Is this legal ?

Simon2015

I received a letter from a consultant doctor which my GP referred me to saying that if I miss the appointment or don't cancel it within 48 hours they can bill me the consultation fee of 220 Euro for not turning up.

Just wondering if this is legal can they really send me a bill for missing an appointment ?

I have never even met this Doctor or set foot in her clinic.

Legally I don't see how they could come after me for the money if I did miss the appointment.

Fred Swanson

This post has been deleted.

Simon2015

Fred Swanson wrote: »

How were you made aware of this no show condition?

It was in the letter I got for the appointment.

billy few mates

I would imagine by accepting an appointment with her you will be entering into a contract with her, one of the terms and conditions of that contract will likely be a 'no show' fee. Obviously her time is very valuable and if you decide not to show up you've wasted an appointment slot that could have been used by someone else. I could easily see her coming after you for any loss of income she would incur if you fail to show up...

billy few mates

If you don't fancy this condition you can always cancel the appointment so long as you do it more than 48hrs beforehand...

Fred Swanson

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pixbyjohn

Simon2015 wrote: »

It was in the letter I got for the appointment.

Fred Swanson wrote: »

This post has been deleted.

But he was made aware in the letter he received :rolleyes:

jsd1004

billy few mates wrote: »

I would imagine by accepting an appointment with her you will be entering into a contract with her, one of the terms and conditions of that contract will likely be a 'no show' fee. Obviously her time is very valuable and if you decide not to show up you've wasted an appointment slot that could have been used by someone else. I could easily see her coming after you for any loss of income she would incur if you fail to show up...

Similar to not showing up for a meal booking. Yeah they could chase you..solicitors would love if everyone did.

Fred Swanson

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IRAC War

I believe this would fall foul of the unfair terms in consumer contracts regulations which you can find with a quick google, so to answer your question (sort of), no not enforceable.

IRAC War

Fred Swanson wrote: »

But can she prove he received it? That is a hurdle for the plaintiff to get over.

The postal rule would likely apply.

Fred Swanson

This post has been deleted.

Pat Mustard

IRAC War wrote: »

I believe this would fall foul of the unfair terms in consumer contracts regulations which you can find with a quick google, so to answer your question (sort of), no not enforceable.

Please do not give legal advice, This is not allowed by forum charter.

_Brian

This is a common enough clause, number of consultants I've been with charge that no show fee.

Simon2015

_Brian wrote: »

This is a common enough clause, number of consultants I've been with charge that no show fee.

It may be common but I don't see how it can be legally enforced.

IRAC War

Fred Swanson wrote: »

Which can be easily rebutted.

Not rebutted, disclaimed. There is a very important distinction. It is almost impossible to rebutt the postal rule when it's properly applied. I'm not asserting it is or is not in this situation.

IRAC War

Pat Mustard wrote: »

Please do not give legal advice, This is not allowed by forum charter.

My apologies, I'm still trying to get a handle on this when legal advice isn't legal advice thing.

While I don't wish to sound flippant I'm getting that unsubstantiated opinion is okay but relatively useless, whereas anything cited would potentially be an issue? Is the specific issue in offering my opinion? Had I said:

"You may find something useful in the unfair terms in consumer contracts regs" would that have been okay or is the mere inclusion of any statute or case law legal advice?

Thanks for the steer, I'm aware of the potential difficulty a site such as this would have, or indeed I myself may incur, buy offering (generally bad) legal advice.

4ensic15

I would not think it is an unfair contract term. The booking can be cancelled up to 48 hours in advance with no fee. If it is cancelled less than 48 hours ahead or there is no show it is highly likely that the consultant cannot use that time slot for another patient and will not earn any fee at all. It would be more unfair if a patient could cause a professional to allocate time for them and then simply fail to show without warning. ANother patient could have availed of the time slot had there been adequate notice. The other alternative would be for consultants to overbook on the basis that there will always be no-shows. this means nobody can rely on being seen at the time of their appointment, causing all kinds of problems with travel arrangements and so on.
As for enforcement, presumably the o/p will have to engage with the consultant eventually. In that case the missing fee will be added to the bill. The o/ps GP will be notified of the no-show and told there is an outstanding bill. IN that case the GP can't refer the o/p to any other consultant.

