In our most recent webinar, Dee Bills, Founder at Front Office GURU, and Heather Blackwell, Senior Manager of Member Marketing at WebPT, walked viewers through the front office issues that are creating stress, burnout, denied claims, and empty spots on the schedule. (If you missed it live, you can still watch the recording.) We had a ton of great questions and not enough time to get through them all, so we’ve collected the remaining ones here.

Cancellations & No-Shows

How do we handle patients who frequently cancel appointments due to health issues and feeling unwell? Alternatively, how do you work with a patient who cancels with sufficient notice, keeps rescheduling, but has not attended since their evaluation?

The challenge of being a rehab therapist—or any medical provider—is that you’re working with people who are struggling with their health, to one degree or another. For patients who frequently reschedule due to health concerns, you may want to have a conversation to try to understand how you can better meet their needs. Are virtual visits a viable option? Should you consider referring them to an in-home provider if they can’t regularly make it into the clinic? Or, in the interest of helping everyone that you can, do you simply live with the cancellations and have your waitlist ready to go whenever that occurs? The right answer might be one you arrive at with the patient.

As far as a patient who has been a no-show since their eval, they might need a reminder of how important treatment is for getting back to full health—and if the reminder doesn’t stick, it might behoove you to stop putting them on the books until they demonstrate that they’re willing to commit to a plan of care.    

What is the legality of charging late fees in the medical field, and also for Medicare, Medicaid, and Workers' Comp? Is it true that if you accept Workers’ Comp, you can't charge a cancellation/no-show fee to any patient with any insurance?

Medicare’s policy on late fees is fairly straightforward: you can charge patients a cancellation or no-show fee, but that fee is paid by the patient and not billed to Medicare. Also, whatever fee you have in place has to be applied to both Medicare and non-Medicare patients equally. Medicaid and Workers’ Comp are more complicated, so I consulted our resident compliance expert, John Wallace. Because Medicaid and Workers’ Comp rules are state-specific, Wallace recommends that you consult with your state’s APTA policy person for specific guidance for your locale.   

How do you handle negative online reviews when charging a late cancellation/no-show fee?

As with any negative review, we always recommend that you read the comment, try to understand the reviewer’s perspective, and then respond calmly and respectfully. In this case, you can offer a polite summation of why the cancellation/no-show fee exists: because empty slots on your calendar equal money out of your practice’s pocket. If you explain that the policy is only meant to encourage attendance (or at least discourage last-minute cancellations) while guarding against financial loss, that’s something most patients should be able to understand.     

How should we handle patients who we charge a no-show fee after the second occurrence, but then question us when we have to cancel an appointment due to a therapist being sick?

It’s understandable that patients might feel aggrieved about having their appointment moved because of illness on the part of a therapist, especially if they’ve had to pay a fee for cancelling themselves. As mentioned above, the purpose of the late cancellation fee is to avoid a situation where your providers aren't treating patients and thus aren’t bringing in revenue, and worse, denying waitlisted patients the opportunity to get in for care. Having a therapist call in sick is undoubtedly an inconvenience for patients, but it’s also a reality of life.      

Scheduling

What texting app, if any, do you use to help make sending appointment reminders easier?

Of course, we’d recommend that you use WebPT Online Scheduling for automated text, email, and phone reminders for upcoming appointments.

What if we do not have another opening to reschedule? They are willing to reschedule, but all of our therapists' schedules are full. How do we enforce our attendance policy for missed or canceled visits?

If there are no open slots to reschedule a patient, it might make sense to waive any fees related to missed or cancelled appointments. Better yet, it would probably be a good idea to have it in your policy that in cases where there are no available appointments, patients would nto be obligated to pay a cancellation fee.  

Clinical Care

How are the practice managers enforcing clinicians to set realistic plans of care rather than the default 2x week for 3 months?

Like much of what was discussed during our webinar, training, reinforcement, and review are critical to getting your team to adopt new behaviors.Practice managers can set the expectation that clinicians shouldn’t prescribe cookie-cutter plans of care, but they have to sit down and review what clinicians are actually doing, and possibly have conversations to make clear that they need to follow your guidelines.   

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If you missed our live webinar where we answered even more questions and discussed how practices can look to solve their front office problems, be sure to watch the recording.