"No Show" Charge Policy

Objective

To set forth CUIMC policy with respect to charging patients who do not show up for scheduled appointments or who cancel scheduled appointments without adequate notice (“missed appointments”).

Policy

CUIMC clinicians may charge patients a fee for missed appointments only in accordance with the following policies and procedures:

  • The department or clinician group must establish a written policy on charging for missed appointments that is provided to all patients, and must notify patients in advance of any such policy and its effective date. The written policy must include a statement of the minimum advance notice necessary when canceling an appointment to avoid a missed appointment charge.
  • Policies on charging for missed appointments must be prominently displayed in every private office where the policy will be implemented.
  • Policies on charging for missed appointments must be applied equally to all patients. The policy of the Centers for Medicare and Medicaid Services (“CMS”) is to allow physicians and suppliers to charge Medicare beneficiaries for missed appointments, provided that the physicians and suppliers do not discriminate against Medicare beneficiaries, but also charge non-Medicare patients for missed appointments.
  • A single, uniform charge should be established for all missed appointments. The amount that the clinician or clinician group charges for a missed appointment must apply equally to all patients. Exceptions to this policy based on patient financial need or otherwise, may be made only on a case-by-case basis in consultation with the Clinical Revenue Office.
  • The charge for a missed appointment is not a charge for a service itself, but rather is charge for a missed business opportunity. Accordingly, clinicians or clinician groups charging for missed appointments must inform patients of the amount of the charge and that the charge may not be submitted to their insurance, and that payment of the charge is the patient’s responsibility.

Procedures

  • Clinicians or clinician groups assessing missed appointment charges must not allow such charges to be swept into collection by the automatic Clinical Revenue Office (CRO) sweep process, because such charges are not for services provided to the patient.
  • Clinicians or clinician groups assessing missed appointment charges must utilize a prescribed financial service class (“FSC”) and write-off codes. Please consult the Clinical Revenue Office for appropriate codes.

 

 

 

Office for Billing Compliance
Policy#: 10039
Original Date of Issue: 1996
Revised: 3/22/2023
Reviewed: 3/1/2024