Karen

I am also in Washington State and L&I will not pay for a no show for a PCE. They pay for a no show for IME and there is even an interpreter no show fee for the IME but not for the PCE.

I have found that if the person is not represented that stating in the PCE letter that is sent you will bill them for the no show it has been pretty effective. If they are represented I have sent the attorney the no show fee and they have sent back a letter stating they are not responsible for thier clien't actions (yet everything goes through them...hmmm) I had one client set up for a PCE through the attorney's office and the client called her legal assistant 3 days before the PCE to cancel and the legal assistant said she would call and get it rescheduled...not so. When we called the client she stated she called the legal assistant and that the legal assistant was supposed to call us...never happened.

L&I needs to change their no show policy for PCEs. For now...you eat the cost.

Jon

Hello,

I'm not sure what others have to say, but the same question was asked in another forum (FCE Certification, "Fees for Cancellation?") and the person who responded is from Indiana. Here was his response:

We have a letter that is mailed to the evaluee days/week before the FCE. We point out that a significant amout of time has been reserved for this apt. and that instances like you asked about may result in a fee of $400 being charged to the insurance company. I have enforced this 2x in 8 years. I have found that when dealing with the more difficult cases, cancellations will happen even if you escort the person to your clinic's front door. I would suggest you consider what percentage of your apts. are canceled and then come up with an appropriate fee for your down time. $400 is a little less than half of what we charge for an FCE.

My policy is that if the person "no shows" twice, I charge the insurance company the $400. I think case managers will be leary of using you if you charge them $400 4x a month for no service. Again, I am speaking about dealing with the more difficult cases, in which case, the case manager is probably already having compliance issues with them anyway. There is a balance for staying in the black, but it think flexibility with case managers and cancellations/no shows will help you get more referrals.

I had an evaluee call and cancel his apt. 36 minutes prior to the start of his FCE today. He is a difficult case-attempting to secretly record his apt. with the MD, threatening the nurse for pain meds, etc. He canceled today because 'his daughter broke his fingers in the car door and he had just left the ER.' Ironically, he wanted to rescheduled the FCE ASAP. I want to see those fingers.....

Hope that helps and if anyone else has anything to add then feel free!

Jenn