IRAC War

4ensic15 wrote: »

I would not think it is an unfair contract term. The booking can be cancelled up to 48 hours in advance with no fee. If it is cancelled less than 48 hours ahead or there is no show it is highly likely that the consultant cannot use that time slot for another patient and will not earn any fee at all. It would be more unfair if a patient could cause a professional to allocate time for them and then simply fail to show without warning. ANother patient could have availed of the time slot had there been adequate notice. The other alternative would be for consultants to overbook on the basis that there will always be no-shows. this means nobody can rely on being seen at the time of their appointment, causing all kinds of problems with travel arrangements and so on.
As for enforcement, presumably the o/p will have to engage with the consultant eventually. In that case the missing fee will be added to the bill. The o/ps GP will be notified of the no-show and told there is an outstanding bill. IN that case the GP can't refer the o/p to any other consultant.

I'm not sure if I'm allowed to point to specifics in the legislation but having lurked here for some time I know you to be a resourceful fellow - 5 will get you 10 there is no reciprocal offer of compensation, this could be problematic given a specific regulation, hypothetically speaking.

IRAC War

4ensic15 wrote: »

I would not think it is an unfair contract term. The booking can be cancelled up to 48 hours in advance with no fee. If it is cancelled less than 48 hours ahead or there is no show it is highly likely that the consultant cannot use that time slot for another patient and will not earn any fee at all. It would be more unfair if a patient could cause a professional to allocate time for them and then simply fail to show without warning. ANother patient could have availed of the time slot had there been adequate notice. The other alternative would be for consultants to overbook on the basis that there will always be no-shows. this means nobody can rely on being seen at the time of their appointment, causing all kinds of problems with travel arrangements and so on.
As for enforcement, presumably the o/p will have to engage with the consultant eventually. In that case the missing fee will be added to the bill. The o/ps GP will be notified of the no-show and told there is an outstanding bill. IN that case the GP can't refer the o/p to any other consultant.

I'm not sure if I'm allowed to point to specifics in the legislation but having lurked here for some time I know you to be a resourceful fellow - 5 will get you 10 there is no reciprocal offer of compensation, this could be problematic given a specific regulation, hypothetically speaking.

By enforceable I mean to say that there is nothing illegal about putting such a term in a contract and therefore it does not make the control illegal per se, such as if this was a contract for a prostitute or some such, however the offending provision in the contract would be unenforceable - again hypothetically speaking.

Apologies, some of my terminology is imprecise - something I am hoping to remedy here!

CIARAN_BOYLE

Simon2015 wrote: »

It may be common but I don't see how it can be legally enforced.

Not sure it can be enforced and if it could be it would be prohibitively expensive. However if you want to see that consultant again you will be asked to pay it before getting an appointment.

gizmo555

4ensic15 wrote: »

The o/ps GP will be notified of the no-show and told there is an outstanding bill. IN that case the GP can't refer the o/p to any other consultant.

Are you serious? Someone who needs medical treatment could be prevented from receiving it because of a disputed bill from a consultant? I very much doubt it.

Pat Mustard

IRAC War wrote: »

My apologies, I'm still trying to get a handle on this when legal advice isn't legal advice thing.

While I don't wish to sound flippant I'm getting that unsubstantiated opinion is okay but relatively useless, whereas anything cited would potentially be an issue? Is the specific issue in offering my opinion? Had I said:

"You may find something useful in the unfair terms in consumer contracts regs" would that have been okay or is the mere inclusion of any statute or case law legal advice?

Thanks for the steer, I'm aware of the potential difficulty a site such as this would have, or indeed I myself may incur, buy offering (generally bad) legal advice.

It's better when law is cited.

There is a lot more scope for discussion in hypothetical scenarios.

This is not a hypothetical scenario, so we can't offer opinions on liability.

It is generally allowed to point to regulations. To say that regulations have a certain effect is generally allowed.

To say that regulations apply in a particular way in relation to the OP's real-life situation and to offer an opinion on whether he would become liable to pay money is not allowed.

We have gone a bit off topic and this thread isn't really the place to discuss this but I hope that is of some assistance.

IRAC War

My apologies I seem to be making a right hames of posting here. I have it now on the legal advice and won't pull this off topic anymore sorry op!

Thank you for the correction Pat.

