Updated: Apr 6
Last-minute cancellations and no-shows are a problem in virtually every medical practice. These can pose a particularly difficult challenge when dealing with long-time patients who may be used to bending the rules or disregarding policies altogether.
In our Miami office, Practice Manager Roxana Gonzalez has instituted several new policies that have proven to be successful at decreasing patient late cancellations and no-shows. If you’re having trouble with these common issues, consider implementing one or all of these solutions in your practice to help make day-to-day operations easier and smoother for you, your staff, and your patients.
1. Institute and Enforce a Policy
If you don’t already have a cancellation policy in place, the first step is to create one and make all existing and new patients aware of that policy. If you do already have a policy in place but it is not being enforced, it won’t do any good. You may need to reiterate the policy to your patients, asking them to sign a copy stating that they have read and agree to it.
You will also need to make sure your front desk staff are aware of the steps that need to be taken in order to confirm appointments and send reminders. A consistent protocol should be followed for each and every patient.
2. Use Automated Communication Systems
Calling every patient several times to confirm an appointment and send reminders can be very time-consuming and can still leave questions as to whether or not the patient is planning on showing up. “We would call every patient two days before their appointment to confirm,” Roxana says, “but often, people don’t pick up their phone and they never call you back, so you’re still not sure if they’re coming in.”
To remedy this, we began using a paid automated system to handle confirmations and reminders. It automatically sends a text to patient cell phones when they make an appointment. Then, they get another text or email a week before their appointment. Two days before the appointment, they’re sent another text or email, asking them to please confirm or call or text to cancel.
“Any practice that has a cash-based business or is a high-volume multi-provider practice should invest in an automated system so that staff can focus on other things,” Roxana says.
3. Introduce a Fee-Based Cancellation Policy
While automated messages are certainly helpful and take some of the workload off of the front desk staff, some patients still do not answer these messages.
“I started noticing trends with specific patients,” Roxana says. “So we came up with a new cancellation policy, which was somewhat controversial at first. Patients have to reserve their appointment with a credit card, and if they don’t show up or cancel within 24 hours, we charge them $75. My nail salon does this, as well as many restaurants here in Miami Beach. But I believe a similar policy could work in other areas, even if the fee is $20.”
At first, we simply notified patients of this new policy and were discretionary – repeat clients got one grace period before being charged. We explained to our clients that in order for us to spend adequate time with them during their appointment, keep wait times low, and avoid double-booking, this policy was necessary.
Since we have implemented this new policy, we’ve seen a steady decline in no-show rates. We do get some push-back occasionally, but we do explain that repeat patients get one grace period, as we understand that emergencies do happen. “After that,” Roxana explains, “we have to enforce the policy.”
While we have had to explain our reasoning behind this new policy to some of our long-standing “VIP” clients, we receive no pushback from new patients.
“Rates should continue to improve, because this is all that new patients know,” Roxana explains. “The hard part is to retrain the existing patients. But awareness of the policy alone is a deterrent. I truly believe that the cancellation policy they sign has helped us reduce no-show and late cancellation rates.”
Your time is valuable, and the reality is, you are running a busy business. Write up a policy that you believe will work for your particular practice and clients, and enforce it. Make sure your patients are aware of the policy to set them up for a successful experience. Remind them that benefits like short wait times and ample time with their provider in the exam room are the tradeoffs for such a policy.
Do you have other tips you use to help deter late cancellations and no-shows in your practice? Please share them with me (Leslie Baumann) via LinkedIn!
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