With the right procedures, staff training, and monitoring, you can virtually eliminate no-shows and cancellations. I know what an ongoing problem no-shows and cancellation are in private practices. Especially since COVID hit. I’m going to give you some basics you can implement in your practice to cut your percentage of no-shows and cancellations way down.
Rescheduling Cancellations Immediately
Every cancellation should be rescheduled in the same phone call as the cancellation. Once you train your staff on this vital point, you need to have someone occasionally doing quality control checks of the front desk. Have a manager take their work to the front desk and work there a while. They can listen to whoever is answering the phone and make sure they are rescheduling every appointment possible.
That manager can then make sure that no one is ever saying, “Would you like to reschedule?” Because that is absolutely forbidden. It’s not up to the parent to make the choice of whether or not they are going to reschedule.
The correct response is, “Let’s get that appointment for (patient’s name) scheduled. I have Thursday at 2:00. Can you make that work? Or, I have Friday at 1:00. How about that? Let’s make that work.”
Your front desk staff member might be a little shy about being this direct. That’s where practice comes in. If they practice this script with another staff member, they will get accustomed to the pattern, and it will become natural for them.
Proper quality control requires that someone monitors the front desk periodically to ensure that the proper pattern has not been lost.
Anticipating Schedule Changes
Your front desk staff should be tasked with staying alert to any community events that could disrupt your appointment schedule. For example, spring break, Christmas break, or the beginning or end of the school year. One of your staff can call the school system at the beginning of the school year and get the school calendar.
In each of these transitional periods, such as when school lets out for the summer, the schedules of both parents and their children tend to go through a transformation. Those parents might be tempted to cancel or miss appointments if your staff doesn’t anticipate this possibility and deal with it ahead of time.
Instruct your staff before and during these transitions to confirm that parents and your patients will still be able to keep their appointments. This will get the parents taking that shift into consideration and more accurately predicting whether or not they can keep their child’s appointments.
It’s also effective to ask parents about any upcoming field trips where their child may be out of reach for the day. In some school systems, these field trips are more common around the end of the year. Whatever you can do to help your parents accurately predict their ability to keep their appointments helps eliminate no-shows and cancellations.
Note: Take advantage of spring and winter breaks by scheduling more appointments. You might be able to get parents who only schedule for peak hours to shift their appointments to mornings or early afternoons.
Involve the Therapist
Encourage your therapists to confirm their next appointments. This is pretty easy when they meet the parents at the end of the appointment. It becomes particularly important in those transitional periods when a conflict could come up. Get your therapists into this habit and then verify occasionally that they are actually doing it.
We can be too forgiving with cancellations because we want to help the kiddos so much. But that works against you by preventing you from helping as many kids as possible.
When a family cancels more than two appointments in an eight-week period, you can consider removing them from your regular, recurring schedule. Most of our parents value their therapists and their predictable schedule. The idea of being taken off their usual predictable appointment schedule will motivate many to straighten out their lives so they stop canceling.
If they come off their standard, recurring schedule, you can put them on a flex schedule where the parent or caregiver calls when he or she can bring the patient in. If there is an opening, schedule the patient.
Fees for Missed Appointments
Consider implementing a no-show fee policy for when the patient simply fails to show up. You have to inform the parents or caregivers of this policy in writing ahead of time. Have your parents or caregivers read this policy when they start (or as soon as you implement it) and sign that they understand.
Make your rules very clear cut. You might consider waiving a charge for the first no-show, then charge for the second, and any further no-shows. Consider some exceptions, such as illness or emergencies. These days, COVID quarantines also have to be considered. Still, the parents should reschedule for the first possible day.
There might be some legal regulations which prohibit cancellation and no-show fees. Check with your legal adviser and insurer before implementing.
For more help on filling your schedule and keeping it that way, check out our free Lemonade webinar library for pediatric private practice owners.