Failure to keep an appointment (i.e. cancellation without notice or “no-show” or arriving more than 15 minutes late for your appointment) is a difficult problem in many medical practices.  When you do not keep your appointment, it results in increased costs to the clinic, and longer wait times for patients who do want to be seen.

If you must cancel or change your appointment please notify us, as soon as possible and we would be happy to cancel or reschedule your appointment.

As of May 1st, 2014 Neurology Consultants of Nebraska requires that if you need to cancel or reschedule an appointment you must notify our office at least 24 hours in advance of your scheduled appointment time.  This gives us time to offer your appointment slot to an alternative patient.

A “no-show” fee will be assessed as outlined below for all patients who fail to keep an appointment, without at least 24 hours advanced notice.

• For the first occurrence, a fee will be waived.

• For the second occurrence you will be charged:
• $50 if you are an established patient
• $100 if you are a new patient

• For the third and subsequent occurrences you will be charged:
• $100 if you are an established patient
• $200 if you are a new patient

If you are a Medicaid patient we are unable to bill you for fees associated with “no shows” per Medicaid guidelines. Thus the following is instituted.

First occurrence you will be allowed to reschedule your appointment.

Second occurrence we reserve the right to discharge you from our clinic.

Any fees must be paid in full, before you are permitted to reschedule your appointment. These fees will not be paid by your insurance.

If you fail to keep your appointment, 3 or more times, we reserve the right to discharge you from our clinic, at our discretion.

I acknowledge I have read and understand the above statements.