Don’t Let Missed Appointments Reduce Your Bottom Line

Missed appointments, which include no-shows and last minute cancellations, can cost a practice in different ways. First, take the lost revenue from the missed appointment itself, add the cost of employees who spend time scheduling the appointment and making follow-up calls with the patient, and then add the empty time that could have been filled with other patients.

According to studies conducted by the Medical Group Management Association (MGMA), the average no-show rate for medical offices ranges from 5 to 8 percent, which can be higher depending on the size of the office and the number of new patients.

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With lost revenue adding up, more practices are beginning to charge for missed appointments, translating the issue into language patients can understand: a financial one.

A missed appointment charge can help a practice recoup some of its lost revenue. Many practices simply hang the threat of a charge out there to get the patients through the door.

The American Medical Association (AMA) Code of Ethics allows physicians to charge patients for missed appointments and/or for appointments cancelled less than 24 hours in advance, so long as patients are properly advised. Medicare’s policy allows physicians to charge for missed appointments so long as the charges apply equally to non-Medicare patients. The amount you charge is up to you, but it must be uniform across the board for all patients, both Medicare and non-Medicare. There is no set amount.

Be ready, however, for extra work that no-show fees may generate. They require additional accounts receivable attention, and it’s a good idea to get a signature from the patient on a financial responsibility form saying he or she understands missing an appointment may generate a fee.

No-show fee or not, it is always helpful to call the patient a couple of days before the visit as a reminder.

Charges often range from a flat fee of $10 to $25 or half the cost of the scheduled procedure. The primary goal is to cut down on missed appointments rather than generate revenue. It may be helpful to check what the usual and customary charges are for missed appointments in your area.

By Delly Parham, AS, CPC


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One Response to “Don’t Let Missed Appointments Reduce Your Bottom Line”

  1. Irene Wright says:

    The CMS has an existing policy that prohibits Medical Assistance providers from billing recipients for missed appointments. According to CMS, a missed appointment is not a distinct reimbursable Medicaid service, but a part of the provider’s overall cost of doing business. As such, it is included in the MA rate and providers may not impose separate charges on Medicaid recipients. State Medicaid programs, including Pennsylvania’s MA program, must comply with the CMS policy on this subjec; therefore MA enrolled providers who render services to MA recipients may not bill recipients for missed appointments. This is from a Medical Assistance Bulletin–are you saying according to AMA’s code of ethics, providers are allowed to bill for no shows?

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