Pain Management Center

MISSED APPOINTMENT POLICY

Due to the high number of patients requiring interdisciplinary pain management, waiting times for appointments can be long.  Because of this, the Pain Management Center has a low tolerance for missed appointments that waste resources and prevent other patients from receiving care in a timely manner.

The Pain Management Center will charge a missed appointment fee for each appointment that is missed without adequate notice (“no showed”).  A no show is an appointment that is:
  • missed without notice
  • missed with less than one day’s notice
  • missed due to arriving 15 minutes or more beyond the scheduled appointment time

If you must miss a scheduled appointment, please notify our office by phone the day before the appointment or 3 days before a new appointment.  Messages are acceptable and can be left at all times including evenings and weekends.

For new appointments (evaluations), we request 3 days notice in order to have adequate time to reschedule the appointment time.  If you miss any new appointment (physician, physical therapy or behavioral medicine) without any notice, we will be unable to continue your care at this clinic.  This means you will be discharged from the clinic.

The fees for No Shows are as follows:

New appointment
$ 40.00
Return appointment (standard) 
$ 20.00
Return appointment (extended)
$ 40.00
Procedure (nerve blocks, etc.)
$100.00

You will be notified by mail of no show fees.  These fees must be paid prior to being seen at your next visit.  You are responsible for any no show fees you are charged; your insurance company will not be billed.

If you no show 3 times in a consecutive 12 month period, you may be discharged from the clinic. 

You may appeal your no show fee by completing an appeal form within 30 days of the missed appointment.  The fee(s) may be only waived by the Clinic Manager or Medical Director and are decided on a case by case basis.

It is required that you sign and date this form (downloadable) and return it to us prior to being scheduled for a new appointment.  This acknowledges that you have read and understand our policy.