Every practice experiences no-shows and cancellations. How should you handle them?
Posted in Risk Management on Tuesday, March 18, 2025
No-shows and cancellations are the bane of health care practices. They wreak havoc on schedules and productivity and can cost your office an astronomical amount. Think about how smoothly the day goes when all scheduled appointments are kept versus a day with several missed appointments.
Most no-shows and cancellations are the result of one of the following:
- Busy lives. Many people’s schedules have become so packed, it’s easy to forget an appointment.
- Financial worries. Some patients may feel they cannot afford the upcoming appointment.
- Vindictive behavior. Perhaps the patient wasn’t happy with their last appointment.
No matter the reason, it’s better to tackle the problem head-on. After all, missed appointments affect office staff, the patient who didn’t show up, and other patients.
Helpful Strategies
You probably won’t be able to eliminate no-shows and cancellations entirely, but it may be possible to minimize them with the following simple tips.
- Encourage patients to choose their appointments on days and times that work best for them.
- Send reminders to your patients, using whichever method is most convenient for them. Options include texts, automated voice messages, personal calls from staff, and emails. Don’t hesitate to offer more than one method to patients.
- Consider the timing of your reminders. If you only send one reminder and it goes out too far ahead of time, you’re setting yourself up for a no-show. It’s okay to send one well in advance of the appointment if another reminder is sent closer to the actual day.
- Patients may be more likely to miss their appointment if they had to wait too long in the past. When your practice is running behind schedule, inform the patient as soon as possible. Depending on the situation, you may choose to offer the opportunity to reschedule. They may choose not to, especially if they took time off work for the visit, but they will appreciate you giving them the option.
- If you know or suspect that a cancellation or no-show is financially driven, discuss various payment options. The patient may be relieved to hear that you are willing to work with them, but likely didn’t know how to approach it.
When It Happens
You’ll always have some patients who continue to cancel or not show up. For these patients, you can try a special set of strategies.
- First of all, make sure the patient understands that first and foremost, you are concerned about their overall health. Express your concern and the importance of follow-up, especially if the visit is part of an ongoing monitoring or urgent situation.
- Each time an appointment is missed or canceled without an explanation, reach out to determine the reason. Offer to reschedule the visit.
- Explain the importance of calling you if they are running late or need to reschedule or cancel the next appointment. They may not realize how their unexplained absence affects other patients who need your attention.
- Make sure they have your phone number readily available and properly labeled in their phone.
- Ask if there is something you can do to help them remember the appointment. Do they need you to change the method or frequency of contact?
- Document all your efforts to reschedule.
- Periodically audit your no-shows and cancellations to see if there is a pattern. Are there more on a certain day of the week or time of day? If several occur the day following a holiday, consider reminding patients right before and after the holiday so it’s fresh in their mind.
- If there is a common reason for missed appointments, be ready to dig deeper. For example, if many patients cite dissatisfaction, you’ll need to get to the root of the problem. More reminders won’t help.
Office Protocol
Don’t wait until a no-show or cancellation situation gets out of hand to decide what steps to take. Have a plan ready for instances like the following:
- If you have a particular patient (or a few) who habitually cancel at the last minute, you may want to consider double-booking that appointment time.
- Determine the number of no-shows and cancellations a patient can have before you have a conversation with the patient to address the issue.
- Have a clear policy about if and when you bill for missed appointments.
- Discuss when you’d consider dismissing a patient for noncompliance, as a last resort. (Hopefully it will never come to that.)
The reality is that no-shows and cancellations are part of running a practice. But, the more you can do to avoid them or decrease the frequency, the better for everyone.