Charging Medicare Patients for Missed Appointments
June 20th, 2013 - Cyndee Weston
Previously, each Part B office had their own requirements regarding charging Medicare patients for missed appointments. TRICARE (TriWest Healthcare
Alliance) regulations required providers to establish office practice policies regarding "no show" fees and required beneficiaries to sign an agreement taking financial responsibility for missed appointments. Other offices like WPS Medicare only required that provider also charge non-Medicare patients for no shows, too.
Fortunately, CMS now has an official written policy that applies to all carriers in all states, effective October 1, 2007. Under the MLN Matters Article MM5613, providers may bill patients for missed appointments; however, Medicare itself does not pay for missed appointments, so such charges should not be billed to Medicare.
Additionally, providers must not charge only Medicare beneficiaries for missed appointments; you must charge all of your patients, including non-Medicare patients. The amount must be the same for all patients.
You should make sure that your patients and staff is aware that they can be billed for a missed appointment and that Medicare should not be billed. Although it's no longer going to be required, you may still want to have your patients sign a form stating they are aware of the new office policy.
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