One of the most common problems doctors want help with is dealing with canceled or rescheduled appointments. If a doctor’s office has too much of this occurring it can wreak havoc on their daily production. Normally, when this is occurring it is a sign that the receptionist is not properly trained in scheduling appointments, managing the appointment book, or handling cancelations and rescheduling.
When you are getting a high volume of cancelations, you should ask yourself these questions:
- Does your receptionist immediately reschedule a canceled patient/client?
- Does your receptionist ask the patient/client to put the appointment in their calendar, phone, or day planner so they won’t forget?
- Do you keep a record of the reasons behind cancelations for future reference and to implement any needed corrections?
- Do you have any sort of policy regarding cancelations that is part of the “welcome to the practice” information given to patients/clients?
- If you have such policy, do you enforce it?
Here are some other questions you should ask yourself as regards appointment no-shows:
- What actions do you take when someone doesn’t show up for an appointment?
- Do you call the patient/client after a certain length of time, e.g., 10-15 minutes?
- Do you have any sort of policy regarding no-shows that is part of the “welcome to the practice” information given to patients/clients?
- If you have such policy, do you show it to no-show patients/clients the next time they come into the practice?
The doctors we deal with are all asked these simple questions, and many more, when they are dealing with cancelations, no-shows, and reschedules. We recommend that you closely evaluate the management systems and training that you have in place with the staff members involved; then, fix or implement the proper procedures to reduce the number of patients/clients lost. This normally leads to increased production without any increase in marketing or staff expense, which, of course, leads to greater efficiency and net income in a practice.
You need to put a system and policy in place to discourage your clients or patients from unnecessarily canceling appointments. First, you should have a company policy that is given to your clients/patients as part of their “Welcome to the Practice” handout, letting them know what is considered a no-show—usually less than 24 hours’ notice—and what happens when a no-show occurs. It is important to make sure that your clients/patients are aware of this policy before enforcing it, or you might create an upset.
Clients or patients who wish to cancel an appointment on short notice or who fail to come to a confirmed appointment need to be gently challenged on missing that appointment. An attempt should be made to get them to keep the appointment if at all possible, and if that doesn’t work, they should be notified of the $25.00 fee to be collected at or prior to the next visit. If the client or patient still wishes to cancel, he or she is to be rescheduled. The fee should only apply if the client/patient has already been given his/her “first-offense warning.” The idea behind the fee is NOT to anger the person or make the person wrong but to inform him or her that you are serious about the importance of appointments being kept and completing a course of treatment on time.
The script would be something like this: “You can’t keep your appointment? Oh dear! The doctor has this time set aside especially for you. Is there anything you can do to make it?” If that doesn’t work, move into the missed-appointment-fee handling.
- For the first offense, the office policy is to waive the fee. The client/patient should be notified of this, and it must be documented in the chart by the receptionist. The ideal way to approach the individual is by saying, “Mr. Jones, it is our office policy to charge $25.00 for late cancellations or missed appointments; but since this is your first offense, we will waive the fee. Now, let’s get you rescheduled. . . .” This message should be practiced so as to be said all at once and in one breath. The entire message should be delivered before the person can interrupt. This part is very important. You should have the client/patient chart in front of you so that you can be accurate in telling the person of his first offense and the waiving of the fee. If you do not have the client/patient chart in front of you, treat the person as if this were the first offense and note it in the chart.
- For the second offense, a client or patient will be called by the OM because a second failure may mean that the person is upset or unclear about something in the treatment. Please give the chart to the OM so the client/patient can be called that day. This must be documented in the chart.
- For the third offense, the client/patient will be sent a letter that will require a $25.00 payment for missing the appointment, plus a $25.00 payment to be held as credit for the next appointment, for a total of $50.00. This must be documented in the chart.