COMMENTS
Our policy is to charge a $25 no-show fee for second no-show and discharge a family if they have 3 no-shows within 2 years. We are not allowed to bill our Medicaid patients and unfortunately they are our biggest offenders. Our real policy is to monitor closely and discharge patients quickly who abuse our policy. We do not, however, have any charge or policy for cancelling without adequate notice and have quite a few same day cancellations which are almost as bad as no-shows.
I personally like confirmation calls when I receive them from my own health care providers. We confirm appointments by phone now but are considering automated and via text message. Sorry for the ramble -- we have had 40+ no-shows for well-care appointments this week -- it's my current hot button!
We, like most of the practices commenting, charge for missed appoinments only after two occurances and warnings (ours are in writing). We Charge $25.00 and the charge is required to be paid at or before the next scheduled appointment.
We also make reminder calls the day before the appointment, where the patient is reminded of any out of pocket expenses as well as their appointment date and time. Therefore, I feel there is no excuse for recurring offences. If they do not pay they do not have another appointment. Most patients get it. If they really want or need the treatment they adhere to the policy or pay the penalty. The ones who don't think it's necessary to pay are typically those who are repeat offenders and we don't generally want them as ongoing patients.
Clearly this is a subject that warrants differences of opinion, but it appears that most practices charge a no show fee or at least would prefer to do so.
If you take a moment to consider the practice as being your personal business, how would you feel about someone no showing and not calling to reschedule?
The fact that it is a medical practice does not change the outcome of an appointment missed.
Having a policy in place and educating your patients on the policy will be rewarding to your practice.
Additionally, respecting a patient's time is of equal importance.
Rebecca Morehead
http://www.practicemanagersolutions.com
We have been charging $25 for no shows as the patient is informed in our "welcome to our office" letter. As for Medi-cal patients, their new patient letter is different. It states that they will not be allowed to reschedule if they no show, they get one opportunity to be seen. Both seem to be successful. We also limit Medi-cal pt's to one per wk.
We have an automated system to remind patients of appointments. I plan to explore opportunites to also text them as reminders.
I run a PT practice in California and no shows are a big concerne. We do the following to help:
1) We have a PRINTED list of future appointment that fits on a standard label which is placed on the back of our business card. No handwriting issues to deal with. I can fit up to 20 visits per card.
2) Our front office staff is instructed to have the patient REPEAT to us when their next appointment is as they leave.
3) Our NoShow fee went up from $45 to $75. We waive the first one but enforce all others. Some physicians have a $300 charge! I'll bet they don't have no-shows.
4) We use an automated reminder call the night before as a courtesy to the patient and state the no-show policy in the message. These calls are cheap and very effective use someone like
www.remindercall.net for best results as they record all outbound calls to prove the message was delivered.
I disagree with those who feel it is insulting for the patient or puts more weight on the caregiver's time than the patient. We instituted our no-show fee of $50 because our physician is booked out 6-9 months in advance for wellness visits. We give 48 hour reminders and a 24 hour grace period. If someone cancels, we can move another patient up to be seen sooner. We did it mostly for other patients, not to collect fees.
As a patient the reminder call works best for. I missed my appointment and was told of the no show fees for the first. I was resched w/o penalty. However, it shld work both ways if a dr keeps his patient waiting more then 1hr or no show for whatever reason - The dr. shld be charged a late and no show fees as well.
Obviously, Bobby Scott has a skewed view. The patient has reserved a block of my work day and I wait for them so that I can provide the service they requested. If they choose to waste that time, I still have reserved that time for them and have not given it to others who would've used that time. Thus, they should incur a charge. Do you believe that a plumber, who you call to fix your plmbing, would not charge you for a visit if you were not home at the appointed time when he arrives at your house? You would receive a charge for the house call, but not for the service itself. I believe that it is no different with physicians. I continue to incur overhead costs, even when the patient does not show up for his/her appt. I believe that the patient should, in most cases, be liable for those costs. Finally, Mr. Steele, my dentist charges for no-shows and I simply show up for my appointments rather than finding another dentist (and there are plenty around) because I respect his time.
I am a new manager at a rural health clinic, & I think the clinic itself has created its own problems. I am currently dealing with the issue of missed appointments. On one morning 3 providers had 17 no shows or last minute cancelations, this is after a person has called the previous day with a reminder. The trend seems to be mostly medicaid/self pay patients, but that is a larger patient base for us than most clinics. For this reason we have just started sending out letters to inform patients of their missed appointments & 2 more will result in dismissal. There is no difference between a call 15 minutes before or just a no show as I can not fill that spot. Our patients are used to getting appointments within 3 days, so there seems to be "no big deal" to miss, they can call & get worked in later that week. The problem is these work in appoinments seem to get slotted into the middle of a regular schedule & are seen in order of arrival & not as & when the provider gets a gap in appointments. Patients call for prescription refills and if it is not at the pharmacy within a few hours they call back. On one occaision a patient called at 11am & had called 4 times (to my knowledge) by 2pm. As a new person in the office, it seems to me that more time is spent running after a small percentage of demanding patients than the entire practice population. It is only fair to other patients, providers and staff to start setting reasonable limits. Suprisingly I am having the hardest time getting the staff to appreciate the limits are there for everyone's benefit. Also the old Practice Management System is not helpful. We will have a new system soon that should allow for a degree of reorganization. I am glad I have found this website as I know there are many other hills to climb before we have a smoother operation & less stress on staff and patients.