This question is for anyone that works with/for a doctor.
Is there a limit to how many times you'll let a patient reschedule, or not show up then call you to reschedule?? I'm not talking about rescheduling a week before the apointment but with same day notice.
Thank you in advance for your opinions.
same as the shoplifters thread...
shotgun
AA
My dentist and personal physician both bill if less than 24 hours notice.
We have discussed billing for no shows, but since we "pre-appoint" people as part of our recall system, we thought this might hurt more than help.
We generally have a 3 strikes rule. After that, we will inform you that if you miss or cancel without notice again, we will gladly transfer your records to another doctor of your choice.
Cassandra
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
On my prosthetic eye patient's I also refuse to ever schedule a future appointment at any price if they no~Show a cumulative three times.
Haven't quite got to the point that I do this on optical and contact lens patients yet. And with the contact lens patient's I can't decide whether recurrent drop~ins bug me more or no~shows bug me more.
Don't you just love it when a patient comes in "to buy a bottle of solution" and "as long as I'm here, I think I'll let you check my contact lenses."
Chip
After the third No Show, we tell the patient we're happy to see them on a walk-in basis only, but that we can't put them on the schedule.
Originally Posted by LanceM
same at my office
After three no-shows, we will still make appointments for them, but we double-book appointment slots for the "frequent no-show" patients, just in case.
We actually had one patient who did not show up for an initial contact lens fitting EIGHT times. She then had the audacity to show up at 11:58 one Friday morning (we close for lunch at 12:00) DEMANDING to be seen immediately. When we explained that we did not have an opening that day at all, she wanted to make another appointment!!! She insisted that the appointment be on a Monday afternoon- despite the fact that our office hours (posted on our door, as well as on a sign at eye level just beside the check-in window) clearly state that we are CLOSED ON MONDAYS.
After explaining YET AGAIN that extra "training" time must be scheduled for a person who is not familiar with the application and general care of contact lenses; and explaining that we are NOT opened on Mondays, her response was, "Whatever. I'm coming in on Monday afternoon at 3:00." And, even though I know it was utterly unprofessional, I told her we'd see her on Monday afternoon.
Though I doubt she bothered to show up for the appointment, I like to imagine that she did................
Make a policy and stick to it. All my various health care providers say that I need to notify them 24 hour in advance if I need to cancel. If I fail to show, I am responsible for the full charge or whatever their fee is. Currently, we do not do this as a eye care practice but think we should for repeat offenders.
I don't like the idea of telling a chronic no-show to walk in. Too disruptive and encourages the wrong behavior. I'm not into a power trip to make them wait.
For us, we tell the patient to call on a day they think they can make it and we will tell them what opening/cancellations we have. I like to encourage the call thing, did I say I don't like walk-ins?
Harry
I'm with LanceM and Timmy. We make it very clear though when a patient makes the third appointment, not after they miss it. If they miss the third appointment, we will only see them on a walk-in basis if time permits. If we're fully booked, they'll have to try again another day.
Thank you all for your replys, our policy is similar you get three strikes then call in the morning for the day you can come in. we have a new employee who disagreed I wanted her to see that our time is valuable and it costs us more to keep rescheduling and wasting slots than it does to lose the patient.
This one might be a little (but only a little) extreme
Another way of dealing with potential no-shows is to double-book with the anticipation that the patient isn't going to show;no loss of income;if the no show shows;they will have to wait and you can fit them in and if they don't like it and leave because of the wait,its not a loss anyway. It's too bad that sometimes you have to be creative with handling these kind of patients but if not they will walk all over your good intentions.
It's not really an issue at our office either, but the couple times that I can remember the patient had no-showed 4 times and I told her that she would have to call on the same day to make an appointment. She understaod. We don't charge for no-shows either, although I can understand why some offices do it, I just don't feel it's right.
I agree that we should charge.
