Providers Can Establish No-Show Fee Policy

Providers have asked for guidance regarding the billing of TRICARE beneficiaries who have missed an appointment without calling to cancel or reschedule within a specific time period (e.g., within 24 hours of the scheduled appointment).

In general, TRICARE regulations do not prohibit providers from establishing practice policies regarding no-show fees. Providers, who as part of their practice standards require beneficiaries to sign an agreement taking financial responsibility for missed appointments, are within their rights to charge beneficiaries for missing an appointment.  If no formal agreement is in place, the provider may not bill the beneficiary for the missed appointment.

For more information, contact your local network representative, refer to www.triwest.com/provider or call 1-888-TRIWEST (1-888-874-9378).

Published Date: 06/01/2009