Patients who "no show" for appointments

[Pete Hanlin]

Hate to add another "burning face" to the growing number of posts with that designation. However, an ongoing problem that is really aggravating concerns patients who schedule appointments and then fail to show up for them.

Naturally, schedules do and will change, but isn't a person obligated to call their doctor's office to inform them that they cannot keep their appointment? We have gotten into the habit of charging the patient a fee if they neither cancel nor keep their appointment. Does anyone else out there have a similar policy? If so, how do you inform patients of the fee, and how much do you charge?

We inform them at the time they miss their first appointment, and we charge $45 for further missed appointments. As you can guess, this is not always popular with our negligent patients.

Thanks,
Pete

[peyes]

Pete, we have the same problem and it's a problem without an easy answer. What do you do if the patient refuses to pay the cancellation fee? Is there any legal recourse? Heck I have a hard time getting patients to pay "legitimate" bills. With a cancellation fee or no show fee do you run the risk of actually losing that patient and is it worth it? On the other hand there are times when no shows are good. Just last Thursday morning we had two cancellations and two no shows but had eight walk-ins at their times. The Doctor (MD/GP) next to us "fires" patients after two no shows! Advises them to find a new Doctor.

[EyeManFla]

We charge a no-show fee on contact lens follow-ups. They are not happy about it, but they pay.
If it is a first time no-show, we remind them that they are taking up time for another patient and if they do it again, they will be charged a no-show fee.
If they no-show more than that, we drop them.

[EyeCon]

Like most Optometrists our OD takes a pretty dim view of " no-shows " especially when it involves a CL follow-up!...If a patient doesn't show up at our office we don't call and remind them of their rudeness or of consequential fees!...but if and when they do arrive for a rescheduled visit we tell them they're being charged $25.00 ( which is the ODs fee for " Limited Service " ) for the missed appointment...they pay out of guilt or embarrassment...but they pay. It may appear slightly devious but hey! sombody once coined the phrase, " Time is money ".

[iglsldy]

We have a "3" strikes and you are out policy. Our biggest "no-show" problem is with Medicaid patients. The Doctor has devised a plan of only seeing Medicaid patients in the mornings, therefore not taking up our prime slots in the afternoons.

[chip anderson]

Don't think my contact and spectacle patients will put up with a no show charge. I have however, posted a sign in my artificial eye department (these people are almost all third party pay and notorious about not keeping appointments). As this work is extremely time consuming and I have had patients who have wasted up to 40 hours of my time in no shows, then called up and wanted their eye with a lame excuse: My baby was sick. My car broke down. The sign says: "This is not school where if you have an excuse it's O.K. If you miss an appointment or are more than 15 minutes late, there will be a $25 charge which you, not some third party must pay."

But lets face it CL patients and spectacle adjustments seldom take more than 15 min. Where the artificial eye appointments are usually for a couple hours.

[This message has been edited by chip anderson (edited 10-31-2000).]

[PAkev]

I talked to an OD the other day who implemented a crafty new policy.

If a person has a history of missing an appointment without giving reasonable notice. He reschedules when they provide their major credit card number with agreement that they will be charged if they don't show up or give a 24hr notice.

Result: They don't show again, he charges their credit card and goes out to lunch on the patient.

Kevin

[Maria]

Is that not illegal?
Sounds good though. If I had a new dress for every patient that didn't turn up....

[PAkev]

Maria,

It is no more illegal than giving your credit card to reserve a hotel room. You don't check in, you still get charged.

As long as there is verbal context exchanged that the customer will be charged if they don't show, it is legal. They are paying for a professionals time which was made available to them.

[hcjilson]

One effective technique is to reschedule the appointment-then keep the miscreant waiting for an hour or so.It sends a subtle message and can be explained away by saying that you were trying to fit the rescheduled appoinment in along with others who had priority.From the Cape with best wishes.

------------------
Harry J

[Suzy W]

Thanks for the idea about the credit card when rescheduling.... I'll have to run it by the OD I work for. It is amazing how many don't show up. It's nice to hear about everyone else's solutions to this.

Suzy

[Tom Bowman]

Yes indeed, no-shows are a problem...BUT, there are ways to keep them down to a minimum and keep the patient happy as well.

Charging the patient a no-show fee (making us look like 'money-mongers') or making them wait an extra hour on their next visit doesn't send out a very good message at all. Especially if we want that patient to keep returning year after year (which is our primary goal). Didn't our parents teach us that "two wrongs don't make a right"?

Some good strategies are:
* Explain to the patient over the phone an idea of the different types of tests that they will receive. This will make the patient feel special, important and build up a sense of excitement. In other words, you won't sound just like every other unimportant optical 'Joe' in the industry.
* When making the appointment, never say things like "The Doctor can see you any time on Tuesday...we're wide open". Somehow we need to get across to the patient that "The Doctor is very busy, but we CAN see you at either 10:00 in the morning or 3:00 in the afternoon". Don't make it too easy for them to see the Doctor. Make it sound more like making reservations at the finest restaurant in town.
* Call the patient the day ahead of their appointment to remind them of their "Eye Health Evaluation". I would much rather show up for an Eye Health Evaluation that a routine exam.
* Ask the patient while on the phone if they are aware of where your office is located. Many no-shows are due to the patient assuming they know where you are located, then driving around for a half hour and finally being too embarrassed to actually come in or call you back. Give them land-marks for reference points.
* Ask the patient if they can arrive 10 minutes ahead of the appointment time to fill out "medical information" (not "paperwork"). This will help keep the practice more on schedule and believe it or not, some patients actually feel that if they are even 10 minutes late, that they have messed up your schedule and will just not show up. This gives them a 10 minute buffer.
* Keep in mind that most all busy offices will still experience a 5-8% no show rate no matter what strategy they use.

I hope this helps.

Tom Bowman
Williams Consulting Group