Charging no-shows a fee

June 26, 2008

I just read the article on no-shows by Dr. Eric Shore (June 6, 2008 issue). I share his concern regarding physicians’ liability when patients neither arrive for their appointment nor cancel. There is an added expense for physicians to follow up on these unreliable patients. What are the legalities of charging no-shows a fee, and what is Medicare’s stance on this?

Q. I just read the article on no-shows by Dr. Eric Shore (June 6, 2008 issue). I share his concern regarding physicians’ liability when patients neither arrive for their appointment nor cancel. There is an added expense for physicians to follow up on these unreliable patients. What are the legalities of chargingno-shows a fee, and what is Medicare’s stance on this?

A. Generally speaking, there is no prohibition against charging no-shows a fee. As you mentioned, there are costs involved (chart pulling, scheduling, follow-ups, as well as the “opportunity cost” of not being able to schedule another patient in that time slot). There are two important caveats regarding these charges, however. First, you will need to check your third-party-payer contracts because there may be a prohibition for such charges. If so, you may want to renegotiate the contract to include no-show fees when it is up for renewal. Secondly, you must let patients know, in advance, that there is a charge for no-shows, and what that charge is. You must also inform patients that these charges are not for a “covered service” under their insurer or Medicare/Medicaid and, as such, will not be billed to them. This should be printed on all of your bills to the patients, and posted in a prominent location in your office.

With these caveats in mind, there should be no legal reason why you cannot charge a reasonable fee for no-shows.

Eric E. Shore

Eric Shore, an attorney concentrating in healthcare law, is a founding member and partner in the law firm of Kane & Shore, LLC in Philadelphia. Before entering the full-time practice of law, he practiced internal medicine for more than 25 years and earned an MBA in healthcare management. He has been medical director at several long term care facilities, a hospital chief of service, and a medical staff officer, as well as being a fellow of the American College of Legal Medicine, the American Academy of Family Physicians, and the American College of Medical Quality. He can be reached at eshore@KaneShore.com,or 610-664-4182.

The answers to these queries are general opinions and are not intended as substitutes for legal advice. You should not rely on these replies in making decisions involving questions of law, but should instead consult with competent legal counsel.