Claw Hammer

gizmo555 wrote: »

Are you serious? Someone who needs medical treatment could be prevented from receiving it because of a disputed bill from a consultant? I very much doubt it.

There is no dispute about the bill. If the o/p wants he can refuse to accept those terms now before being liable to pay anything. If the o/p needs medical treatment he should turn up for his appointments. There is no such thing as a free lunch. If you deal with a professional, another professional can't take up the matter until the first one is paid. The GP would be very embarrassed if a consultant is left unpaid.

Simon2015

Claw Hammer wrote: »

The GP would be very embarrassed if a consultant is left unpaid.

I don't think my GP would be embarrassed because it happens all the time.

There is even a notice up in my surgery that says you must pay before hand if you want to see the Doctor.

gizmo555

Claw Hammer wrote: »

If you deal with a professional, another professional can't take up the matter until the first one is paid. The GP would be very embarrassed if a consultant is left unpaid.

What do you mean "can't"? Another professional can do whatever he likes. He might choose not to, but that's a different matter. There's no law preventing a medical consultant treating me just because another consultant claims I owe him money.

And what has the GP's embarrassment to do with it? The OP's query was whether the charge for patient no-shows is legally enforceable.

seamus

I would say if that consultant's office had a policy of ringing to confirm say a week in advance and mentioning the cancellation penalty in that phone call, it would massively strengthen their ability to enforce it.

In real terms, the time and finances required to chase such a €220 bill are onerous.

More than likely they state that policy in order to "encourage" people to cancel their appointments, as the number of no-shows they get on first-time referrals is huge. If someone rang up to reschedule, they'd probably waive the cancellation fee and then blacklist them if they no-show again.

TheChizler

seamus wrote: »

More than likely they state that policy in order to "encourage" people to cancel their appointments, as the number of no-shows they get on first-time referrals is huge. If someone rang up to reschedule, they'd probably waive the cancellation fee and then blacklist them if they no-show again.

That's basically it. GF works as admin an a hospital outpatient department, some days only 1 or 2 people will come in out of 20 for scheduled appointments, wastes a huge amount of staff and medical supplies which go off when not in deep freeze, not to mention that some of the children can literally die if they hurt themselves after missing an appointment. Even a phone call in the morning would reduce a huge amount of waste. They tried implementing a 'stick' kind of like the above but the patient advocacy group kicked up a stink so they just have to put up with it.

davo10

As someone who works in the health field, I can offer some clarification to the op's question:

Yes the consultant can charge you for a missed appointment. When you make an appointment with a health care professional, in person, by phone or by email, you enter a contract for a service and the service provider can charge you for failure to attend.

http://www.consumerhelp.ie/services-contracts.

(See "cancelling a service" paragraph")

In reality the health care provider will not follow you for that charge, they will however refuse to make you another appointment. Typically the referral is sent back to the GP with a note informing him/her that you did not attend. If the patient wants another appointment to be made, the charge will have to be paid before another appointment is made so effectively the charge is only paid if you want another appointment. In most cases, because of long waiting lists and the annoyance this causes to the consultant, no new appointment will be issued and the patient has to go somewhere else. No patient-Doctor relationship exists as the patient reneged on the service/contract.

So in essence, the charge is a method of telling you to go waste someone else's time.

davo10

gizmo555 wrote: »

4ensic15 wrote: »

The o/ps GP will be notified of the no-show and told there is an outstanding bill. IN that case the GP can't refer the o/p to any other consultant.

Are you serious? Someone who needs medical treatment could be prevented from receiving it because of a disputed bill from a consultant? I very much doubt it.

You would be wrong. The patient is not prevented from receiving treatment, however they may not receive it from the consultant who they failed to attend a previous appointment. No patient/Doctor relationship exists as the person did not attend so the consultant can refuse to accept the referral. The patient may then have to be referred to someone else, usually with a stern warning from their GP that failure to attend/short notice cancellation prevents the appointment being offered to someone else who may need it.

gizmo555

davo10 wrote: »

You would be wrong.

I would not. The OP's question was whether a no-show charge is legally enforceable.

Whether it is or not, two other posters claimed that where a no-show charge remains unpaid "the GP can't refer the o/p to any other consultant." and that "If you deal with a professional, another professional can't take up the matter until the first one is paid." (My emphasis.)

