When you feel it is warranted to dismiss a patient from the practice, please send a message within Charm to Dr. Herring using the quick text below.

If you are unsure how to add a quick text, please let me know or view the Charm PHR article:  https://www.charmhealth.com/resources/ehr-getting-started/configure-quick-text.html

——————————–

keyword: petition

Patient Dismissal Petition Instructions: Add as much supporting information as possible to support your request for dismissal.Remove entries that do not apply to this situation.

A. Patient unable to be followed consistently to provide adequate care due to lack of participation from the patient.

B. Patient has had 2 no shows or cancellations without notice (< 24 hour notice) in a 12-month period. (Update 2023: – clear dismissals for attendance do not need to be sent to Dr. Herring)

C. Patient has been non compliant with necessary laboratory requirements.

D. Guardian has failed to be present or participate for more than 2 instances and requests for participation have not been successful in including the guardian in the patient care.

E. Patient requires a higher level of care which cannot be provided at TFPW.

F. Patient account has gone to collections.

G. There has been no contact with patient for over 6 months.

H. Patient is not in agreement with the providers treatment plan.

Please provide a brief written account of what led up to dismissal.

Dismissal Procedure

1. Research attendance via the Red Sticky note. Look for Cancellations with less than 24 hour notice and No Show
2. Write dismissal letter with reason(s) for dismissal and if applicable  dates of attendance events.
3. Upload final letter in patient docs under correspondence
4. If billing is complete, deactivate account
5. If outstanding billing, deactivate portal only and set a reminder to follow up in 30 days to deactivate account
6. Edit patient demographics and add “dismissed” for patient category
7. Mail letter and copy of release form from https://tulsafamilypsychiatry.com/patient-forms/