How should Medi-Cal Dental dentists handle a patient’s missed appointment, and what steps can they take when a patient misses multiple rescheduled appointments? These scenarios may arise for providers, who are encouraged to review all considerations and steps to avoid inappropriately billing or dismissing a patient. As a publicly funded program, Medi-Cal has additional rules as well as resources that may not be available under commercial dental plans.
Providers cannot bill Medi-Cal recipients for missed appointments. If a Medi-Cal patient misses an appointment, the dental office can work with the patient to reschedule and has two additional options:
- Record the patient’s name and missed appointment information in the Department of Health Care Services’ Missed Appointment Notification form, or
- Report missed Medi-Cal appointments by phone to Medi-Cal Dental Telephone Service Center at 800.423-0507.
In either case, Medi-Cal will assist the provider with rescheduling the patient’s appointment.
In some circumstances, for various reasons, patients may miss multiple rescheduled appointments, and a provider may find it necessary to dismiss a Medi-Cal patient. While there is no penalty for dismissing a Medi-Cal patient, the provider should make every attempt to reschedule the patient, including by filling out the missed appointment form or calling Medi-Cal.
Dismissing a patient: Take steps to avoid or reduce risk
If a dentist chooses to sever the patient-provider relationship, they must first consider potential risks and act in accordance with ethical standards of treatment. In addition to state laws and any Dental Practice Act requirements, the ADA’s Code of Ethics can help guide a dentist’s decision-making. Patients cannot be dismissed or discriminated against based on limited English proficiency or status within a protected category under federal or state law, including race, national origin, sex, disability and age.
When dismissing a patient, the dentist should:
- Provide a formal written notice stating intent to withdraw care and requiring the patient to find another provider.
- Mail the confidential written notice to the patient via first-class, certified mail with a return receipt requested.
The Dentists Insurance Company’s Risk Management analysts can provide guidance on the dismissal process along with sample letters and other resources to protect dentists before finalizing the patient separation. If you have questions or concerns about a possible dismissal, seek guidance before taking action. All CDA members can use TDIC’s Risk Management Advice Line at no cost as a benefit of membership.
CDA members also have access to a legal reference guide that includes helpful considerations for terminating doctor-patient relationships.
Find the latest news on Medi-Cal Dental Program changes in the CDA newsroom and in the weekly member newsletter, Inside California Dentistry.