Do You Need a No Show Policy in Private Practice?

[@MindMoneyBalance]

Of course I have a no-show policy! You touched on this, but I also think it's good modeling to set an expectation and follow through with it. Once you start waiving fees, you can get into an uncomfortable dynamic where your client expects the fee will be waived OR they start fibbing about why they missed to try and have the fee waived. Yuck for both sides.

[@PrivatePracticeSkills]

Of course you do! :) I completely agree. I also think this is where knowing your clients well come into play. I tend to work with highly accommodating clients who rarely take advantage. Sometimes waving the fee is a healing experience in these moments. But if I catch someone working the system I definitely get much tighter about when I would waive!

[@UnlimitedMullets]

Always helpful. Thank you for covering this potentially cringey topic! I especially like the part where you show that you know your audience and remind us not to, in my opinion, dismantle the process by apologizing.

[@PrivatePracticeSkills]

Thanks! I encourage people not to apologize because I'm guilty of doing it early on. Even now I'm still feel tempted to do it - I'm only human! :)

[@brandiwilsonplpc7532]

Another option that I've I really come to like it charging the full session fee for a no-show and offering a "make-up" session within the same week if possible. This has allowed for some flexibility, while still making sure I hold the boundary.

[@josephyoo1610]

Have you ever had a patient refuse to pay when you send him/her an invoice? What do you suggest we do with such noncompliant patient?

[@everyonesrunnin]

Thanks Marie! Would you be willing to share your list of emergency circumstances that exempt a client from paying the no-show fee?

[@Enchanteralle]

I wish my company can implement this. It sets boundaries for clients which is essential in therapy. Thanks for sharing!

[@PrivatePracticeSkills]

It does make a huge difference not only for your income, but in our client's commitment to growth.

[@Enchanteralle]

@@PrivatePracticeSkills I completely agree with you! Also, do you ever have clients who are constantly showing up to appts late? What is your policy for that besides discussing the issue with the client if it does occur? I know sometimes life happens and sometimes my patients are ok with shorter appt or choose to reschedule. It's just that working in a non-private practice setting requires me to see them no matter what. I'm definitely sure I have more space to wiggle in my own policy if I do set up a private practice.

[@LondynBrielle]

I wish that insurance would allow us to charge a standard set rate across the board for late cancellations or no charges and just like car insurance when they get dinged with it, they would take the responsibility of increasing a clients co pay due to their "accident"history because no show fees are great and all but we only get paid if the ct pays us. if they quit therapy cuz they are mad about it, u can send it to collections, but thats more out of pocket cost for us and the ethics law make it dang near impossiblw to discharge based on outstanding unpaid balances until its gotten so bad u have literally worked for free and will likely never see that money again!

[@monasixtyfive4962]

I find your videos very helpful. Could you please share a template for your consent form for tele -therapy?

[@ThePossumone]

The only No Show I have are the ones I am doing for free strangely enough

[@milanapetruseviciute3566]

What do you do if they don’t pay the fee ?

[@mickirios9842]

Very helpful, thank you

[@thedigitalpractice8236]

Great job!

[@blink56k]

I understand we can't charge Medicaid/Medicare clients for understandable income-based reasons, but I don't think it's fair that some commercial/private insurances should dictate whether we charge a fee or not. They already underpay us-it feels like a slap in the face for them to devalue or time by forbidding n/s fees. But yes, good to double-check contracts. :-)

[@PrivatePracticeSkills]

It is bizarre that insurance has that authority! But what can ya do? Though that is one of many reasons that I've personally opted not to accept insurance. To each their own!

[@WarrenRichardson]

Hey Marie, I think my new psychotherapist takes everyone's credit card before the first session- does that mean for sure they have the same "no show" policy as you so even more incentive for me not to miss session?

[@GuadalupeGarcia-fy7hr]

Do you have any thoughts for new client no shows? I struggle this problem and it’s quite frustrating.

[@PrivatePracticeSkills]

Yikes! That is rough when that happens. I talk about this a bit in my video about the initial phone screening: kzbin.info/www/bejne/fpfTlKilg9mCbrM I've found that if I'm really thorough at the beginning, then people who would otherwise no-show for the first session don't even bother booking an appointment, and those who do book are already pretty invested.

[@maureenarmendariz3590]

Just to clarify, if a client DOES cancel before the 24 hours, you don't charge them?

[@eyecandie2004]

I have not been able to collect a no show fee and Medicaid doesn’t allow you to bill the client a no show

[@PrivatePracticeSkills]

This is a great point. It's very important for those going through third party payers to check with the policy if charging for a no-show is allowed. You're right that in most cases we're not able to still bill the insurance or charge the client in this case.

[@jessiemillen9171]

you can consider charging a deposit...