Question No-Show fees & Medicaid

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6
Location
New Orleans, LA
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0
Hello,


Currently our practice has a policy that says if a patient does not show up for their appointment, we charge them a $25 no-show fee to reschedule/make future appointments. They are notified of this policy when they make their appointment and it is included on our payment policy that the patient's sign at their first visit. We are located in Louisiana and accept Louisiana Medicaid. Recently I've seen posts saying that providers are not allowed to charge no-show fees to Medicaid patients. Is this true?


I've looked it up in the Louisiana Medicaid Provider Manual and it's a bit unclear. It says the following: "Services not provided or not documented: Providers shall not bill Medicaid or the beneficiary for a missed appointment or any other services not actually provided". We are definitely not trying to bill Medicaid for missed appointments, so that I understand. We aren't billing the patient after the missed appointment; we are charging them a no show fee that is collected if they reschedule/ make a future appointment.


Can anyone clarify and give me answers?
 

thomas7331

True Blue
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3,454
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The language sounds pretty clear to me. If I'm understanding you correctly I think you're saying here that 'charging' the patient's account and 'billing' them are not the same thing. I don't believe Medicaid would buy this, and I don't think that is the intent of the wording, which I interpret to mean simply that you can't ask Medicaid beneficiaries to pay for missed appointment.
 

sls314

Guru
Local Chapter Officer
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181
Location
Toledo, OH
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I've looked it up in the Louisiana Medicaid Provider Manual and it's a bit unclear. It says the following: "Services not provided or not documented: Providers shall not bill Medicaid or the beneficiary for a missed appointment or any other services not actually provided". We are definitely not trying to bill Medicaid for missed appointments, so that I understand. We aren't billing the patient after the missed appointment; we are charging them a no show fee that is collected if they reschedule/ make a future appointment.

That language is very clear. You are not in compliance. You're charging patients a fee for a missed appointment.

A "no show" fee is literally a fee for a missed appointment.

It doesn't matter that you don't charge them until they reschedule a future appointment - you're not supposed to be collecting it at all, and you likely owe refunds to all the patients you've collected those fees from in the past.
 

SharonCollachi

True Blue
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1,980
Location
Clovis, CA
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It doesn't matter that you don't charge them until they reschedule a future appointment - you're not supposed to be collecting it at all, and you likely owe refunds to all the patients you've collected those fees from in the past.
PAY ATTENTION TO THIS PART RIGHT HERE.
 

thranowski

Networker
Messages
59
Location
Orlando, FL
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Here in FL, patients who miss more than 3 appointments, we're allowed to ask them to be assigned to another office.

FL also has incentives for patients to come in. Example: for a cervical screening, certain age PEs, the patient gets a $25 gift card, they just have to call and let insurance know they went. So maybe look into that and encourage your staff to alert the patients to these benefits. It has helped us with compliance.
 

lburns23

Networker
Messages
38
Location
Tucson, Arizona
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We cannot bill Medicaid patients for no-show fees, so we have set a limit on the number of times a patient is allowed to no-show/reschedule with less than 24 hour notice, before they're discharged from our clinic. We also give them warnings if they're getting close to that limit.
 
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