Failed Appointment Policy

Clients are welcome to cancel or reschedule appointments with at least 24 hours’ notice. Changes made with more than 24 hours’ notice are considered routine and do not incur any fee.

When less than 24 hours’ notice is given, or a scheduled appointment cannot be completed as planned, the time reserved cannot typically be offered to another client. For this reason, a Failed Appointment Fee of $225 will be charged unless the appointment is otherwise remedied (see below). This fee is billed to the client, as insurers will not pay this fee.

A scheduled appointment may be considered a “failed” appointment in any of the following situations:

• Not attending a scheduled session (no-show)

• Canceling with less than 24 hours’ notice

• Rescheduling with less than 24 hours’ notice

• Arriving 7 minutes or more late, resulting in inability to complete the full 53-minute session

• Being unable to participate in or complete a 53-minute session due to circumstances including, but not limited to:

  • Attending session under the impairing influence of alcohol, recreational drugs, or misused prescription medication

  • Schedule conflicts or work obligations

  • Being required to work overtime

  • Personal or family crises or other life events

  • Parenting responsibilities

  • Illness

This policy applies regardless of the reason given for the missed or incomplete session because the appointment time has been reserved specifically for you and cannot usually be reassigned with short notice. Consistent application of this policy ensures fairness to all clients and supports the sustainability of this practice.

THE LOOPHOLE: We understand that many circumstances leading to missed appointments are outside of a client’s control, so we have a pathway for clients to remedy the failed appointment and avoid paying the $225 fee.

How to trigger a fee waiver

If each requirement below is completed, the $225 Failed Appointment Fee may be waived:

• Advise the office as soon as you realize that you cannot keep the appointment as scheduled.

• Schedule and attend a makeup appointment within 7 days of the missed appointment.

  • The makeup appointment must be kept as scheduled and not canceled or rescheduled.

  • In rare and significant logistical circumstances that make scheduling within 7 days impossible (e.g., clinician unavailability, pre-planned travel, hospitalization), the makeup session must occur at the earliest available appointment time, as determined by the clinician.

• Attend regularly scheduled session(s) as planned during the week of the makeup appointment.

  • These session(s) must be completed as scheduled and not canceled or rescheduled.

  • In practice, this typically means:

    • For clients seen 1x/week: 0 sessions during the missed week and 2 sessions during the makeup week (one makeup session plus the regularly scheduled session)

    • For clients seen 2x/week: 1 session during the missed week and 3 sessions during the makeup week (one makeup session plus two regularly scheduled sessions)

If any portion of the remedy process is not completed, the $225 failed appointment fee will remain in effect.

Early Departure from Session Fee

Psychotherapy at this clinic is scheduled in 53-minute sessions and reimbursed according to the Washington State Labor & Industries (L&I) fee schedule.

If a client chooses to leave a session before 53 minutes have been completed, services must be billed based on the actual billable time in accordance with L&I guidelines. In these situations, the client will be responsible for paying the difference between the amount the insurer actually pays for the shortened session and the amount the insurer would have paid had the client completed the full 53-minute session. This difference in the fee payment is the responsibility of the client and will be charged to the client as an out-of-pocket fee.

patterns of problematic attendance

Consistent and reliable attendance is an important component of effective treatment and a stable recovery process. A persistent pattern of any combination of no-shows, late cancellations, failed appointments, or frequent rescheduling - particularly these occurring in close proximity - may result in modification of scheduling arrangements.

Depending on the severity, frequency, and overall impact of the attendance concerns, responses may range from shifting to appointments offered on a same-day, space-available basis to transferring care to an alternate provider if it is determined that the structure required for effective treatment cannot be maintained.