by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Nov 20th, 2015
No-shows can and should be billed
By: Cyndee Weston (Jun/20/2013)
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.
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
Quick, Current, Complete - www.findacode.com