Finances

Apply Proven Strategies to Reduce No-Shows

?By Maria Sampalis, OD

SYNOPSIS

No-shows are inevitable. Apply proven strategies to minimize no-shows and reduce their negative impact on revenues.

COMMUNICATE EFFECTIVELY. Confirm a week out, then a day out and make rescheduling easy.

DOUBLE-BOOK PATIENTS. Accommodate as many same-day requests as possible.
CHANGE ROUTINE FOR REPEAT NO-SHOWS. Let them know to just call the same day they are thinking of coming in rather than making appointments days or weeks in advance.

No-show patients can decimate your practice’s profitability. By applying proven strategies, you can lower your no-show rate and increase profitability. Each no-show patient costs my practice $80. That is the average amount my practice earns for each comprehensive examination after the patient’s insurance has been applied. Let’s say I have as little as two no-show patients per week, that means $160 per week is lost, adding up to $8, 320 annually.

Here are some ways to reduce your no-show rate. These seem to fall into two categories:

1) Essential steps that you need to perform without fail
2) Strategies that reduce your no-show rates

CALCULATE TOTAL COST OF NO-SHOWS

Not only is it a loss of revenue to lose a revenue-generating time slot at the last minute (when it is often too late to re-fill), but it takes a lot of effort to just schedule the appointment, which typically involves:

1. Answering the phone, finding the appropriate time and date
2. Verifying insurance
3. Answering questions
4. Calling to confirm

Your staff has done all that work and the patient hasn’t even come in yet.

ESSENTIAL STEPS YOU MUST DO WITHOUT FAIL

Confirm and Re-Confirm
Call and confirm with the patient one week out and then two days before the exam. If you keep getting their voicemail, try again the day before to talk to the person directly. Remember, train the staff member making these calls to always be pleasant and to kindly remind the patient that if they can’t make it, to please call the practice or leave a message. You also could confirm and ask for response via text message and/or e-mail. In today’s world, a text message or e-mail asking for confirmation may be responded to faster than a phone call.

Patient recall systems like Solutionreach and DemandForce make sending reminder e-mails, texts and even phone calls an automated activity. These systems are able to integrate with your practice management system’s appointment book and then automatically send reminder e-mails and texts to patients, and can even make automated reminder phone calls. My practice uses The Appointment Book (TAB) to automatically send reminder texts and e-mails. As an independent practice that leases space inside two Sears stores, we are provided with access to this online system for free by Sears Optical.

Have Patients Booked Two to Three Weeks Out

Have as a goal the kind of practice that is booked two to three weeks out. That way if someone cancels at the last minute or fails to show up, you can call the next patient and offer to get them in sooner, to make up for the no-show.

Another strategy to avoiding no-shows is to ask patients if they would like an earlier appointment slot if one happens to open up. My practice isn’t busy enough that this strategy makes sense for us, but in the future it may be a possibility.

STRATEGIES TO LIMIT NO-SHOWS

Charge a No-Show Fee

If you have the luxury of being very busy and booked out, you can charge patients a no-show fee. Some offices charge $25 dollars. However, before you do this, remember that you are not allowed to bill Medicare and Medicaid patients for such things as no-show fees. I don’t have a no-show fee in my practice, but other practices have successfully used it as a tool to get patients to cancel in advance rather than simply not showing up. There are different thoughts on the usefulness of no-show fees. One is not to ever charge a fee for fear of losing a patient. If you do decide to enforce a no-show fee, be sure to let patients know about this with signage at the office, in addition to a reminder when they book their appointment and again when you leave a message to confirm their appointment.

Double-Book Patients
If you are able to do so, double-book time slots. If your office is efficient you can benefit from double-booking even if everyone shows up. You can do this just by accommodating more of the surprise phone calls you may already get for same-day emergency visits or for patients who want to come in at the last minute due to an issue with their glasses or contact lenses.

Strategically Accommodate Seeing Whole Families

A lot of offices don’t like to book more than three appointments for a family, because if they don’t show then that is an hour and a half where you could have seen three or four patients. But offices need to accommodate working families and mothers. The solution: Book these appointments in 15-minute time slots instead of 30-minute slots. Most of our business is built on family referrals and loyalty, so we need to accommodate these patients despite the difficulty.

Make Rescheduling Easy; Don’t Wait for the No-Show to Call You
Call the patient that didn’t show up and remind them that they missed their appointment and ask if they would like to reschedule. If you get no response, or if the patient is not ready at that point to reschedule, call back in a week and try again.

Turn Repeat No-Shows Into Same-Day Only Patients
There usually are a handful of patients in your practice who are repeat no-shows. One way to deal with this is to politely let the patient know that since they have repeatedly failed to show up for their appointments, you are recommending that they simply give you a call the day they would like to come in for their appointment and you will do your best to accommodate them. Your receptionist might say: “Give us a call the day that you are looking for and we will try to see if we can get you in.” This kind of patient is more likely to keep an appointment made the same day than a week or more before. To make it as easy as possible for these patients, you can let them know the days and times during those days when you are less busy, when your office will have the greatest chance of working them in at the last minute.

Whatever you do (and regardless of how frustrated you may be), do your best not to discourage even repeat-no shows from visiting your office. It’s never good business to turn patients away!

Related ROB Articles and Videos

Having a Strong Recall Program

Automated Recall Drives Practice Growth

Effective Recall: Create Urgency and Make Scheduling Convenient

Maria Sampalis, OD, is the owner of Sampalis Eye Care in Warwick, RI, and North Dartmouth, Mass. To contact her: msampalis@hotmail.com

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