Unfair Gaps🇺🇸 United States

Personal Care Services Business Guide

3Documented Cases
Evidence-Backed

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All 3 Documented Cases

Idle Capacity from Recurring No-Shows and Late Cancellations

$100-$200 per missed appointment; tens of thousands per year

No-shows and late cancellations create unfilled appointment slots in personal care services like therapy and behavioral health, leading to lost billable time for providers. Industry no-show rates range from 5-20%, with estimates of 5-7% nationally causing tens of thousands in annual losses per practice as slots cannot be quickly refilled. Fees mitigate but do not eliminate the capacity waste, especially with short-notice gaps.

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Lost Revenue from Uncollected No-Show and Cancellation Fees Due to Regulatory Restrictions

$Tens of thousands per year per practice

Providers in personal care services, particularly mental health and behavioral health, cannot charge no-show or late cancellation fees to Medicaid and Medicare patients due to federal and state prohibitions on balance billing for non-rendered services. This results in completely unbilled lost appointment slots, while fees are only enforceable for private pay or certain insured clients with signed agreements. No-show rates of 5-7% lead to substantial annual revenue shortfalls as these slots remain empty without compensation.

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Risk of Provider Sanctions for Improper No-Show Fee Billing to Medicaid Patients

Provider status revocation leading to full revenue loss from Medicaid clients

Federal Medicaid rules prohibit charging patients for missed appointments, making no-show fees illegal for these clients despite signed forms; violations can lead to patient reports, audits, and removal from Medicaid programs. Practices attempting to bill risk fraudulent billing accusations, especially if trying to pass fees to insurers. This recurring compliance issue affects systemic fee processing workflows.

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