Hi Bev,
Do you charge for contact lens fittings on a package price basis or hourly basis. It is harder to know what to charge (when they no show) when we have a package price on the fitting of contacts. What do you recommend?
Sam Johnson
Texas
Sam,
Normally, we charge a sliding scale depending on the involvement for fitting. Base is $100 plus lenses. Toric $150 + box of lenses. Bifocals/others vary such as $150 to $200 plus lenses. This includes standard 2 follow up appointments, training plus lens price. Exam fee is seperate. I would recommend a $40 no show fee if a patient fails to notify you 24 hours in advance. I would also put it in writing in a policy form.
Hope all is well in Texas!
Bev,
Most of the offices I've worked in refuse to either 1-see the patient if they no show 3x's or 2-tell them they can not take up their evening appts or 3-Walk-in only. Now that the weather is getting nicer more and more people N/S their appointments and feel nothing to call the office a couple days later and say, "I'm sorry, I missed my appointment! That burns me because what if the Dr. decided it was a nice day and he wanted to go play golf and send the rest of the staff home and no one called the patients to reschedule? They would look for another Dr. It really gets me when we call to confirm and they say, "We'll be there"!:angry:
Golden rule 3, make it and stick to it. I could tell you who most of those patients are that aren't showing up but I might get into trouble.
we use the 3 strike rule here and if they want to book a 4time we tell that our schedule is full for six month and to call us one month before to book that appointment
Go ahead say it. the anonimity of the internet is wonderful. Medicade
One of the ways to decrease no shows is to call everyone the day before and remind them of their appointment. Since I see more than 42 patients a day this can occupy one of my staff for up to 2 hours. Recently I've been toying with getting a computerized system that makes the calls for us in the evening. It's really quite sophisticated: the machine can address the patient by the first name (has thousands of first names in its database) and reminds him/her of the appointment. The patient can "press 1" to confirm the appointment, "2" to cancel the appointment, "3" to reschedule etc. You can even have the machine connect to a live operator (it it's during your work day). Every morning when the staff come in to work they can be presented with the report of all the patients who were called and which ones confirmed. It can also be programed to call cell phones or work phones if the first number didn't work. It can also send an email. I have a feeling that this may be the way to go to decrease or eliminate noshows. It can also be used in place of the annual cards that are usually sent out.
Ilanh:
Nothing annoys patient's more than to be called by a machine, unless it's being put on hold before they and thier problem (or desires) are recognised and forced to listen to the doctor's commercials.
Chip
Chip,
I'm not sure I agree with you. It's true that being called by a machine is agonizingly annoying if it's a self-promotional, advertising or political kind of message. However, a message in the doctor's voice that says " Hello Pam, this is doctor Smith calling to remind you of your appointment at the Smith Eye Center tomorrow at 4PM" would be considered a welcome reminder and a much appreciated service. Personally, I know that I am very appreciative when I receive calls of this nature from Sears repair service (to remind me of a service call) or from my public library (overdue books). Furthermore, we send cards out to all our patients who have not been seen by us for over a year. The vast majority of the responses I have received from patients is that this is a much appreciated service ie: "I completely forgot about my diabetic retina check until I got your card...".
I don't think anyone would think a _personal_ phone call to remind of appointments, or sending a postcard/letter is a bad idea. What our practice likes to pride ourselves on, is the personal touch. So you will get a phonecall from a real person. We reserve a time for you (pre-appoint) and will gladly reschedule if it doesn't work..We hand write thank you's for referrals, sympathy/getwell cards etc..
By being personal, you establish the relationships that will keep people coming back to the practice year after year.
Cassandra
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
I do all the calls myself, but also see the advantage of a computerized system and I'm not offended at all when some of my personal dr's call me using this system. If it frees your workers, I'm all for it because it does take a lot of time.
This is primarily for practices that have to call large numbers of patients every day. If you have under 30-40 patients to call on a daily basis it may make more sense to allocate a staff member to do it.
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