Wiki No Show Charges

[domaha28]

We have a no show policy in our office that if a patient no show's their appointment, there is a fee that is charged to the patient. My concern is that I am told we cannot bill any patient for a no show that has Medicaid or a Medicaid plan. I understand Medicaid patients have no financial responsibility if they have active coverage. It just seems to me that Medicaid patients can come and go as they please and we cannot utilize our policy for those patients. I am in New York State. Does anyone have problems with this or do I have the wrong information? Any suggestions or knowledge would be greatly appreciated. Thanks!

 

[CodingKing]

Active Medicaid members (whether normal medicaid or a medicaid managed care plan) cannot be charged a no-show fee. If they end up with a gap in coverage you might be able to charge during the gap, but if they refuse to pay and become eligible again you cannot refuse service based on the outstanding balance.

 

[michellepilcher]

Active Medicaid members (whether normal medicaid or a medicaid managed care plan) cannot be charged a no-show fee.

You need to check with your state Medicaid. In Alaska, Medicaid recipients can be charged for No Show appointments. They are informed in the recipient handbook they are responsible for all no show fees and that Medicaid will not reimburse for them under any circumstance. Every state will be different.

 

[CodingKing]

Sorry I should add. When i handled a NY Medicaid MCO, it was prohibited to charge no-show to Medicaid member. it was our contract because it was mandated by the state. That was as of about a year ago. You are correct though there is a subset of states that have different rules.