Missed appointments/late shows

[aec3409]

lately it seems that we've had a good amount of people either canceling their appointments within 2-3 hours of the appointment time, or failing to show all together. We currently do have a no-show fee in place but we just implemented it earlier this year and some patients have gotten sass and saying they "refuse to pay because they never got a letter about it going into place" even though there is a sign on the check in desk. *eye roll*. My question is,
1. Does your office have a no-call/no show or cancellation policy and what is it?
2. What do you do when you have patients get worked up about paying it? Do you charge it every time?

[RichR]

Yes, our office has a no-call/no show/cancellation policy. It's a 48 hour cancellation policy and a $25 late/no show charge.

Our office is diligent in enforcing this which cuts back on the pushback from patients. Everyone, no matter what, needs to be treated the same. Remaining consistent is key. Everyone has the same expectations of us and from us.

I know for a fact, when I make an appointment anywhere else, I'm told that there's a xx hour cancellation policy and that I'm expected to show up at or before my appointment time. It's fair to say that most, if not all, patients go to other practitioners and the same policies and procedures are standard. If you get pushback, it's reasonable to explain to the patient that, "hey listen, there's other people who wanted your appointment time... if you're late, it puts both the doctor and the other patients behind-it's in everyone's best interest to follow and enforce our policies"

[Mizikal]

Our office is diligent in enforcing this which cuts back on the pushback from patients. Everyone, no matter what, needs to be treated the same. Remaining consistent is key. Everyone has the same expectations of us and from us.

You have two options when you implement something like this. You can say that is okay to cancel but in the future we will charge you cancellation fee of $20.00 if they cancel with 48 hours. The problem with that is last time the canceled they didn't pay and you have to document that they used their one time freebie.

The other options is as of 09/01/2016 we will charge a $25.00 cancellation fee if you cancel within 48 hours of your appointment. I would put signs everywhere and let everyone know that when they make their appointment and do it to everybody no exceptions.

They both have merit but I like the second one. Just have to remember when you tell your patients they owe or will owe$25.00 you are firm when you say it don't apologize for the fee and don't tell them you don't want to charge them. You can sympathize with them and make sure no matter who they talk to in the office that no one is going to say they don't have to pay it this time or say they think it is a stupid rule. The fee is their to ensure people show up and if they don't you aren't losing money because of people's poor planning and time management.

[PartTimer]

Yes, you must reinforce it over the phone first, every time. If you get lots of detailed questions about the policy before they schedule, money is on them never showing up in your office. We've been known to double book these patients if it's really obvious: it has yet to bite us in a few years time.

The first time someone no call no shows, they are listed as "walk in only." If they are more than ten minutes late without a call, they basically turn into a walk in patient/least priority. We are not bashful about telling them why: other people want your appointment time: people who can make the appointment. We also let them know it costs staff and doctor time when you don't show, cascades and throws off an entire day if you show up late, etc.

Some doctors get very tentative about these policies, but if the patient can't even bother to show, what are you losing? If they show up and complain, you are getting more fees to offset the missed time slot from before, and if that patient still wants to see you, they will be more reluctant next time to skip out. These are the same type of people who want to leave work early for a "gotta make it" hair appointment or oil change.

[RichR]

These are the same type of people who want to leave work early for a "gotta make it" hair appointment or oil change.

This is an EXCELLENT point.

[obxeyeguy]

h if you're late, it puts both the doctor and the other patients behind-it's in everyone's best interest to follow and enforce our policies"

I went to an MD office once that had a sign that said if you are more then 10 minutes late, you will need to reschedule. I took this as a type of contract, and that I would be seen within that 10 minute window, not! I left. You may also want to check the legality of this, we are not the oil change place or manicure office. My understanding is its illegal to bill for any medical service NOT performed, and you surely can't bill insurance, so good luck on that.

[Mad12345]

My understanding is its illegal to bill for any medical service NOT performed, and you surely can't bill insurance, so good luck on that.

A late fee is not a medical service. Either get a credit card on file for that, or make them pay before ever seeing them again. They can choose to go somewhere else if they don't like it.

[Lelarep]

Its legal to bill, as long as you are not charging it to insurance, then its very much against the law.