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Empty beds and patient no-shows are bad for medical practice business.

We recently opened up a can of worms blogged about patient no-shows, and whether medical practices should charge for them or not. Regardless of your philosophy, there's one thing we can all agree on – no-shows are not good for business!

Here are ideas from MGMA resources and the healthcare industry to reduce patient no-shows – and yes, some do include charging.

  1. Track the reasons each patient gives for a no-show. Trends in excuses can help point to solutions. For example, are they covered by a certain insurance carrier, seen by the same physician or on a certain day of the week?

  2. Call your patients to reschedule their missed appointments. In this economy, you can't afford to wait for patients to call you back.

  3. Set automated reminder phone calls the day before an appointment.

  4. Or, even better, have staff make routine reminder calls the day before an appointment. Research from the American Journal of Medicine shows this is more effective than automated phone systems – but certainly more time consuming.

  5. Send postcards/mailers a few weeks in advance to remind patients of their appointments.

  6. Develop a call list of patients who are able to come in for short-notice appointments. When a no-show happens, these patients may be able to fill the empty spot.

  7. Allow patients to prepay for their next appointment, giving them an incentive to return.

  8. Send "Sorry we missed you!" appointment letters (with or without fees) to patients.

  9. Place a nominal charge on your patient's bill that will clear when the patient shows up for the appointment. If they do not show, the patient will pay the charge.

  10. Reward patients who show up on time with discounts on their bill.

  11. Limit appointments per patient to one per week.

  12. Explore ways to text appointment reminders to interested patients. Kaiser Permanente recently implemented SMS and its pilot program showed a .73 percent improvement in no-shows, saving $150 per appointment.

  13. Provide the option to send your patients an e-mail appointment reminder.

  14. Update/confirm contact information when a patient makes an appointment. This will help you track down patients who don't show.

  15. Print future appointments on a business card to give to the patient before they leave your office. "I couldn't read the handwriting" excuses won't fly with this method.

  16. Have patients repeat the date and time of their next appointments, whether they're in your office or on the phone.

  17. Discharge patients who accumulate a set amount (your choice) of no-shows in a year.

  18. Charge for same-day cancellations (which can be just as bad as no-shows), unless it's an emergency.

  19. For patients who use public transportation, remind them to schedule their appointment according to the transportation schedule.

  20. Schedule repeat offenders during a time that has less of an effect to the overall schedule.

  21. Consider overbooking when appropriate. Overbooking doesn't have to mean double booking. It could be shortening time between visits or adding more visits to a certain time of day. But beware – longer wait times and lack of understanding about scheduling can leave patients feeling disrespected, according to an Annals of Family Medicine research article.

  22. Always thank patients who cancel and reschedule well in advance of your no-show policy. A little goodwill can go a long way.

  23. Schedule accurately so patients don't have long wait times, which may lead them to believe that the practice doesn't value their time, convincing them to not value yours.

  24. Compare the number of patients handled by each of your doctors and their clinical staff.  Consider reassigning the load so patients are evenly distributed and seen by the provider they visit with the most.

  25. Evaluate your practice management system to see if it can supplement or automate any tracking or patient reminder tools you're currently using.

  26. Hold a gift card drawing for all patients who show up on time in a given month.

  27. Clearly explain, and have new patients sign, a written no-show policy.

  28. Elizabeth Woodcock, MBA, FACMPE, CPC, in the book Mastering Patient Flow, offers the following suggestions to reduce the number of no-shows:

  29. Develop strong relationships with patients to increase their commitment to your practice. Suggestions include sending birthday or holiday cards and assigning nurses to specific patients to work and follow up with.
  30. Schedule appointments within a reasonable time of the patient's call. The longer the lapse, the greater the chance of a no-show.
  31. Switch to open or advanced access scheduling to provide appointments the same day a patient is looking for an appointment.

Did we miss any? Add them to the comments.  


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