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Dynamic Chiropractic – May 6, 2008, Vol. 26, Issue 10

Billing for Missed Appointments

By Samuel A. Collins

Q: Recently, I experienced a rash of missed appointments and am hoping there is a way to bill for these appointments, even though the patient did not show up and thus received no treatment.

Is there a code?

A: Unfortunately, there is no CPT code for a "missed appointment." It's not a billable or reimbursable service (or nonservice, as it were) from any insurance carrier. However, an office is not precluded from billing a patient for a missed appointment. In fact, charges for missed appointments are very common among all health care professionals. Dentists, in particular, typically have strict policies on missed appointments and will charge patients when they miss (or at least when they do not notify or reschedule within 24 hours of the appointment). Policies such as this are more common than uncommon. The fear of the charge generally will influence a patient to not miss an appointment or, at the very least, to contact the office before a set time in order to reschedule an appointment. The latter is, in reality, what most offices would prefer, as they have the ability to schedule another patient for that time.

If you wish to start implementing a missed-appointment fee, there are a few things that should be done to avoid confusion and misunderstanding. Patients must be informed at the time they schedule the appointment that there is a specific policy about missed appointments. It would be best for this policy to be posted in a conspicuous place, available to read at the time or, at minimum, given verbally. This should be part of office protocol and followed in the same manner with each patient. This way, the office can ensure the patient was clearly informed and cannot later state they were not aware of the policy. The burden of proof that the patient was made aware is on the creditor (doctor). This would include costs and what constitutes a missed appointment, such as less than 24 hours notice.

Remember, it's not so much that the doctor wants the fee but simply for the patient to respect the professional status of the services and the office. (Note: The fees for missed appointment are typically a minimum of $20-$25, rather than the full price of the services that would have been provided.)

Many offices are elastic in implementing the policy and may even forgive payment for those patients who have a valid excuse or other issues that were precedent. A patient who has had the fee forgiven may likely be more respectful after a favor has been afforded and feel a greater sense of obligation to the office in the future.

Although it could go the other way, it's best to remember why the policy is there: not to collect a fee but to ensure compliance. If a patient does not comply, at least we know to not schedule them and exacerbate the situation further.

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