Blog - Got No-Shows? Here's a Plan of Attack

Got No-Shows? Here's a Plan of Attack

October 15, 2019

No-shows are a big challenge for many aesthetic practices. They diminish the opportunity to fully schedule the day with revenue-producing visits. And they take away time from other patients, too.

In our increasingly casual society, it can be difficult to address the no-show trend. And the truth is, there is no “one thing” that practices can do to make them disappear. If you are serious about reducing the number of no-shows, it will require diligence and a multifaceted approach.

Start your plan of attack by analyzing data from the appointment scheduling system for the last six months. Assess the following to understand the profile of your no-shows.

● What percentage of all patients are no-shows?
● How many no-shows are typical per day? Per week?
● What’s the percentage breakdown of the no-show appointment types: New patient consults? Post-ops? Injectable/filler patients? Long-term rechecks such as one-year post breast augmentation?
● For consultation no-shows, is there a trend with a particular procedure type?
● What are the top 10 referral sources of your no-show patients?
● What’s the demographic profile of no-show patients?

As part of this assessment exercise, you might learn that no-shows aren’t being tracked in the computer or the medical record of established patients. They should be tracked in both. Assign a code in the practice management system that “closes” each no-show visit so that it shows up on reports as a no-show. And verify that the staff are documenting no-shows in the medical record. This is essential. If a patient were to suffer a complication or untoward outcome, their record would reflect that they did not show up for their necessary post-op appointment(s), which may have contributed to the issue.

Now that you have this data in-hand, you are ready to begin “Operation No-Show” in your practice. The more of the following techniques you implement, the more you’ll chip away at the no-show rate.

1. Schedule aesthetic consultations within two to three days of the patient call.

If people must wait seven days or more to get on the consultation schedule, they may take the slot but keep calling other surgeons. If they get in faster somewhere else, the chance they will no-show with your practice increases.

2. Take a credit card guarantee.

Finer salons and restaurants do. We think plastic surgeons should too.

3. Charge for no-shows.

Provide patients a written policy that explains the charge for no-show appointments. Here’s an excerpt of such a policy. Not only does it explain what the patient will charge, but it also reinforces that you’d like them to call and cancel or reschedule if the patient’s plans change.

If your schedule changes and you cannot keep your appointment, please contact us so we may reschedule you, and accommodate those patients who are waiting for an appointment. As a courtesy to our office as well as those patients who are waiting to schedule with the physician, please give us at least 24 hours’ notice.

If you do not cancel or reschedule your appointment with at least 24 hours’ notice, we may assess a “no show” service charge of $_____ to the credit card you provided when you secured your appointment. This “no show charge” is not reimbursable by your insurance company.

4. Confirm appointments.

These days many practices have moved from a phone reminder to a text or email reminder. Both are loved by most patients and far more time-efficient.

If you do confirm by phone, train staff to make the calls with grace and professionalism instead of talking at lightning speed, which we often observe. And if they get the patient’s voice mail, use the negative option: “If we do not hear from you by Wednesday at 5:00 pm, we will release the time for another patient.”

5. Charge for injectables prior to the appointment.

We find that charging patients $500 – $1,000 cures them of their “appointment amnesia” and they show up. Or, they call to cancel or change their appointment.

6. Pre-register new patients.

The less anonymous people feel, the more apt they are to arrive on the day of their appointment. We’ve recommended pre-registration for decades because it works to reduce no-shows and give staff the information they need to verify eligibility. Plus, it makes check-in faster.

7. Maintain an up-to-date work-in list.

If you’ve trained patients to call and reschedule or cancel, you’ll have the opportunity to fill those slots. In that case, a work-in list is invaluable for keeping the appointment schedule full.

8. Schedule post-op appointments when you schedule the surgery date.

And stress the importance of showing up for post-op visits for safety reasons. It increases the likelihood that patients will do just that.

Author - Karen Zupko, President
An internationally recognized thought leader and speaker, Karen Zupko advises physicians and healthcare managers about the challenges and trends impacting the practice of medicine. Click here for more info about the author. 
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