Procedures for Patient Discharges

Patient discharges are quite common if the patients fail to pay their dues. Since a practice administrator deals with the situation, most physicians are unaware of what the procedure of patient discharge entails. You might wonder if you are required to sign the letters of discharge. This, along with various other elements of the process, needs to be discussed to ensure that both physicians and patients know what the patient discharging process is like.

Why Go For Patient Discharge?

You might question why your practice administrator is opting for this action in the first place. There are quite a few reasons where you have enough ground to discharge patients. Some of them include the following:

  • The patient creates chaos and disruption in the facility.
  • The patient doesn’t attend their required appointments.
  • The patient is noncompliant and doesn’t follow the instructions of the treatment.
  • The patient seeks drugs to satiate their needs rather than because they have a genuine reason.
  • The patient doesn’t meet financial obligations.

The Procedure

Are you unaware about how to complete the patient discharge process? Well, the procedure is quite straightforward. However, before you take this action, you must have made all efforts possible to address the ability of the patient to meet their financial dues. Also, no payor contract should be violated in the process. If, after following these rules, you still feel that patient discharge is the answer, here are the steps you must take:

Send a Letter to the Patient

You must inform the said patient about the discharge via a letter. At least give a 30-day notice to your patient. Your goal should be to ensure that the discharging action doesn’t cause disruption in care and allows the patient enough time to look for a new physician. Hence, if you are a specialist or if the patient in question has a chronic condition, try to give more time.

The Technicalities of the Letter

It is not required for a physician to sign the letter and neither does it have to be the physician who must be sending the letter. It can come from the practice as well. The bottom line is that the letter must be thorough and should be written properly. While it is not required, it is good if the physician’s name is in the letter. Also, the practice should make a point of consulting the physician before sending the letter. This will allow the physician to gauge whether the letter is understandable and is sensitive to the given case. After all, the health care provider is in a much better position to make the letter personal to the treatment and patient, while the practice is a better judge of the business side of things.

Offer Emergency Care During the Notice Period

Just because you have told them that they will be discharged doesn’t mean you should stop delivering care at that very moment. You are required to deliver all the necessary treatments until the patient is completely discharged. If the patient is in a state of emergency, you have to treat them. Unless the notice period is over, you are required to fill their prescriptions. Let your patients know of these rights via the letter. The transparency of the process will save you from a complaint.

Transfer Records Upon Discharge

Regardless of why you discharged a patient, you are required to transfer all medical records as required by the federal or state law. Just because a patient is yet to clear their dues doesn’t mean you can hold onto their medical records or refuse to release them. At the end of the day, the ability of another practice to deliver quality care depends on previous medical records. Hence, you are liable to transfer it all.

Make Recommendations to Patients

You might not be too keen on helping your patients out if they are being discharged. However, you are still required to help them. You can’t leave them high and dry. You must make recommendations about other physicians they can consult or other charities that might be able to help them out. This makes sure that your patient continues to receive the required care.


There are times when patient discharge is the only option you have. You might not agree with the action, but it is an inevitable outcome if the patient meets any of the requirements detailed above. What you can do is ensure the quality of care delivered to the said patient is not hampered because of the action. Make the process as transparent as possible and help your patients out. Their health should matter to you, regardless of their issues.