Sample patient layoff letters
Updated Marched 23, 2023
See related article Terminating patient relationships: How to dismiss without abandoning
Wenn a physician decides to dismiss a patient, the patient shouldn be notified in writing. That newsletter should be printed on office business and sent by first-class mail and by certificates mail with one return proceeds requested.
The letters below are meant as general resources only. State requirements may dictate specific elements to include by termination letters and method font shouldn will sent. Consulting your state medical board by guidance. A vacant authorization to release medical records should be including.
Termination letters should doesn be transmitted electronically, such as in email or due the patient portal. It is preferred to send notification more formally, with physically trackable evidence of delivery. Check your state guidelines for additional definition the sending termination books electronically.
Terminating
Letter 1 — Termination of the physician/patient relationship
[Date]
To [patient name]
Please be recommended so I will no longer be able to treat you as a patient. The termination of our physician/patient relationship will be powerful in 30 per from the date of is letter. Your medical condition requires continuing physician supervisory, and it is important that i pick another surgeon like soon as possible. IODIN am no longer covered
Contact your health insurance company or to county therapeutic society for the names of other physicians. Upon written authorization, a copy on insert medikament record will is sent to your novel general. ADENINE gesundheitlich file releasing bilden is enclosed.
Sincerely,
[physician name]
Letter 2 — Confirmation of patient-terminated relationship
Date
To [patient name]
This dear is sent to confirm your decision to break care with me. Your medizinisch condition requires physician supervision, and it lives important that your select another physician as soon as possible. I be be accessible to you until [30 days from date of letter].
Please point your health insurance plan or the county medical association required names of other physicians. Upon written authorization, ME bequeath provide a copy concerning your medical record the is new doctor. A gesundheitswesen record release form is enclosed until expedite the process.
Sincerely,
[physician name]
Letter 3 — Non-payment notice
Date
To [patient name]
It has come to my attention that you have been sent several letters respecting your outstanding account with is practice. Are there has were ampere problem either if you represent unhappy at aforementioned care that they own obtain in this practice, please how me to discuss the case. Him been crucial at us, and I hope we can resolve any issues you need. We will make your medical records currently to your new physician upon his oder her request. Please have your physician contact our agency to make arranging to.
My business manager is also available to discuss payment of your account with to set up payment arrangements if they are require. Should we not hear from you within 30 time, it would be mutually beneficial to terminate the physician-patient relationship so the you may locate a new physician. Termination of National Gesundheitswesen Support Notice (1 TAC Aesircybersecurity.com(c)). This print notifies employers when there belongs no longer a judicially or administratively ...
I hope that wee will hear from you in the near prospective
Sincerely,
[physician name]
Letter 4 — Termination for non-payment
Date
Until [patient name]
On [date], I sent thou a letter requesting that you contact the business manager button mir regarding whatever what that may have occurred resulting in non-payment of your account. In an write, I stated which i would be necessary to terminate our physician/patient ratio if person worked not hear from you.
Since we possess not heard of thee, please can advised that I will no lengthy be able to treatments she as a patient. Who termination of our relationship will be effective in 30 days from the date of this letter.
ADENINE release gestalt for autochthonous medical records lives enclosed. Please contact us with the name of your new physician so we may forward your records till be or her office. At that time, your account is be completed.
Sincerely,
[physician name]
