Read Sample termination letters text version

Sample termination letters
Whenthephysiciandecidestodismissapatient,thepatientshouldbenotifiedinwriting.Thelettershouldbeprintedon officeletterheadandsentbyfirst-classmailandbycertifiedmailwithareturnreceiptrequested.Physicianscanadaptthe followingsampleletters. Termination of the physician/patient relationship Date   Certifiedreceipt#______________ [patientaddress] Alsosentfirst-classmail. Dear[patientname]: PleasebeadvisedthatIwillnolongerbeabletotreatyouas apatient.Theterminationofourphysician/patientrelationshipwillbeeffectivein30daysfromthedateofthisletter. Yourmedicalconditionrequirescontinuingphysiciansupervision, and it is important you select another physician as soonaspossible. Contact your insurance plan or the county medical society fornamesofotherphysicians.Uponwrittenauthorization,a copyofyourmedicalrecordwillbesenttoyournewphysician.Areleaseformisenclosed. Sincerely, [physicianname] Non-payment notice Date   Certifiedreceipt#______________ [patientaddress] Alsosentfirst-classmail. Dear[patientname]: Ithascometomyattentionthatyouhavereceivedseveral lettersregardingyouroutstandingaccount.Iftherehas beenaproblemorifyouareunhappywiththecarethatyou havereceivedinthispractice,pleasecontactmetodiscuss thesituation.Youareimportanttous,andIhopewecan resolveanyissuesyouhave. Mybusinessmanagerisalsoavailabletodiscusspayment ofyouraccountortoimplementpaymentarrangementsif theyareneeded.Shouldwenothearfromyouwithin30 days,Ibelievethatitwouldbemutuallybeneficialtoterminatethephysician/patientrelationshipsothatyoumay locateanewphysician. Ihopethatwewillhearfromyouinthenearfuture Sincerely, [physicianname]
Confirmation of patient-terminated relationship Date   Certifiedreceipt#______________ [patientaddress] Alsosentregularmail. Dear[patientname]: Thisletterissenttoconfirmyourdecisiontodiscontinue carewithme.Yourmedicalconditionrequiresphysician supervision,anditisimportantyouselectanotherphysicianassoonaspossible.Iwillbeavailabletoyouuntil[30 daysfromdateofletter]. Pleasecontactyourinsuranceplanorthecountymedical societyfornamesofotherphysicians.Uponwrittenauthorization,Iwillprovideacopyofyourmedicalrecordtoyour newphysician.Areleaseformisenclosedtoexpeditethe process. Sincerely, [physicianname]
Termination for non-payment Date   Certifiedreceipt#______________ [patientaddress] Alsosentregularmail. Dear[patientname]: On[date],Isentyoualetterrequestingthatyoucontactthe businessmanagerormeregardinganyproblemsthatmay haveoccurredresultinginnon-paymentofyouraccount. Intheletter,Istatedthatitwouldbenecessarytoterminate ourphysician/patientrelationshipifwedidnothearfrom you. Sincewehavenotheardfromyou,pleasebeadvisedthatI willnolongerbeabletotreatyouasapatient.Theterminationofourrelationshipwillbeeffectivein30daysfromthe dateofthisletter. Areleaseformisenclosedforyourwrittenauthorization. Pleasecontactuswiththenameofyournewphysicianso wemayforwardyourrecordstohisorheroffice.Atthat time,youraccountwillbeclosed. Sincerely, [physicianname]