Patient Dismissal, Late Cancel and No Show Policies

Patient Dismissal Policy

Purpose: To define the situations under which a provider or department may and may not elect to dismiss a patient from receiving care within the department.

Definitions:

  • Columbus Regional Health: Consists of Columbus Regional Hospital and Columbus Regional Health Physicians.
  • No-Show: An appointment missed without notifying the department in advance or patients who arrive more than 10 minutes late for check-in and cannot be seen that day will be considered a no-show.
  • Established Patient: An established patient is one who has received professional services from a physician/qualified health care professional or another physician/other qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.
  • Chronic No-Show Established Patient: A patient will be considered a chronic no-show if the patient has logged three or more no-shows in a rolling 12-month period beginning with the first no-show event. The no-shows do not need to be consecutive.
  • New Patient: A new patient is one who has not received any professional services from a
    physician/qualified health care professional or another physician/qualified health care professional of
    the exact same specialty and subspecialty who belongs to the same group practice, within the past
    three years.
  • Chronic No-Show New Patient: A patient will be considered a chronic no-show new patient if the
    patient has logged two or more no-shows with that practice notwithstanding timeframe.
  • Violent patient: A patient will be considered violent if they exhibit any hostile action of a hurtful
    nature, or any action that displays an intention to physically harm any employed or contracted
    person or other patient of the practice.
  • Harassment: Harassment is any verbal or physical conduct that shows hostility toward an individual
    based on their race, color, religion, gender, sexual orientation, gender identity, marital status, age,
    physical or mental disability, or any other class protected by federal, state, or local law.

Policy:

  • It is the policy of Columbus Regional Health that its providers are not required to continue treating a patient who is uncooperative or violent or who harasses any CRH staff.
  • Patients may be considered for dismissal from the department for exhibiting any of the following behaviors:
    • Chronically missing appointments (see the CRH Appointment No-Show and Late Cancel Policy
      for further detail);
    • Refusing to cooperate with the physician, advanced practice provider, or any employee of the
      practice;
      • As patients possess autonomy and self-determination, which includes the right to accept or refuse medical treatment, a patient has the right to decide whether or not to proceed with a specific course of treatment. However, if the patient has repeated noncompliance or the provider is of the opinion the patient-provider relationship has been irrevocably damaged due to the patient’s refusal to cooperate, the provider does have the right to end the patient-provider relationship.
    • Threatening or filing of lawsuits against individuals, the department, CRHP, or CRH;
    • Displaying a threatening or hostile attitude that makes any staff member or other patient feel
      unsafe;
    • Demonstrating violent or abusive behavior;
    • Violating the Controlled Substance Agreement;
    • Loss of provider/patient therapeutic relationship, including but not limited to, treatment,
      nonadherance, follow-up noncompliance, and social/print media slander.
  • Patients may not be considered for dismissal for either of the following listed reasons:
    • Financial reasons, such as the inability to pay for services rendered;
    • Race, ethnicity, sexual orientation, gender identity, sex, citizenship status, pregnancy, disability, military status, religion;
    • Patient’s age may require a transfer of care to an appropriate provider.
  • In addition to dismissal from the practice, violent or abusive patients, or patients engaging in
    harassment of any kind will be managed in accordance with all Columbus Regional Health Physician risk management policies, up to and including charges being filed with applicable law enforcement
    agencies.
  • A patient’s return to services within the department will be at provider/department discretion.
  • A patient will have 30 days from letter print date to transfer to a new provider. During that time, they
    are to receive acute care and medication refills.
  • Per CRH Rules and Regulations Article V, Section 1, Part 3 (5) providers are still responsible for
    providing care to a patient who has previously been dismissed from their practice as needed as part of the unassigned patient ED back-up call rotation.
    • The only exception to this is circumstances in which the dismissal occurred due to violent,
      abusive, harassing, and/or threatening behavior toward providers or staff.

Late Cancel & No Show Policy

Purpose: To define the policy for late cancellations and no shows of patient appointments across all Columbus Regional Health.

Definitions:

  • Columbus Regional Health: Consists of Columbus Regional Hospital and Columbus Regional Health Physicians.
  • Late Cancel: An appointment cancelled within 24 hours of the appointment start time.
  • No-Show: An appointment missed without notifying the department in advance or patients who arrive more than 10 minutes late for check-in and cannot be seen that day will be considered a no-show.
  • Established Patient: An established patient is one who has received professional services from a physician/qualified health care professional or another physician/other qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.
  • Chronic No-Show Established Patient: A patient will be considered a chronic no-show if the patient has logged three or more no-shows in a rolling 12-month period beginning with the first no-show event. The no-shows do not need to be consecutive. 
  • New Patient: A new patient is one who has not received any professional services from a physician/qualified health care professional or another physician/qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.
  • Chronic No-Show New Patient: A patient will be considered a chronic no-show new patient if the patient has logged two or more no-shows with that practice notwithstanding timeframe.

Policy:

  • No Show
    • Any appointment that qualifies as a no-show by the above definition will be marked either manually or by the system as no-show in the Final Appointment Status of the scheduling system.
    • No-shows for established patients will be tracked at the department level over a rolling 12 month period, beginning with the first no-show event.
    • No-Shows for new patients will be tracked at the department level.
    • Chronic no-show patients may be subject to dismissal by the individual department affected.
      • Please refer to the CRH Dismissal Policy for appropriateness and procedures.
    • It is at the discretion of the department to accept or not accept patients that have been dismissed by other departments as new patients.
      • Please refer to the CRH Dismissal Policy for appropriateness and procedures.
  • Late Cancel
    • Any appointment cancelled within 24 hours of the appointment start time will be considered a Late Cancellation and marked as "Cancelled" in the Final Appointment Status of the scheduling system.
    • Office staff will manually mark an appointment as Cancelled and add a Cancellation Reason based on definition in linked Standard Work Instruction.
    • Patients cancelling their appointments via MyChart will follow the definitions for Late Cancel and No Show outlined in this policy.