Both of these assertions are untrue. There is nothing which would legally prevent a GP referring a patient to another consultant.

davo10

Ok, just to clarify, are you saying the charge is not legal/ it cannot be enforced or that a doctor cannot legally follow you for the fee? If you are saying any of these, you are wrong and so are the others who agree with you. When you make an appointment with a health official, you enter a contract for services and as the link I provided indicates, the Doctor had the right to charge you for that appointment if you failed to attend. I do not say that as a matter of opinion, I say it from experince.

Now, in reality, doctors do not follow the patient for the fee, I have never heard of such a case here, but I have heard of it in the UK where consumer legislation is broadly similar.

You are correct, the non payment of the fee does not preclude referral to another but you would need to accept a number of important consequences of re-referral, firstly you go back to the end of the waiting list for the new consultant, consultants in private hospitals often share rooms and consequently secretaries, a re-referral often gets processed by the same secretary and as all referrals contain names/addresses/dates of births, the patient can be identified as having failed a previous appointment.

I say this again to you, the charge is legally enforceable but never is, it is a way of telling the patient to go elsewhere, and if they do want a new appointment with the same consultant, the payment of the fee can be enforced before a new appointment is made.

gizmo555

davo10 wrote: »

Ok, just to clarify, are you saying the charge is not legal/ it cannot be enforced or that a doctor cannot legally follow you for the fee?

Neither. My last post was perfectly clear.

davo10 wrote: »

You are correct, the non payment of the fee does not preclude referral to another

This is exactly what I said in my last post.

bobbyss

davo10 wrote: »

Ok, just to clarify, are you saying the charge is not legal/ it cannot be enforced or that a doctor cannot legally follow you for the fee? If you are saying any of these, you are wrong and so are the others who agree with you. When you make an appointment with a health official, you enter a contract for services and as the link I provided indicates, the Doctor had the right to charge you for that appointment if you failed to attend. I do not say that as a matter of opinion, I say it from experince.

Now, in reality, doctors do not follow the patient for the fee, I have never heard of such a case here, but I have heard of it in the UK where consumer legislation is broadly similar.

You are correct, the non payment of the fee does not preclude referral to another but you would need to accept a number of important consequences of re-referral, firstly you go back to the end of the waiting list for the new consultant, consultants in private hospitals often share rooms and consequently secretaries, a re-referral often gets processed by the same secretary and as all referrals contain names/addresses/dates of births, the patient can be identified as having failed a previous appointment.

I say this again to you, the charge is legally enforceable but never is, it is a way of telling the patient to go elsewhere, and if they do want a new appointment with the same consultant, the payment of the fee can be enforced before a new appointment is made.

I don't have any stats but as far as I know hundreds (thousands?) of people fail to turn up for medical, dental appointments every year. That would be a great source of income for the medical people if they did want to pursue those who do not cancel.

If you are on a medical card and don't turn up, what doctor is going to to take legal action anyway coz all the patient say is I have no money to pay anyway.

GM228

davo10 wrote: »

As someone who works in the health field, I can offer some clarification to the op's question:

Yes the consultant can charge you for a missed appointment. When you make an appointment with a health care professional, in person, by phone or by email, you enter a contract for a service and the service provider can charge you for failure to attend.

http://www.consumerhelp.ie/services-contracts.

(See "cancelling a service" paragraph")

You can't enter a legally binding contact without consideration.

To be a legally binding contract there must be an offer and acceptance and also consideration (a loss to one party and a gain to another).

That is why deposits are taken for most services taken out which are the consideration part.

4ensic15

GM228 wrote: »

You can't enter a legally binding contact without consideration.

To be a legally binding contract there must be an offer and acceptance and also consideration (a loss to one party and a gain to another).

That is why deposits are taken for most services taken out which are the consideration part.

If you make an appointment whre a fee is to be paid there is automatically consideration. A deposit is simply security for the payment.

davo10

bobbyss wrote: »

I don't have any stats but as far as I know hundreds (thousands?) of people fail to turn up for medical, dental appointments every year. That would be a great source of income for the medical people if they did want to pursue those who do not cancel.

If you are on a medical card and don't turn up, what doctor is going to to take legal action anyway coz all the patient say is I have no money to pay anyway.

