Posted on 15. Jun, 2009 by in Toolkit
Missed appointments cost you money. And if you want your no-show policy to be effective, your patients must be crystal clear about the fees you’ll charge for missed appointments, as well as the potential for dismissal if they miss multiple appointments.
Don’t waste time trying to write no-show policy letters from scratch. Simply customize these two sample letters to ensure your medical practice doesn’t lose time and money on no-shows. The first is a sample warning form, and the second is a sample dismissal letter.
1) SAMPLE WARNING FORM
It has been noted in your chart that you have missed at least two scheduled appointments with our office. We ask you to show consideration by notifying our office at least 24 hours in advance if you are unable to keep an appointment. We would like to have the option to offer that appointment to another patient who needs to see the doctor.
This letter serves as notice that if you fail to give us a 24-hour notice of cancellation in the future, there will be a $25.00 cancellation fee billed to your account that is non-covered by your insurance. You will bear complete financial responsibility for this fee. Repeated missed appointments may result in dismissal from our practice …
We are concerned that you may not be receiving necessary medical care because of these missed appointments. Please call if you are still experiencing problems. We value you as a patient.
2) SAMPLE DISMISSAL FORM
As a result of at least three or more missed appointments without prior notification, our practice...
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