Cancellation fees for no show surgeries

[OBcoder2017]

Our office wants to implement a no show or late cancellation policy for surgeries. Can someone give me input as to whether Medicare and Medicaid patients are exempt from being able to be charged this type of fee in Missouri?

 

[csperoni]

Medicare permits no show fees provided they are also charged to non-Medicare patients. You must have a written policy.
https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNMattersArticles/downloads/MM5613.pdf

I found this online regarding Missouri Medicaid patients:
https://law.justia.com/codes/missouri/2017/title-xii/chapter-208/section-208.148/
It seems the first no show (or cancellation < 24 hours) in a 3 year period cannot be charged, the 2nd is a $5 fee, and 3rd $10. My personal opinion is those fees certainly do not help offset your provider downtime or staff expenses.

In our practice in NY, where Medicaid & Medicaid HMO patients may not be charged at all, we found approximately 80% of our no-shows were exactly those patients. We decided not to charge patients at all unless they miss 3 appointments. So the policy is really to address the chronic flaky patients, as long as they are not Medicaid.

 

[SharonCollachi]

I'm in California, and we don't see Medicaid patients.

We charge $200 "missed procedure" fee, if the patient does not show, cancels less than 2 business days in advance without an acceptable reason (one acceptable reason is fever), doesn't follow instructions so we cannot do the procedure (doesn't stop their blood thinner, eats after they're supposed to stop, etc.).

We also charge $125 for an office visit no show.

We intend for the amounts to be punitive. We want them to be memorable. We have a 1.7% no-show rate for 2019, so we're doing something right.