Failure rates are high in Med card patients and low in private patients, those who do not have to pay for treatment often mistakenly believe that there is a free pass for failing to attend appointments. Failed appointments represent a huge loss to clinicians, never, ever a potential gain. Studies also shown that failures to attend are highest among patients attending for the first time and that those who fail to attend once, tend to do it repeatedly. This is why most clinics, including my own, do not offer a second appointment to anyone who fails the first. If we do accept them back, they pay for the first, failed appointment in full before a second one is made.

The point of the fine is to move those patients on, not to go after them for the money. If they want to stay at the practice, they have to pay the charge. The fine equates to the time wasted by the patient not turning up, the Clinician does not profit over and above what would have be earned had the patient attended or the appointment being offered to someone else.

davo10

GM228 wrote: »

You can't enter a legally binding contact without consideration.

To be a legally binding contract there must be an offer and acceptance and also consideration (a loss to one party and a gain to another).

That is why deposits are taken for most services taken out which are the consideration part.

Offer = appointment for service for a fee.
Acceptance = patient and clinician agree time and service and fee.
Consideration = patient gains by service provided, Clinician gains by being paid, Clinician loses by patient not showing up, patient loses by service not being provided.

A deposit is not required for a contract to be formed.

Curly Judge

My Doctor, who is very good and therefore very busy charges a 100% deposit for new patients who start no showing.
He is a bit more tolerant of us older types who have been with him for years.
With him it's more the bad manners that annoys him rather than any loss of revenue.
In fairness, his secretary operates a text alert system which sends a reminder the evening before.

Simon2015

davo10 wrote: »

Failure rates are high in Med card patients and low in private patients, those who do not have to pay for treatment often mistakenly believe that there is a free pass for failing to attend appointments. Failed appointments represent a huge loss to clinicians, never, ever a potential gain. Studies also shown that failures to attend are highest among patients attending for the first time and that those who fail to attend once, tend to do it repeatedly. This is why most clinics, including my own, do not offer a second appointment to anyone who fails the first. If we do accept them back, they pay for the first, failed appointment in full before a second one is made.

The point of the fine is to move those patients on, not to go after them for the money. If they want to stay at the practice, they have to pay the charge. The fine equates to the time wasted by the patient not turning up, the Clinician does not profit over and above what would have be earned had the patient attended or the appointment being offered to someone else.

What if the person missed the appointment because they were too sick to attend do they still have to pay the fee ?

Curly Judge

Simon2015 wrote: »

What if the person missed the appointment because they were too sick to attend do they still have to pay the fee ?

Too sick to make a phone call?

davo10

Simon2015 wrote: »

What if the person missed the appointment because they were too sick to attend do they still have to pay the fee ?

Absolutely, most patients visiting a Dr are ill. A patient who is too sick to attend an appointment may require a home visit or to be admitted, but a simple phone call would be invaluable to both Doctor and patient.

In your case I suspect it is a consultant visit which has a higher tariff and there tends to be less leeway given to non attenders. Patients don't have to pay the fee, they have the option to just go elsewhere.

bobbyss

davo10 wrote: »

Failure rates are high in Med card patients and low in private patients, those who do not have to pay for treatment often mistakenly believe that there is a free pass for failing to attend appointments. Failed appointments represent a huge loss to clinicians, never, ever a potential gain. Studies also shown that failures to attend are highest among patients attending for the first time and that those who fail to attend once, tend to do it repeatedly. This is why most clinics, including my own, do not offer a second appointment to anyone who fails the first. If we do accept them back, they pay for the first, failed appointment in full before a second one is made.

The point of the fine is to move those patients on, not to go after them for the money. If they want to stay at the practice, they have to pay the charge. The fine equates to the time wasted by the patient not turning up, the Clinician does not profit over and above what would have be earned had the patient attended or the appointment being offered to someone else.

I see.
So if I am unemployed and have a health card (this means I pay nothing or a nominal fee am I right?) and I fail to turn up for an appointment your clinic (and most clinics too) will not take me for a second appointment unless I pay for the first one, which I didn't have to pay for in the first place?

I heard on the Marion Finucane show a while ago the huge problems that people who don't turn up for appointments and especially those who don't even bother their arssess to phone in to cancel. I have some experience of that myself from a different perspective and I find it infuriating that such people seem to treat medicine in such a caviler fashion and seem to think that there are no consequences for others when they don't cancel.

