Latest Doctor's Office Side Gig--Pay Them if You're Late or Reschedule!

[youbet]

You bet,yes it's certainly possible they haven't checked in, but I'm not certain not checking in is that unusual.

I'm sure it varies. At my doc, if you went in and quietly joined the crowd in the waiting room without checking in with the receptionist (no phone or "my chart" involved) you are just never called.

I agree on not accommodating tardies unless it can be done without moving anyone else's time out.

 

[Koolau]

It's rare for any of our appointments to run more than 15 minutes "late." We missed one appointment years ago - just accidentally overlooked it on the calendar. The policy of a fee for late/missed appointment was waived when we called. The receptionist shared that the extra fees were for the chronically late/blow-off types. It wasn't a money-maker but a way to encourage people to be on time and to call in if the need to cancel should arise. YMMV

 

[SecretlyFI]

I haven’t encountered this yet, but I would not sign it and I would explain why, saying I always have to wait more than 15 minutes between the waiting room and the exam room and don’t get paid anything.

But what I did encounter twice recently at the hospital for minor outpatient tests is them telling me I have to “make a good faith payment” at check-in, before the procedure. Translation: they want your credit card number. I refused both times, saying I always wait for the EOB and the bill. After a little back and forth, they accepted my refusal, telling me “ok but next time you’ll have to pay it”. Turned out not to be true since it played out the same way the second time.

Driving home I thought of how I’ll handle it next time. I’ll offer them $20 cash. I would not be shocked if they tell me they can’t accept cash. I believe that would be BS because the truth is that the real objective is to get their hands on your credit card or checking acct info, in case they have to collect from you later.

 

[youbet]

the truth is that the real objective is to get their hands on your credit card or checking acct info, in case they have to collect from you later.

Yep. Deadbeats and other non-payers of all sorts are a significant problem for providers of medical services and one driver of our high medical costs. I noticed at our doc, there is a sign stating that "payment is required at the time of service." Inquiring about it, I was told that wasn't meant for established patients with existing accounts.

It's interesting how folks expect to pay their plumber at the time of service but expect their doc to wait a few months.......... And I'm guilty of that..........

 

[Koolau]

Yep. Deadbeats and other non-payers of all sorts are a significant problem for providers of medical services and one driver of our high medical costs. I noticed at our doc, there is a sign stating that "payment is required at the time of service." Inquiring about it, I was told that wasn't meant for established patients with existing accounts.

It's interesting how folks expect to pay their plumber at the time of service but expect their doc to wait a few months.......... And I'm guilty of that..........

I hear what you're saying. But with the way insurance w*rks, no one wants to pay up front and maybe have to ask for a refund from the doc. Or they fear the doc's office will decide "We've got ours - let the patient fight with the insurance."

It ends up that we'll occasionally get a bill that's finally "settled" after 6 months from date of service. No way did the doc's office know what my share was when the service was rendered. Had I paid up front, the doc's office wouldn't have been nearly as interested in participating in the process of w*rking out who actually owns - me or the insurance company.

SO, I wait for the bills to show up. I always pay them. I realize that not everyone does.

 

[ransil]

I walked out once after I sat in the exam room with no pants for 30-45 minutes, I put my pants back on.
Did not return to that doc for 2 years.

 

[becca]

I'm an early riser so I try to get the first appointment of the day which usually negates a waiting time. My practice (so far) has not instituted a late or no show fee, however for my last appointment I started getting email and text reminders weeks in advance and the last week almost every day.

 

[Koolau]

I'm an early riser so I try to get the first appointment of the day which usually negates a waiting time. My practice (so far) has not instituted a late or no show fee, however for my last appointment I started getting email and text reminders weeks in advance and the last week almost every day.

I had a doc who, it didn't matter if you got the first appt. of the day. You'd still wait 45 minutes or more. He either had hospital rounds or was just late. I was happy when he became a "hospitalist" and I got a dedicated "family practice" doctor.

 

[FIYes]

I have seen the notice about a charge for late or no show for years, but I don’t recall having to sign anything about it. I have experienced long waits. Last week I had a doctor’s appointment and I had to wait 30 minutes past my scheduled appointment time before I was called. I had arrived early and I noticed several people who arrived after I did who were called back before I was. This is the first time I have experienced this with this doctor. They recently moved to a new, fancy building. I found myself wondering if perhaps they were over scheduling to help pay for the new offices.

Forty years ago I had a dermatologist who was chronically late. At my last appointment with him, I called him out for it. I found another dermatologist. I understand things happen and a schedule can have delays. However, when it is every time, that just shows a lack of respect for my time.

 

[Lorenzo]

Forty years ago I had a dermatologist who was chronically late. At my last appointment with him, I called him out for it. I found another dermatologist. I understand things happen and a schedule can have delays. However, when it is every time, that just shows a lack of respect for my time.

