Patients who do not show up for scheduled appointments disrupt practice flow by taking dedicated time slots away from other patients and negatively impact the productivity of both the provider and staff. Practices often waive ‘no shows’ as a normal part of business but when translated to a bottom-line impact, using a rate of collections per visit of $125, having five no shows a week would translate to $32,500 in lost collections per year.
After understanding the financial impact of these no-show patients, physicians and practice staff should be determined to best position their practices to ensure this doesn’t continue to happen. Although some of these practices may seem fundamental, it is valuable to understand the significant impact that these best practices have on improving no show patient numbers.
1. Appointment Reminders
Be sure your practice management or scheduling system has the ability to contact patients to send reminders and confirm appointments. Whether the reminders occur by phone, text message or email, having different automated methods of reaching your patients will help decrease no shows and even encourage patients to call in to reschedule, so your practice’s schedule is open for others. A critical step to this process to ensure utmost success is by making sure the front desk office staff is confirming patient contact information at every visit and noting their preferred method of contact for appointment reminders.
2. Evaluate No Show or Short Notice Cancellation Trends
Understanding reasons for no shows and cancellations on short notice could help scheduling staff be more successful. Provide scheduling staff with a simple grid for tracking cancellation reasons. This grid would contain information regarding appointment day and time, provider, insurance carrier and reason for cancellation. If trends are seen by appointment day and time block, consider double booking during those times to maintain productivity. If there are trends by insurance carrier, have staff call and confirm those appointments in addition to automated reminders. While there will always be reasons beyond the patient's and practice's control for missed appointments, evaluating data for trends and implementing changes engages and educates staff and benefits the practice.
3. Follow-Up with No Show Patients
Reach out to reschedule no show patients within 48 hours of a missed appointment. Scheduling staff should be scripted to communicate concern for the patient, reschedule the appointment and remind the patient of the practice's policy on missed appointments. If a particular patient is a repeat offender with several missed appointments, a note should be placed on the account so the patient is either double booked or placed on the schedule at a time when a regular no show patient would not be as disruptive.
4. Keep a Short Notice List of Patients
For short notice cancellations that create opportunities in the schedule, practices should keep a list of patients who could come in on short notice. These patients often have appointments scheduled in the future but would like to get in sooner. The practice can accommodate both the patient and help maintain productivity by reaching out to these patients to fill a scheduled slot left open by a short notice cancellation or another no show.
5. Implement a Patient No Show Policy
Clearly communicate with patients upon initial registration and annually that the practice has expectations for the patient to be responsible in keeping their scheduled appointments. The policy should include a window of time to cancel appointments with appropriate notice, often 24 hours, and that the practice will assess a fee to the patient for no show appointments. No show fees can range from $25 to $40 for each missed appointment, which will be an incentive to the patient to make their appointment. Finally, communicate that repeated no shows could be considered for dismissal from the practice.
While no physician practice is immune to disruptions by patient no shows, there are several tactics to be considered to help maintain practice productivity that also drives patient accountability. With the right approach, practices can better manage their schedules so patient no shows have less of an impact on productivity and the bottom line.
Richard Lopez del Rincon is the senior vice president of office-based physician services at R1. Richard obtained his degree from the University of Miami.