15 minutes, and I am firm about it. Frankly, I resent their being 15 minutes late as it totally screws my schedule. I stay on time for the most part, but someone's being 15 minutes late can ruin everything. I don't think I should see them at all if they are more than 5 minutes late, because technically they are supposed to be there 10 minutes before the appointment time anyway. However, clinic policy beyond my control says 15 minutes, so I see them so long as it is merely 15 minutes and not 16! However, if they are late they are told that I have moved on to the next patient and I have to try to work them back in between the other patient's that were on time. Other people obviously cannot be made to wait on account of Ms Tardy's irresponsibility, so s/he is likely going to wait a while. When I'm lucky, they don't like the sound of that and leave. When I'm unlucky, they stick around and I have to rush later to work them back in. When I'm very unluck they are nasty about having to wait an hour, as if it were my fault they couldn't arrive on time. IME, once you get a rep for being inflexible about it, you weed out the people with punctuality issues and the others know you mean business and get there on time most of the time, unless it really could not be helped.
I dismiss after the 3rd no-call no-show each and every time. We do not charge a no-show fee because it is too expensive to try to collect it and uneven collections can apparently be a medicare fraud issue. I am not allowed, per policy, to prescribe for people with an outstanding balance and failure to make arrangments and/or keep them current. I never know what the arrangments are (I know there is one patient who pays $1.50 a week on a bill that is still over $7,000. She has never missed a week in years. She has medicaid now and doesn't have new bills compounding, but still keeps paying toward an old bill that the clinic actually wrote off years ago. She doesn't have to, and the $1.50 just goes into the employee assistance fund, but it does a lot for her self esteem to know she is going to pay off that bill someday. It isn't my patient and I don't even know who it is. I just know we have one such patient), and I could not possibly care less. There is an alert in the medical record about them in case they should try to do an end run and call to request something after having fallen behind in a payment plan. I can't prescribe for them. If I did, I'd get fired.