Know your patients. The responses to no-shows from a practice that largely sees people with their own transportation may be very different from one whose patients get there using one (or more) buses. This will also have an impact on communications. Can you use text messaging or phone calls, or is regular mail the only way to consistently make contact?
Ways to Cut Missed Appointments
One of the best ways to cut down on missed appointments, according to the experts, is to send out reminders. Ms. Boling’s group calls patients 48 hours before they are scheduled. Due to the long wait times, they also send a new patient letter two weeks or so in advance.
“On those rare occasions when our phone system goes down, I can tell the difference,” she says. “Our patients rely on that phone call. I would estimate a doubling of the no-show rate if we don’t call them.”
The most efficient way to contact patients should be tracked. Work to match the preferred method of communication to the patient. Some may like calls, others text, email or your patient portal. When possible, give patients an opportunity to confirm or cancel an appointment easily. If they cancel, make sure your system notifies someone to reset the appointment.
Fees for Missed Appointments
Fees for missed appointments are controversial. Dr. Grunbaum has seen them be useful and has seen little negative feedback by using common sense. Although the MGMA doesn’t have an official stand on the issue, Mr. Gans thinks all they do is “tick people off.”
Some practices charge the entire reimbursable amount. Most put the fee at $25–50. This is enough to get a patient’s attention, but not enough that patients feel they are being punished. This amount often coincides with the patient’s copay.
“For me this is the fee that works,” says Dr. Grunbaum. “It eliminated 95% of my missed appointments, and although each practice is different, the goal needs to be reducing no-shows.”
Some practices waive the fee for the first missed appointment. The patient is reminded of the fee and told it will be imposed the next time. Collection of the fee varies, with some sending out a bill and others relying on payment at the next visit.
‘Since Monday & Tuesday mornings have the most missed appointments, these are the days we are considering overbooking,’ says Ms. Boling.
Overbooking
Overbooking is another possible response. This means an additional appointment is made available on the schedule. It also means the practice walks a tightrope. Add too many slots, and the providers run even further behind. Add too few, and you are still losing revenue.
