No Shows & patients who come in late

[mwest]

This is a question for practicing doctors. I am wondering how do you handle "no shows" and patients who come in really late?
Do you anticipate some "no shows" and overbook in advance. How do you manage to be on time?

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[deleted87716]

I do not overbook or play other scheduling games. I consider my patients' time to be as valuable as my own, and strive to stay on schedule (although this isn't always possible). However, an open appointment slot is lost revenue.

Consequently, I expect people to keep their appointments or cancel with at least 24 hours' notice to allow another patient to have their appointment slot.

Our cancellation policy is posted in the lobby, and is part of the financial agreement that patients sign when they become patients of our practice. Patients also receive an automated phone call two days prior to a previously-scheduled appointment reminding them of their appointment and allowing them to cancel if needed.

The first no-show is usually excused, although we do make a point of re-explaining our policy to those folks.

We typically charge a no-show fee after that. The fee is $25, roughly the cost of a co-payment. It's intended as a deterrent, not to replace the lost revenue from the missed appointment. Patients who repeatedly fail to keep appointments may be dismissed from the practice.

Patients who arrive more than 15 minutes late for their appointments are typically asked to re-schedule. This is generally left to the discretion of the doctor, however...if we have time to see them without getting behind, we usually will. Likewise, if the appointment is for something that can't wait, we'll try to be accommodating. Again, a missed (or rescheduled) appointment is lost revenue.

In either case, we don't penalize people for genuinely unavoidable circumstances.

 

[lowbudget]

Our group has an open access model, where we strategically block off slots to accommodate same-day appointments or walk-ins. Schedulers are not allowed to schedule into that slot until the day of. Patients are more likely to honor appointments they make on the same day.

We have EMR and have a patient's web portal where patients can make/cancel their own appointments online. Giving patients more control cuts down.

We invested in an automated appointment-reminder system. I don't know what the stats are, but I've noticed less no shows on my schedule.

Late patients continue to be a problem in our practice. I don't remember what our policy is... because I don't think we have one. I think we've been accepting all late comers. We have appointments at X:00, X:15, X:30, X:45 and so if a patient comes in at X:22, they are technically not late for their X:15 appointment (or X:15 walk-in slot). Crazy. But as a doctor (I'm employed and thus have no control), I will tell my nurses to bump their late ass to the end and I will see them when I get to them.

Funny thing is my patients have been tolerant in the last couple of months. Must be the swine flu. My clinic's been slammed and people will wait in the waiting room. Either, they are understanding because of all the media hype... or they're just too damn sick to complain.

 

[GoodmanBrown]

We have EMR and have a patient's web portal where patients can make/cancel their own appointments online. Giving patients more control cuts down.

We invested in an automated appointment-reminder system. I don't know what the stats are, but I've noticed less no shows on my schedule.

Resurrecting an old thread here, but two questions:

1) Are all self-scheduled appointments 15 minutes long? If the person registers for an annual physical, do they get 30 minute block?

2) Can people cancel automatically with the appointment-reminder system, or do they have to call the office back? If they cancel over the phone, does that register immediately with the computer, or does a scheduler have to manually cancel the appt.? Thanks!

 

[deleted87716]

Most web-based scheduling portals give the office a lot of control over the scheduling process. Typically, patients select from a short list of appointment types with pre-defined lengths, and can't schedule more than one appointment on any given day. They can usually cancel their appointment online, as well, but the practice can enforce any late-cancellation policy.