CANCELLATIONS & CONFIRMING APPOINTMENTS POLICY

  • Cancellations and Confirming Appointments

    Our desire is to provide every patient with the treatment they need, along with the special attention they deserve. We do not overbook patient appointments. However, we will DOUBLE BOOK any unconfirmed appointment. As a courtesy to our patients, we call 2 days prior to your appointment to remind you of your appointment and answer any additional questions you might have about your appointment. If we are unable to reach you one business day before your appointment by 2PM on a Monday - Thursday or 11AM on a Friday, it is considered an unconfirmed appointment and will be taken off our schedule. Please insure you have provided us with the phone number(s) where we can best reach you or leave you a message during daytime hours. If you know you will be unable to keep your appointment, please call us as soon as possible. So that we can accommodate all our patients’ needs, we ask that you provide us 24 hours notification if you are unable to keep a scheduled appointment. For those patients who are unable to provide us 24 hours notification, we do have a broken appointment policy whereby you may be charged a fee of $50.00. We understand that circumstances do arise that are beyond your control. We do waive this fee on a case-by-case basis. If you break three appointments within a year, we will no longer be able to see you in our office. Due to federal regulations, we are not allowed to charge or collect a broken appointment fee from Medicaid patients. Medicaid broken appointments are reported to the Virginia Medicaid System. Once a Medicaid patient does not give us a 24 hour notification of cancellation and breaks 3 appointments in our practice within a 1 year period, they will be terminated/fired from this practice and can no longer be seen. We understand that circumstances do arise that are beyond your control. The decision to terminate/fire a patient will be determined on a case-by-case basis and the patient will be notified in writing. Patients who consistently break appointments after having confirmed their appointment may be asked to pay a Reservation Fee before an appointment is rescheduled. Reservation Fees will be applied to your appointment.

  • SIGNATURE

    I understand the policy for broken appointments whereby I have not provided a 24 hour notification for a cancellation.