Ensuring consistent attendance and a smooth flow of appointments is essential for therapists to manage their practice efficiently and serve as many clients as possible. No-shows or last-minute cancellations can hinder this process.



For therapists working with patients under the VA/TriWest healthcare system, there are unique considerations to be aware of in managing these challenges. Please read below if you work with this patient population, as they do not allow charges for no-shows.



VA/TriWest Considerations

  • No-Charge for No-Shows:

    • VA/TriWest guidelines strictly prohibit therapists from charging patients for missed appointments. This means therapists need to employ non-financial strategies to encourage regular attendance.

  • Encouraging Patient Attendance Without Charging:

    • Education: Emphasize the importance of consistent therapy for optimal outcomes. The therapeutic journey often requires commitment, and regular attendance can play a pivotal role.

    • Reminders: Implementing an automated system or personal calls to remind patients of their appointments can significantly reduce no-show rates.

    • Feedback: Engage in open dialogue with patients. Understanding the reasons behind missed appointments can help in addressing underlying issues.

    • Flexible Scheduling: Consider offering varied hours, including evenings or weekends, to accommodate patients' schedules.

    • Teletherapy: If feasible, offering teletherapy or virtual sessions can eliminate barriers related to transportation or physical mobility.


Cancellation Notice:

If it is necessary to cancel your scheduled appointment, we require that you call at least 48 hours in advance, and calling early in the day is appreciated. Appointments are in high demand, and your early cancellation will give another person the possibility of having access to timely medical care.


Late cancellations will be considered as a "no-show" except in case of emergency



No-Show Policy

A "no-show is someone who misses an appointment without canceling it in an adequate manner."No-shows" inconvenience those individuals who need access to medical care in a timely manner. A failure to present at the time of a scheduled appointment will be recorded in the patient's chart as a "no-show". The first time there is a "no-show", there will be no charge to the patient. Any additional "no-show" will result in a fee of $35.00 billed to the patient's account.


Cancellation Fees:

Cancellation within 24 Hours: A fee of $50 will be applied for appointments canceled with less than 24 hours' notice. This fee is designed to account for the time reserved for your session that could have been allocated to another client.


No-Show or Late Cancellation (after session start time):  The full session fee will be charged for appointments that are canceled after the scheduled session start time or in case of no-shows. This policy is in place to acknowledge the time and effort dedicated to preparing for the session.


Late Arrivals:

If you arrive late for your scheduled appointment, the session will still end at the scheduled time. Late arrivals can affect the quality of your session and may not allow for the full therapeutic benefit.


Emergencies:

We understand that emergencies can arise, leading to last-minute cancellations or no-shows. If you encounter such situations, please notify us as soon as possible so we can work together to find a suitable solution.  Please be aware that insurance companies typically do not cover missed session fees, so any applicable charges will be your responsibility.


Why a No-show Policy is Essential:

  • Predictability: Helps in planning and scheduling other clients.

  • Respect: Establishes mutual respect for both client and therapist time.

  • Financial Stability: Ensures consistent revenue and reduces loss of income.


Key Components of an Effective No-Show/Cancellation Policy:

  • Clear Definitions:

    • Define what constitutes a "no-show."

    • Specify how much notice is required for a cancellation to not incur a fee (e.g., 24 hours).

  • Consequences for Non-compliance:

    • Outline the fees or penalties for no-shows and late cancellations.

    • Explain any other potential consequences, like the rescheduling of future appointments or discharge from the service.

  • Exceptions:

    • Understand that emergencies and unforeseen circumstances happen. It's essential to clarify what might be considered an acceptable reason to waive the no-show/cancellation fee.

Communicating the Policy:

  • Initial Session: Discuss and hand out the policy during the initial session.

  • Signatures: Have clients sign an acknowledgement form that they understand the policy.

  • Reminder System: Use automated systems, SMS, or email reminders to notify clients of upcoming appointments.

  • Visible Posting: Display the policy in waiting rooms or on the office door.

Regularly Review and Adjust the Policy:

  • Feedback: Encourage feedback from clients to ensure the policy is fair and practical.

  • Updates: Regularly review and, if necessary, adjust the policy to ensure it aligns with the practice's needs and the community's standards.

Legal and Ethical Considerations:

  • State Laws and Guidelines: Ensure that the policy aligns with state laws and any governing body's guidelines (like a national therapy association).

  • Ethical Treatment: Ensure the policy treats clients with compassion, understanding that each individual's situation might be different.

  • Accessibility: Ensure the policy is accessible to everyone, considering individuals with disabilities or those who might not speak the primary language used in your practice.

Consider Offering Make-up Sessions:

  • Flexibility: For clients who occasionally miss appointments but are otherwise committed, consider offering make-up sessions or alternative solutions.

  • Limitations: Set clear boundaries about how many make-up sessions are available and under what conditions.



A clear and fair no-show/cancellation policy can improve the efficiency and effectiveness of a therapist's practice while also promoting respect and understanding between therapists and clients. Regularly reviewing and communicating the policy ensures that it remains relevant and beneficial to both parties.


Please find two examples of Cancellation/No-Show policies attached to this email. Remember, each therapy practice is unique, so tailor your policies to suit your specific situation and client base.


Disclaimer: This article provides general information and guidance. Consult with legal professionals if you need advice on creating legal agreements and contracts.