You—or your front office staff—may be incredibly organized, but that doesn’t mean your patients share your appreciation for schedules. While therapists define “cancellation” many different ways, there’s no gray area with no-shows. If a patient fails to appear for a scheduled appointment and fails to notify you, it’s a no-show. And these are all-around detrimental to your practice: your business is affected in terms of both time and money; you don’t get to do the job you love; and your patients don’t get the help they need. So, how do we reduce these problematic no-shows? Here are four tips for decreasing patient no-shows:
In a Practitioner’s Journey article entitled “How to Reduce Cancellations, Reschedules and No-Shows: Our Strategy,” the first suggestion the author offers is to make a reminder call: “Appointment cards are helpful, but in the end, a phone call is your best bet.” How much of a best bet? An article on American Medical News explains that a patient is significantly more likely to keep an appointment when he or she receives a phone call reminder, according to a study from the June American Journal of Medicine.
Now, in a perfect world, you and your entire staff would have the time to personally call every one of your patients to remind them about their appointments. However, the same study explains that busy practices “frequently have a hard time fitting in these calls, which means that sometimes they don’t happen at all.” Furthermore, the same study questioned the cost-effectiveness of personal phone calls.
What’s the compromise? Automatic text, email, and call reminders. There are countless case studies showing how phone and text message reminders save thousands of labor hours, increase revenue dramatically, and decrease patient no-shows—all in addition to saving you time and guaranteeing the reminders actually get made. And depending on which service you choose, they’re easy to use and fairly customizable. With WebPT’s automated appointment reminders, for example, you simply select the method and interval best suited for each patient when you schedule his or her next appointment.
Your clinic might have a flawless scheduling system. I know with WebPT’s Scheduler, you can create some very beautiful—and optimized—calendars. However, no matter how beautiful your calendar is, you must make sure it can hold up to no-showers. In a blog post titled, “30 Ways to Reduce Patient No-Shows,” the Medical Group Management Association (MGMA) advises practices to schedule accurately to avoid long wait times for patients. Practitioner’s Journey agrees in this post: “If you want patients to respect your time, then you need to start that process by respecting theirs. Make sure you stay on time. Don’t reschedule patients. Keep regular office hours.” If patients don’t feel you value their time, they might not respect yours—which means they may miss appointments without notice.
That being said, patients must still understand that you’re busy, so book tightly. Sometimes the looser your schedule, the more reschedules you’ll encounter. Patients may figure they can get an appointment some other day—no big deal. When you effectively and efficiently schedule appointments, though, you illustrate to patients that it is indeed a big deal. But understand that running a tight ship is very different than overbooking. As Practitioner’s Journey explains, “overbooking to deal with last-minute scheduling changes is like treating symptoms instead of causes—it’s not getting to the root of the problem. In fact, just like running late, it’s probably creating more of them.” Of course, no-shows will still occur. And when they do, consider having a list of patients who are available for short-notice appointments. That way, you can contact them to fill emptied spots.
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Are your patients bailing on therapy because they’re confused about their insurance coverage—or getting angry with you because they misunderstood what insurance would actually pay? Download your free copy of The PT Patient’s Guide to Understanding Insurance today. That way, you and your staff will be well-equipped to help your patients navigate the increasingly confusing world of insurance benefits before it becomes an issue—and turns into a no-show.
As I mentioned at the beginning of this post, there are many ways in which rehab therapists define cancellation. No matter your definition, though, make sure you document your stance on it. Create a written no-show and cancellation policy, and provide it to your patients. Within this policy, consider how you want to disincentivize no-shows. Consider these suggestions from the MGMA:
- Place a nominal charge on your patient’s bill that will clear when the patient shows up for the appointment. If the patient does not show, he or she will pay the charge.
- Allow patients to prepay for their next appointment, strengthening their reason to return.
- Reward patients who show up on time by discounting their bill (just be sure those discounts don’t violate any laws or contractual obligations).
- Discharge patients who accumulate a set number of no-shows in a year.
- Charge for same-day cancellations, unless it’s an emergency.
- Conduct prize drawings for all patients who show up on time in a given month.
In addition to creating a policy (and sticking to it!), make sure patient contact information is current. Whenever a patient makes an appointment, you should not only confirm his or her contact and demographic information, but also have the patient repeat the date and time of his or her next appointment. Whether the patient is standing in front of you or communicating with you via phone, your repetition will increase the patient’s chances of remembering.
In her book Mastering Patient Flow, Elizabeth Woodcock, MBA, FACMPE, CPC, recommends practitioners build strong patient relationships to reduce the number of no-shows, because such relationships increase a patient’s commitment to the practice and treatment. As we’ve discussed in several other posts, rehab therapists must make sure patients are satisfied with their services. After all, some patients don’t show up for their appointments because they weren’t happy with their last one. Furthermore, exceptional care coincides with engagement. Get your patients excited about, and invested in, their treatment plans. Progress—and praise of said progress—will only increase their commitment. (Hint: Check out how this practice used WebPT Outcomes to better measure and communicate patient progress, thereby boosting patient satisfaction and engagement.)
Practice Management and Reporting
In this blog post, MGMA encourages practitioners to evaluate their practice management system to see if it offers any tracking of no-shows and cancellations. MGMA also advises practices to switch to an advanced scheduling system that allows for same-day appointment booking and rearranging. Lucky for you, WebPT can do both of those. Our enhanced scheduler offers you and your front office full flexibility. And through reporting, you can obtain valuable metrics on your patients.
The Lost Patient Log
As we discussed here, the Lost Patient Log is the perfect tool for identifying active patients who don’t have any future appointments on the schedule (see the column on the right in the screenshot below). That way, you can peruse the list and target patients who may be MIA.
The Productivity Report
In addition to displaying the number of patients each therapist has seen as well as the types of documents they have completed, WebPT’s productivity report provides the raw number of cancellations and no-shows. While you can’t dive deeper into that aspect of the report just yet, WebPT is preparing to launch an all-new analytics tool that will enable therapists, administrators, and owners to gain a much more thorough understanding of their patients’ attendance patterns. Stay tuned to the WebPT Blog—and your inbox—for more information about that launch, which will take place later this year.
Okay, so when we get down to brass tacks, this was actually way more than four tips. Still, I hope you found them valuable. And I want more! What’s your advice for reducing no-shows? What experiences do you have with the aforementioned tips?