10-Point Patient Termination Plan

1. Develop a policy for provider-patient termination that is made available to patients at the initiation of service.

2. Keep accurate and detailed documentation.

3. Consider sending a “pre-withdrawal letter” that gently expresses your concern about the patient

4. Discuss the situation with a colleague, risk-management professional, or legal advisor.

5. Explain to the patient that he or she is being terminated from care, and provide an explicit reason. Do not delegate this task; speak directly with the patient.

6. Inform clinic staff of the termination.

7. Send a certified letter with return receipt to the patient and the insurance carrier stating the termination, and that care will be discontinued in thirty days’ time, noting the specific date.

8. Offer the patient interim care.

9. Provide names and contact information for suggested potential alternate providers.

10. Offer to transfer records when given written permission.

Have you ever wanted to fire a difficult patient? You know, those patients who fail to complete indicated tests, refuse necessary treatments, miss appointments, do not pay bills, are rude, unreasonably demanding, dissatisfied, dishonest, threatening, violent or litigious?

When the patient-provider relationship is unable to continue towards a therapeutic goal, termination may become an attractive option for both parties.There is no official guideline for terminating the NP/PA-patient relationship, but this 10-point plan can make the process easier.

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