Q&A: Non-adherence to medication recommendations

January 22, 2010

Get your questions answered on discharge letters.

Q: We have a patient who is non-adherent with recommendations for her medication and check-ups. We sent her a discharge letter via certified mail, but it was returned to us as unclaimed. What should we do? Are we still responsible for this patient's care? How else can we have her discharged from our practice?

A: When sending a termination letter, send it by both certified and regular mail to the patient's last known address. If the certified letter is returned to you, then you generally can assume that the letter sent via regular mail was received.

Often, a person will not claim a certified-mail letter because he or she thinks it is a bill, a lawsuit, or some other document he or she doesn't want to receive. Also, often, the post office will require the recipient to go to the post office to pick up a letter sent via certified mail, especially if nobody is home during the day. By contrast, a letter mailed by regular mail will be delivered with our without the cooperation of the recipient.

During the 30-day notice period, the physician's obligations are to continue to see the patient for emergent or urgent care and to ensure that the patient has sufficient medication to cover this period. An obligation to continue to see a patient beyond the 30-day notice period could exist if no alternative care is available to the patient within a reasonable geographic area.

Send your practice management questions to mepractice@advanstar.com. Answers to our readers' questions were provided by Judy Murray of Clayton L. Scroggins Associates, Cincinnati, and Steven I. Kern, JD, of Kern Augustine Conroy and Schoppmann, Bridgewater, New Jersey.