A client with generalized anxiety disorder frequently skips weekly scheduled appointments with a primary nurse therapist in the managed care organization (MCO), showing up only when the client is feeling severely stressed
Which of the following statements best explains this behavior? 1. The client is aware that MCO's frequently "double-book" appointments to balance out the "no-shows."
2. The client does not have transportation for scheduled appointments with the therapist.
3. MCO consumers do not have to make co-payments for missed appointments.
4. MCO consumers find it easier than non-MCO consumers to not keep scheduled appointments, partly because services are prepaid.
4
Rationale: Perhaps because services are prepaid, MCO consumers find it easier to skip scheduled appointments. This is sometimes referred to as DNKA (did not keep appointment). Some MCOs deal with this problem by not scheduling future appointments until the client makes co-payment for all missed appointments. Transportation problems are a frequent reason for failure to keep appointments; however, this does not seem apparent as the client is able to keep appointments when the client feels it is needed. Most clients are unaware of the scheduling practices of an MCO and do not realize the clinical and administrative importance of missing scheduled appointments.
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