer rules.
2. Specify How Far in Advance Patients Must Cancel
You should always make it clear to patients that they have a certain grace period during which they can cancel their appointment and not be charged.
The American Medical Association suggests that patients have 24 hours prior to the appointment to cancel without having to pay the fee, but that any period under that will cost them. This is a guideline and not a set rule, so you’ll want to establish the timeline that will work best for your practice and put it in writing.
3. Indicate Whether You’ll Keep a Credit Card on File
Some practices choose to keep a credit card on file so they can automatically bill for no-shows. If you plan to do this, note it in your policy, and let patients know that they’ll be charged the fee automatically after missing a visit.
Don’t Include These Two Factors in Your No Show Policy
Now that you’ve got a handle on the three key features to include in your no show policy, it’s a good idea to take note of the topics you should leave out.
First, never tell patients that they’re being charged for the actual missed visit. Instead, indicate that they’re being billed for your missed business opportunity. Medicare specifically notes that if you charge the patient for the actual missed visit, it is then subject to assignment and limiting charge provisions.
Secondly, don’t mention that the policy applies to appointments that the patient misses in settings outside of your practice. No-show fees are not applicable to inpatient hospital visits.
Remember the No-Show Best Practices
Don’t forget that you can’t bill insurers for no-shows — you can only bill the patient directly. In addition, some insurers have specific rules about what you must include in your no show policy, which you must follow.
It’s essential that your policy encourages patients to reschedule missed appointments as soon as possible, since you don’t want to get into issues if patients who miss appointments get sicker and you don’t follow up. Always document no-shows in the patient’s record and indicate whether you followed up to reschedule.
Have every patient sign your no- show policy as part of their initial patient paperwork and keep the signed copy in their file.
As with any patient-facing contract, it’s also a good idea to run your draft no show policy past your healthcare attorney to make sure it’s compliant with all of the insurers and with your state licensing board.
No-shows not only cost your practice money they can also add a serious legal risk to your practice. Get practical, step-by-step instruction from attorney, Jeana Singleton, JD, on how to reduce your legal risk and revenue due to no-shows in her online 60-minute training: Patient No-Shows: Reduce Legal Risks and Lost Revenue.
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