No-show fees

[Psychferlyfe3000]

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Hi all,

I have my own practice and charge a $200 no-show fee. However, I keep backtracking on it (eg, canceling it altogether or making it $100) because I feel so guilty about charging that amount. I am wondering what other folks charge.

 

[theduderino]

I charge 50 for late cancellations or 150 for no-shows. I end up having a very lenient policy around charging it, esp if it's a patient that is otherwise reliable. I will also usually let the first time slide, regardless of whether they have a reasonable explanation. This makes me feel less guilty if I eventually charge them since they've had ample warning. If there are a lot of no-shows for a particular patient, I'll usually think about discharging them from the practice.

 

[Atreides]

I charge the full fee but am very lenient about waiving the first no-show. Almost inevitably, they'll no-show again and I don't waive that. so effectively, I'm getting a 50% no-show reimbursement.

 

[Sushirolls]

I gave everyone a first time freebie. Tell them it was first time freebie. ( But it is not in the policies).

Then a step increase fee structure. Next no show gets charged and is X, then next gets X + Y, then next is (X+Y) + Y, etc until it tops off at what my full cash rate is for a follow up.

Majority of people don't do no shows too often, and most get charged at lower dollar rate that people don't really push back on, but those who are habitual are going to get the escalation of fees. They usually drift away from the practice, but I have 1-2 right now that seem to be okay with reaching towards the full cash appointment rate.

Should my practice get more full in the future, I might decrease the number of steps, i.e. Y is a bigger number.

 

[calvnandhobbs68]

I do $90 for followups/$200 for intakes (which almost never gets paid because if someone no shows an intake they ain't showing up lol).

I almost always charge for a straight up no show. I will often charge for a late cancel but I give people at least 1 a year if it seems like a good reason (sick, transportation issue, can't get out of school, etc). If you're "sick" late canceling more than once a year, I start charging.

 

[Ironspy]

I charge the full fee per practice policy for all cancellations <48 business hours since a late cancellation is the same as a no show for me. I’ll occasionally halve it for first no show and often waive for true emergencies for otherwise reliable patients. 85% of the time I charge full fee.

 

[romanticscience]

I charge $150, waived 1x annually (no questions asked) or if the appointment is rescheduled within the business week. It's a bit less than my full rate but often I can use the break or can fill with admin/forensic activity.

 

[Dr. Pookie]

I also charge a $200 no-show fee for follow-ups, but I always waive the first one regardless of reason. This is for an established patient. I am pretty lenient, though, and won't charge it if they call later in the day apologetic and I can fit them in later in the week, etc.

If a patient no-shows their initial consultation then I still bill them but only $50 (all of them have card on file), because I don't want to charge someone I will never see again too much. I just consider it dodging a bullet when a new pt. no-shows.

 

[clausewitz2]

My policy is fairly straightforward, full freight if no-show or cancellation with less than 48 hours, I generally waive the first no-show and the first late cancellation each provided I can reschedule the patient in question in a reasonable about of time. I used to only do 24 hours or less for late cancellation but I got an awful lot of T-25h cancellations at one point. I will also occasionally waive late cancellations on days where I just so happen to have an open slot later in the same day they're able to make it to instead, although this is pretty rare. Very well-established patients who have an excellent track record for timeliness get a bit more leeway at my discretion. Also if I find out someone has been medically hospitalized for some reason.

I also struggled with feeling like I should be giving people a break more of the time and initially got pushed into no-show fees by our practice owner (a psychologist) but having a really simple, explicit policy has been helpful. I am sure I have lost a small handful of patients over the years over these fees but after trying to push back once or twice with special pleading an overwhelming majority of patients accept reasonable, clear, explicit boundaries like this and don't jump ship. Some of the folks who have raised the biggest stink about it actually end up being my most long-term patients so in that way I think the old analytic idea about fee negotiations being a vital part of the treatment frame wasn't just a convenient excuse to soak people for all they have.

 

[ObsequiousAplomb]

I charge $200 for any no-shows.

For the first one, I send them a reminder of the policy and assist them with rescheduling.

For the ones after that, I charge the full fee unless there's a good reason to waive it (hospitalized or similar level event) and remind them how to reschedule, but don't actively assist. I will give them the appointment later in the day, but still charge them the no-show fee because they did no-show. Usually they are appreciative, because they're used to other providers without that capability.

The only people who fight me on no show fees are the initial consultations. So I stopped charging them and consider it a bullet dodged and ban them from rescheduling. I do send them polite letters and lists of referrals. I might consider outsourcing the letters to doximity's chatgpt

 

[clozareal]

Full fee unless it's an emergency. I'm not giving out freebies without them asking for it, but will do once if they argue.

 

[Psychferlyfe3000]

Okay, I appreciate all the helpful responses. Thanks all.