I did not know that most clinics charge for the first appointment if they don't show up -and that is good, but is this true for medical card holders also?

goz83

Simon2015 wrote: »

What if the person missed the appointment because they were too sick to attend do they still have to pay the fee ?

Not the most common excuse reason for no shows, but it's up there, just behind the "death in the family", or "car broke down". Sure there are genuine ones, but most are pure lies.

I'm a therapist. I work in my clinic 3 days a week, making 4 appointments available per day. Were I to work more days at the clinic, I would not be mentally fit to give 100% to my patients. I operate a 48 hour, no penalty amendment, but I do charge a small booking fee, which does not come close to covering losses incurred by no shows, but does encourage people to adhere to the booking policy.

One grows tired of excuses and a few posters here have hit the nail on the head. If someone doesn't have the decency to make a phone call, they deserve to be charged a no show fee. I would tend to black list patients who do not show up and if they call for another booking, they must pay in advance, often on top of a no-show fee. Some consultants might only be losing 10 minutes for a no show. I lose 90, so the patient will not be coming back to me until the balance is settled. In my experience people often get sick on the bank holiday weekend. Of course, I would rather be at home my family, so why should ignorant Aholes get away without paying a fee? I've got bills and my secretary gets paid whether people show up, or not.

Simon2015

goz83 wrote: »

Not the most common excuse reason for no shows, but it's up there, just behind the "death in the family", or "car broke down". Sure there are genuine ones, but most are pure lies.

How do you know who is lying or are you just making assumptions ?

One grows tired of excuses and a few posters here have hit the nail on the head. If someone doesn't have the decency to make a phone call, they deserve to be charged a no show fee.

I don't know if you have ever been seriously ill but I have been in the situation were I have been too sick to make a phone call or at least making a call would be the last thing I would be thinking about due to being sick.

4ensic15

Simon2015 wrote: »

How do you know who is lying or are you just making assumptions ?


I don't know if you have ever been seriously ill but I have been in the situation were I have been too sick to make a phone call or at least making a call would be the last thing I would be thinking about due to being sick.

Why wouldn't you go to the doctor if you were that sick?

Simon2015

I rememeber a few years ago my appointment with a consultant was cancelled at the last minute.

I got a call from his secretary just half an hour before the appointment claiming the Doctor was sick and could not see me that day.

At that stage I had already left the house and was on my way to the hospital.

I wonder could I have billed the Doctor for the time I had wasted due to his cancellation ? somehow I don't think so. Yet when its the other way round patients are expected to pay for a no show.

Simon2015

4ensic15 wrote: »

Why wouldn't you go to the doctor if you were that sick?

Because I was physically not able to leave the house due to been sick.

4ensic15

Simon2015 wrote: »

I rememeber a few years ago my appointment with a consultant was cancelled at the last minute.

I got a call from his secretary just half an hour before the appointment claiming the Doctor was sick and could not see me that day.

At that stage I had already left the house and was on my way to the hospital.

I wonder could I have billed the Doctor for the time I had wasted due to his cancellation ? somehow I don't think so. Yet when its the other way round patients are expected to pay for a no show.

If you had agreed a fee to be paid by him when you met him, of course you could have billed him. At least you were contacted before you got there and not left hanging around.

goz83

Simon2015 wrote: »

How do you know who is lying or are you just making assumptions ?


I don't know if you have ever been seriously ill but I have been in the situation were I have been too sick to make a phone call or at least making a call would be the last thing I would be thinking about due to being sick.

It is quite easy to tell actually. Usually they claim not to have received the reminder text, or email. We send 2 texts and get "read" notifications. Then their phone is off/unanswered at the time of their appointment. If their phone is on, 90% of the time they answer a few minutes later to a second number we call from and the excuses are always delayed/stuttered. It's often a very sunny Saturday when these people decide their car has exploded on the motorway.

Usually, the genuine ones call in advance and are looking to reschedule their appointment. They NEVER mind losing their booking fee on short notice.

I called a motorway bluff before, citing a full no show fee, as agreed in the booking terms. The patient managed to get her car fixed (engine failure and "billowing smoke" if I remember rightly) within minutes and called to say she would be making her appoint, but wasn't happy :P

Car wasn't smoking when she pulled up...but she was:pac:

I generally don't treat very sick people, so it would rarely be a reason for people not to show.