The number one thing I hate about running a business is everything money related. I think transparency is key - especially in healthcare. So I'd like to talk a little about the no show/cancellation policy we needed to put forth over the past several months.
If you miss your appointment - you agree by booking that you are responsible for the cost of the entire visit. This could happen accidentally, because you had an emergency, a loss in the family, you forgot, you were in traffic, etc etc.. Things happen. This also includes cancellations under 24 hours prior to the appointment.
Many places have these policies. Growing up, my dentist had this policy on their wall. Most doctor's offices. Hair salons. A lot of service places. For every time I forgot to go to my own therapist, I paid the full fee. And I never argued because she provides a service and I booked that timeslot. I was responible.
There have been points when I offered a partial refund to some people who had significant emergencies (when we state in the signed and acknowledged policy there are no exceptions), but they were still unhappy.
There are no exceptions to this policy from this day forward. I am sorry. I will break down why.
Would you go to your job every day if you didn't get paid?
Would you show up and be present for a couple hours and then be happy when your boss says "nah, you aren't getting paid. Nevermind"?
The service industry works like that.
Private practice works like that.
While many "big" agencies can afford to offer their practitioners salaries so they get paid no matter what, we cannot. We offer hourly rates by how many hours they are working. Worked hours only include patient visits or paperwork completed for our practice.
So if your provider is working 6 hours that day, and you miss your 1.5 hour appointment - you just cost them a significant amount of their workday that can no longer be paid for them.
We rely on you to attend your appointments so we can pay our bills. By booking an appointment, you are booking a period of time that cannot be made up. If cancelled before 24 hours, we can fill that spot and boom, problem solved.
We offer extended evaluation and follow up times -- most places offer 60 minute evaluations and 15 minute follow ups. This means we technically "lose money" by not seeing more patients per hour. We do this for QUALITY.
We offer $250 evaluations and $100 follow ups. This is more affordable than most places, and we do payment plans when needed. I have chosen to take insurance - which pays us significantly less than self pay rates and requires us to forfeit 8% of our income to a billing company. Many people chose not to accept insurance because of that.
I cannot continue to offer these prices or taking insurance if we do not bring in enough income to cover overhead.
While you think "it's just one visit I missed, no big deal - I shouldn't have to pay" -- it kind of is. Even if your provider agreed to take a cut to their check so we can refund you - I still have to pay for the support team that I'm sure you have called, emailed or texted before. The one that needs to call the pharmacy or insurance on your behalf.
They are answering the phones and the emails Monday through Friday for all of your concerns -- and every hour they work, I need to pay them. I still have a billing company I need to pay for so we can accept insurance. I still need to pay for the work phone the assistant uses. I still need to pay for the phone company our business number goes through. Our business address. Our electronic medical record system. Our emails. Our website. Our malpractice insurance. Our self-scheduling service. There is so much more.
When it was just me, I didn't care about no show fees. I took the loss, and it didn't matter. My accountant literally shook his head at me looking at the business revenue this past summer. But now it's not about just me anymore - there are more people who are relying on this business to run daily. I want to offer a raise to our support staff because they deserve it. I also want to have enough incentives to offer our practitioners so they stay working with us and do not move on to somewhere "better." I'm sure you've attended visits in places where therapists or providers are constantly quitting. I am working my ass off in every manner possible to make sure I can retain our staff.
I'd like to keep Paperwork Psychiatry running and moving forward to serve more people -- but I also want to continue to be transparent about the money component.
It needs to be understood that for this service to continue running, we rely on you to show up for your appointments or if you can't (and you can't cancel on time) -- then please take responsibility for the time booked. I know we can't always control life circumstances, but at the end of the day, we really do rely on every single appointment booked to attend in order to pay our bills by the end of the month.
I hate being a businessperson. I went to school to be a prescriber. I hate that I can't offer free healthcare. But here we are. So..
That's the why of all of this.