Each month, you either pay rent or make a lease or mortgage payment for your office space, no matter how many patients you see during that month. Hefty malpractice insurance premiums must be paid whether you see 15 patients a day or 20. And while you can modify your staffing levels based on practice volume, it’s next to impossible to make those adjustments based on daily fluctuations in the appointment schedule. In short, most of your overhead is fixed, which makes every additional patient you see each day very important to maintaining a healthy bottom line. Aside from efforts to increase patient volume, it’s important to ensure doctors appointments are kept.
The most obvious and effective way to reduce no-shows is to make reminder calls to patients or give them appointment cards. Yes, it takes time, but when you call someone on Monday for a Tuesday or Wednesday appointment and find out they’ve completely forgotten and can’t make it, you have time to fill that slot with someone on your cancellation list or with a patient who calls in needing to be seen sooner rather than later.
Maintain current contact information for all of your patients so that you can reach them easily for reminder calls. A note in the file about whether they prefer to be contacted via their mobile phone or at home is useful, and be sure to note if they’re okay with your office leaving a message on an answering machine or voicemail. For privacy reasons, some patients might not want a child or spouse to pick up a message as seemingly benign as a reminder call from a doctor’s office.
When you’re scheduling on the phone or in person, repeat the day and time of the appointment, and remind patients to call at least 24 hours in advance if they need to reschedule. Getting into this habit will, over time, help reduce your no-show rate because it clearly communicates to patients the importance of maintaining an orderly schedule. Be sure to explain your no-show and appointment cancellation policies to all new patients.
If you have certain individuals who chronically don’t show or cancel appointments at the last minute, have a private conversation with them (i.e., not while they’re standing at the check-in desk) about the impact their behavior has on the practice. Explain that when they don’t show up, it not only throws the office schedule off, but also makes it more difficult for other patients needing to be seen to get on the schedule. If this little talk doesn’t result in more reliability on the part of the patient, it might be time to ask them to find another healthcare provider. If you go this route, give proper notice in writing so that you are not faulted for patient abandonment.
If, no matter what you do, you still have no-shows most days, compensate by overbooking ever so slightly. Track no-shows and same-day cancellations for a month or so to determine the number of open slots you end up with on an average day. Pay attention to whether you tend to have more no-shows on Mondays and Fridays, for example, as opposed to mid-week, and then overbook accordingly.
Profit margins in medical practices are slim. Seeing (or not seeing) one or two additional patients each day can make a big difference over a period of months. Consider this conservative formula: 1 missed office visit each day, times $50 reimbursement, times 20 working days in a month, equals $1,000, or $12,000 annually. It really does add up. So keep your schedule full and reduce your no-show rate by using the ideas in this post.
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