You see, this is where we the patients should be able to charge doctors fees for THEM being late, too. They should have some skin in the game.

 

[Dalton]

I've seen it, it's incentive. All my doctors have gotten super-efficient with their scheduling. I bet I haven't had to wait at all (in the waiting room, after my appointment time), for any of my appointments this year. I've maybe waited 10 minutes after being put in the exam room (and could hear the doctor in the hall discussin patient stuff. I've had at least 17 healthcare appts (12 phys therapy, 6 specialist) this year, fwiw.

They can't get their appointment load fixed in order, and eliminate/reduce all those long waits that everybody above is complaining about, if they have multiple late patients or are holding an appointment for someone who isn't going to show, (and they can fill that appt with a short notice or "emergency" patient if they know a day ahead of time...I always tell them, when I call to schedule an appt, that I can come in whenever, and on short notice, if they get an opening). Any disruptions in their already tight schedule have a ripple effect that can often be felt days down the road.

 

[brett]

Our physician and dentist have had this but only for appt. no shows.

I asked about it. It is aimed at those who are frequent no shows. Hard to believe, but some people are.

 

[harllee]

I have seen this notice but have never been asked to pay it. My problem goes the other way--extremely long waits. I have a rare eye problem ( had been to 4 eye doctors with no help). There is a doctor at Duke that all the other doctors told me I needed to see about the issue, he was an expert on my issue. Took 4 months to get an appointment. A couple of weeks before the appointment I got a notice to be prepared for long waits and for the appointment to take 2-3 hours. It was true, there was a long wait and the appointment took 3 hours. BUT he diagnosed the issue in 5 minutes, told me that all the medications I had been taking were making me worse and to stop them immediately and put me on a different medication. Now just a couple of weeks later my eye are much better. So definitely worth the long wait for me.

 

[pacergal]

It is virtually impossible for medical providers to run on time, at least based on what I saw during my career. Over time, we went from 20/40 minute appts depending on severity of clients need for being seen, to everyone gets 15 minutes no matter what. By the time the patient and medical assistant get back into the room and vitals/brief history taken, the dr is down to maybe 10 minutes, IF they are running right on time. You are looking at 30 patients or more in a day, often with complicated medical concerns. Very rarely did someone come in with one simple problem.
And no extra "catch up" time in the schedule, so if you had a very ill patient and needed stat labs or needed to call an ambulance, everyone else on the schedule simply waits.
Impossible, IMO.
It's not the docs who run the practice, it's the insurance companies.
Off my soapbox now.

 

[ShadowBloom]

Some thoughts:

• my pcp and other doctors' practices since long ago had a sign that you were required to sign a financial agreement and leave a credit card number, but they never asked me for one
• my dentist states you agree to a charge of $75 for a missed appt or late cancellation and they donate the fee to a charity you chose from several they offer. I don't believe I've got a card on file with them, so I don't know how they'd collect if you never go back.
• my eye doctor is chronically late, which they've addressed by adding techs. So you get the preliminaries done on time but then sit a long time waiting for the doc to review results and meet with you.
• when I've had procedures at hospitals they've all asked for some upfront payment, then all backed down when I say I always pay after getting the EOB (one did insist I at least pay the amount remaining on my deductible. That amount changed between the time I scheduled the procedure and the day it was performed, and when I pointed it out they adjusted the payment that day).
• I also had one doc who used to calculate my share and collect it right after the visit; I'm not sure what they did that other doctors can't, but they were never off by more than a few cents.
• my pcp isn't as on time as he used to be, but he's not bad. I'm usually at the office early, and once when I got there at 9:50 for a 10:00 exam they took me in right away. When I was leaving at around 10 I heard his assistant tell him "the 9:45 is here"
• my father's heart surgeon was always hugely late for visits, which was claimed due to his doing procedures in the morning that became complicated and ran late

 

[ivinsfan]

I do remember back in the day when I had regular OB appointments for both pregnancies things often ran late..sometimes very late. I never said a word because well that's the nature of OB work

 

[RunningBum]

Some of my doctors have the policy of being charged if you don't show. They help reduce those with mulitple text reminders. I have had cancel PT and dental appts once each because I wasn't feeling well at all the morning of the appt. No push back or charges.

Waiting sucks. But in the past year I've seen my GP, 3 specialists, dentist, endodontist (for root canal), PT, and chiropractor, plus at least 4 procedures or scans (nerve blocks, MRI, x-ray), and none of them have kept me waiting long at all. Maybe 15 minutes tops. I have some choices which towns to go ts and I avoid the facilities and doctors that tend to be more crowded, unless I think the care will be much better there. Perhaps they also do less crowded scheduling since they have fewer no-shows due to the reminders and the possible penalties.

Some here have talked about their time being as valuable, maybe even more so if they make more money. This was probably true in my working days too, however, if I waited longer at a doctor's office it didn't affect my earnings since I was on a salary. I might have to work later to make up for the time missed. Doctors (generally) get paid by patients they see. If someone no-shows that day, they usually can't just make it up by bringing someone else in that day. I'm sure not everyone here was on a salary like me, but I'll bet many of you were/are.

 

[Drifter]

Some of the replies are not quite accurate. My wife has been a nurse for over 30 years. If you aren't present when your name is called, they simply skip to the next person. Besides what used to be a quality visit and time with your doctor has now turned into rooming patients every 6 minutes. It has turned into billing insurance and the money, not folks getting the proper care they deserve. There are doctors and nurses leaving and either retiring or finding different things to do with their time. I won't get into the 3 different billing charges depending on if you have insurance,don't have insurance or Medicaid. Ahh, pay cash? Get a reduced 10 percent bill. The whole system is corrupt.

My sister in law was diagnosed with stage 4 cancer liver and pancreas. She was about to start chemo and 2 days ago went to a well known med center. The docs said we are 100 percent certain you don't have pancreatic cancer. It was pancreacitis. They said, who told you that you had cancer? And here she would be getting chemo for something she didn't have in the first place. I had a similar experience. Told I had early stages of COPD, put on inhalers, etc. Went to a specialist and I don't have that or asthma and not taking any meds. Makes me wonder how many people are taking meds for stuff they don't really need.

 

[MichaelB]

./.
It's interesting how folks expect to pay their plumber at the time of service but expect their doc to wait a few months.......... And I'm guilty of that..........

Of course, it helps that the plumber has only one price and it’s quoted upfront. The physician has multiple prices, differing fee agreements with each insurance company, and a bottomless pit of billing codes to choose from.

 

[Lorenzo]

I wonder by who and how adjudication of individual cases will be handled? Example: doc played an extra couple of holes over at the country club this morning and is now late for appointments vs. doc had the patient before you have a heart attack right in the office and was delayed getting to you. And all the cases in-between these extremes........

In the last couple of years, I've found doc appointments to be kept fairly close to schedule and the front offices well run. The worse offender is my GP since patient issues to be dealt with vary all over the board and he sees a lot of geezers like me who frequently add new issues to the reason for the follow-up appointment. My specialists do better since the reason for the appointment is usually confined to a specific issue. As an example, my electrophysiologist has PA's that update my records, do vitals including an EKG, renew prescriptions and summarize any issues. Doc then shows up fairly timely, gets the one minute update from the PA just outside the door, and steps in and deals with you and the updated tests and information for 15 minutes.

Well, I was just making a joke. But yeah.

 

[Qs Laptop]

As the OP, I do enjoy reading about doctors offices scheduling practices, however, the topic was whether or not you've encountered this requirement that you sign a document stating you will pay the doctor's office if you are late or cancel within 24 hours of your appointment.

 

[athena53]

Some here have talked about their time being as valuable, maybe even more so if they make more money. This was probably true in my working days too, however, if I waited longer at a doctor's office it didn't affect my earnings since I was on a salary. I might have to work later to make up for the time missed. Doctors (generally) get paid by patients they see. If someone no-shows that day, they usually can't just make it up by bringing someone else in that day. I'm sure not everyone here was on a salary like me, but I'll bet many of you were/are.

This actually makes it harder on patients who are hourly workers, IMO. I was always salaried so waiting was annoying but didn't cost me Real Money. People who are paid by the hour are hit in their wallets if the doc is running late.

I haven't yet encountered a doctor who has this policy but I could see it happening. I'd read once that docs are reluctant to take Medicaid patents not only because of the low reimbursement but because they're perennial no-shows. (In fairness- that may be due to needing public transportation or not having any reliable transportation at all.)

Shear Madness, the kid-friendly place where I take my grandchildren for haircuts, now has a policy that if you're a no-show once you need to pay in advance when you make an appointment. I think it's nice that they give you one "fail". Stuff happens.

 

[RunningBum]

This actually makes it harder on patients who are hourly workers, IMO. I was always salaried so waiting was annoying but didn't cost me Real Money. People who are paid by the hour are hit in their wallets if the doc is running late.

...

I guess it depends on whether you can make up the hours later. If not, I agree. But some hourly jobs have flexibility to work a little later to get your hours in.

 

[friar1610]

If any of them tried that I'd tell them to pound sand and find another doctor. Either that or tell them they can pay me $50 for every 15 minutes or increment thereof I have to wait, which of course wouldn't happen. The arrogance is something I wouldn't put up with.

In effect, they are saying, “My time is extremely valuable but yours isn’t.”

 

[CaptTom]

One practice I was at recently (at a big-city hospital) I noticed that patients were given 15 minutes. If they were later than that, the staff would have to check whether or not the doctor would be available. Sometimes they weren't.

I'm pretty much OK with that. You snooze you lose. That's better than making others wait (and be late.)