Ouch! Would they expect to get the money back for a class they don’t attend one week? The law is the law and i dont necessarily blame my therapist for this, it is the professional body who have told her these are acceptable guidelines (unless she has breached these and done her own thing). I’m sorry that you weren’t able to provide us with 48-hour-notice due to (their reason). Either way, wishing you and your family best wishes! Welcome to the table! . . Thanks for any feedback. Thanks for dropping in today to share your thoughts from the other side. I use a credit card processing system that allows me to save the credit card user’s profile and keep it on-file. Then, the day you try and enforce your cancellation policy will be the day you’ll learn how little consent you really obtained from your client. AND, the second part of this equation is that it is also contingent upon the contract you have with each managed care contract that you have a contract with. . One client in particular ended therapy after I only gave 21 hours notice because she stated that I ‘made a big deal about the cancellation policy’, which was actually only a few minute discussion during the intake about what it was before she signed on the dotted line. I am having some trouble with my cancellation policy as well. In reality, I do waive my fees for sudden illness and / or a lack of childcare. I’m never upset with clients when they miss an appointment. The only difference between 24 and 48 hours is personal preference. I used to put this in writing but found that clients often felt this was too formal so I now only declare it verbally. I’ve met many therapists who were so uncomfortable discussing money matters with their clients that the went broke or passed the difficult conversations on to office staff rather than dealing with their own issues. This was one of the fears everyone had with big consolidation.". I, too, would be frustrated with this situation and, frankly I’m not sure how your practice can be doing so well if this is an ongoing pattern in your practice. Do the following counselor statements resonate with you? As a new professional who started off working in addictions, I (and too many of my peers) were too quick to declare all too often that our clients were “resistant.” In hindsight, what I believe now is that “resistance” in clients is more accurately described as “therapists asking clients to move too quickly or take too big of a step forward.” And, clients struggling with their addictions are the perfect example of this . I’ve been considering a 48 hr policy but cannot find anyone in my area who does that. Many clients benefit from breaks in therapy . CPT codes generally correlate to the amount of time you are engaging in clinical work with a client. Not something that builds confidence for the customer. I don’t know if that fits for you or not . What do you have in your disclosure statement? If I have a need to end early . You know, I completely missed that Terry was asking about her EAP clients so thanks for bringing it to my attention. It sounds mean, but you have to do this if you want to make a living. She’s seriously sick!” “Dave has no excuse for missing his appointment, but he swears that I never told him my policy, and he’ll quit therapy and slam me online if I charge him.”. I want to make sure that you don’t feel this way, if someday you miss an appointment. And, if you are implementing this fee after you have gone through the initial informed consent process, you will need to provide an addendum and discuss the change in policy. If not, you should. win / win in which, I hope, the client is more likely to complete his / her work with me. . And, if I see a need to extend a session with a client for some clinical reason . Hiding behind the business office isn’t being honest. OK, so I understand why I then said, for example, if there was an agreement between two parties to manufacture 10,000 cds on a certain date, and the party who was making them’s factory was hit by lightening the day before, they would not owe damages for not delivering them on time. I agree Janine, it’s a two way street. . (3) You must act as a professional at all times including dress, speech, behavior. I think not! This blows my mind. I have started wondering if this practice has started to undermine my professionalism and encourage cancellations. I bet you don’t have too many cancelled appointments, right? I’m not Pat, but I posted her response on her behalf. I hope you’ll drop back in again soon – or sign up to receive email updates in your inbox! In the second scenario, I’m right there with you – it really is sad that a medical professional is unable to address these money issues head on. . A variation on that might be to relegate repeat offenders to seeing you in non-prime hours of operation. by Anthony Centore | Dec 16, 2012 | Counseling Blog, Private Practice | 14 comments. it’s up to the social worker and yes the letter from his place of employment Welcome back! I get sick. I used to work in an agency whose primary client base was Medicaid patients. I was really upset so she decided to disclose the reason for her “emergency”, which was an event she could have planned in advance so as to give me reasonable notice. I’m just now starting my private practice and struggling to come up with a cancellation and vacation policy that makes sense for me. If I did, that would then become a clinical issue to be discussed and a business boundary to be enforced. Any advice in this situation would be so much appreciated. . However, I can say that when therapists are perceived by their clients as lacking humanity, their relationship and the work they are able to do together are compromised. Your experience is not all that uncommon. I haven’t until now offered a free cancellation for sickness. I have even had people say to me “why do you need my copay when you get all that money from insurance.” Of course, I explain that their copay is anyway from 25% to 75% of the total pay that I will receive. Do you work independently or own this clinic? No-shows and last minute cancellations are the bane of all therapists. Filed Under: Money Matters, Time, Writing | Publishing Tagged With: Appointments, Disclosure Statement, Fee, Policy, Your email address will not be published. Welcome back to Private Practice from the Inside Out! I’m also in the United States and am not an attorney so can’t speak to the enforceability of your therapist’s policies or her personal or clinical motivations. Sure, emergencies come up for my clients – but they also come up for me; I don’t charge them for theirs and I don’t compensate them for my own. I did not realise, whilst i was given the terms in writing, that in no circumstances was cancellation possible. Thanks for your great web site Tamara – I’m going to take some time to look through carefully. I am the next of kin and had to be there at all times to give consent to medical treatment, let alone the emotional reasons for not being there! I’m really surprised by that number. practice. Many offices such as optometrist and dentist call their patients the day before to remind them of appt.Can we legally offer this option and then say in a cancellation policy “You may be contacted 24 hours in advance and can cancel at that time.. Then when a client cancels at the last minute (or doesn’t show for an appointment), I usually mention while talking to the client (or in leaving a message on voice mail) that s/he doesn’t need to worry about mailing in the payment. "Cancellations happened sooner and sales went up," he told BTN, "which is what we wanted." Concerning your cancellation policy . Laura, is it possible that there is another reason for so many cancellations? Doesn’t sound like this is the therapist for you. And, your cancellation policy sounds very well thought out. However, to “keep trying” beyond that seems to me to be excessive and possibly even unwelcome. You are exactly right about it not being your responsibility to educate your health care professional. Hi Tamara, I haven’t been here in some time and my private practice is doing well…even though I’ve cut my hours to be with my beautiful grandson. (You should note that insurance companies do not typically reimburse for missed appointments.) . However, if you are practicing in the United States, FaceTime does not permit you to practice in a HIPAA-compliant fashion.
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