I’d like to receive the Board’s position on billing new clients who no-show to their first scheduled session. When clients first book a first session with me they are automatically sent my informed consent policy including no show/cancellation policy. Prior to their first session with me some will have electronically completed the form while others have not.

With current clients who provide me with a form of payment they are aware they will be charged if they no show. But they have agreed to my policies through informed consent that’s been signed and discussed with them.

If I inform all new clients prior to their first session of my no show/cancellation policy is that enough to then charge the client in the event they do not attend? And secondly, is it within the realm of ethical or not to require all new clients to at least provide a credit or debit card (all stored securely online with my HIPPA platform) that can be charged in the event of first session no show?Thanks in advance for your response. In the past it has seemed to me that until a client actually attends a first session it is hard to enforce a no show/cancellation policy. And I’d like to require some form of payment that I can charge in the event they do not meet the no show/cancellation policy, but obviously will not do this if it is not ethical in the view of the board.

I have consulted on your enquiry. While NSRP would not state this to be a “position”, we are happy to share some of the typical information that NSRP references for questions about billing and provide some additional considerations.

Principle 6nA registrant shall reach an agreement with an individual, group or organization concerning the psychological services to be provided, the fees to be charged and the billing arrangements prior to providing service.

6.1 A registrant sets fees based on the amount of time spent and complexity of the services rendered and does not base fees on the basis of advantage or clinically significant benefits accruing to the individual receiving services.

6.2 Interest may be charged on an overdue account as long as the client is informed of this practice at the time of billing.

6.3 Prior to using a collection agency or legal option to collect fees, the registrant informs the client of this intent and provides an opportunity for payment to be made.

6.4 A registrant does not request advance payment for psychological services however funds may be held in trust if agreed on by the client. Trust funds are applied only to services rendered with any excess returned to the client on the termination of services.

Some considerations and options:There could be a legitimate reason, or buyers’ remorse or something similar – which a potential client may have difficulty dealing with if they have not had any previous direct contact with the psychologist and have not had the opportunity to have had any questions about the consent answered.

There does not appear to be anything specifically stated in the professional ethics or standards that would indicate that a psychologist could not charge for a missed first session or ask for a credit / debit card in advance, provided there was clear consent. If a psychologist was to charge a fee for a first missed session, the consent could include what the fee would be, the circumstances where the fee would be charged, the steps that could be taken (regarding cancellation) to avoid the fee and the process to “appeal” if the missed session was due to circumstances beyond the control of the client (e.g., power outage, accident). In addition to the overall consent form being signed, it might be good for the client to initial the “fee for no show” section (as well as initial any other points the psychologist wants to emphasize).

Other options:Reduced fee for a no-show session.

Allow clients one “no show” during their treatment. If this happens on the first appointment and the client re-books, make it clear that future no-shows will be charged.