What do you do when a patient misses an appointment? While an opening in the schedule might seem like a good time for staff to take a break or catch up on their to-do lists, missed appointments are a growing problem in physician practices. With today’s need to maximize every dollar, practices should take a closer look at the effect these missed appointments have on their bottom lines.
Explore this issueJanuary 2008
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Missed appointments should not be taken lightly; there is a price for no-shows and last minute cancellations. In addition to affecting efficiency, failure to manage this area of a practice can result in staggering associated costs. For example, if the average E/M charge for a patient with rheumatoid arthritis is $100 and there are five no-shows each week, the lost revenue could be $26,000 a year or more.
Effective October 1, 2007, healthcare professionals can bill Medicare beneficiaries directly for missed appointments. Medicare guidelines state that physicians must bill and charge the same amount to non-Medicare patients for missed appointments. The policy states that, “the charge for a missed appointment should reflect an amount indicative of a missed business opportunity and should not be a charge for the service itself (to which the assignment and limiting charge provisions apply).” Note that Medicare does not reimburse for missed appointment fees and charges, so providers should bill patients directly.
The CMS policy allows charges to Medicare beneficiaries for missed appointments if: