No-ShoWS & CaNCellatioNS

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No-ShoWS & CaNCellatioNS

taBle of CoNteNtS
Know the Warning Signs of a No-Show . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Before You can Heal the Body, You Must Train the Brain . . . . . . . . . . . . . . . 3 Turn Your Front Desk Into the No-Show Reduction Department . . . . . . . . . 4 Adapt Your Scheduling Policies to the Patients Needs . . . . . . . . . . . . . . . . 5 Enhance Patient Compliance With the Care Plan . . . . . . . . . . . . . . . . . . . . 6 Keep the Appointment in Front of the Patient . . . . . . . . . . . . . . . . . . . . . . . 6 Know the Score . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 About MediServe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

One of the biggest drains on revenue for many private practice PTs are appointment no-shows and cancellations. On average, 10-15% of all scheduled appointments end up as a no-show. The ultimate solution to the no-shows and cancellations problem requires a practice-wide commitment, starting with the practice owner. In todays busy world, appointment no-shows and cancellations are becoming more common. Its important that we, as an industry, come up with new and better ways to enhance patient compliance. There are many sophisticated tools out there that can be used to help private practice owners improve their process, drastically reduce appointment no-shows and cancellations and increase profits. Weve put together a list of strategies, based on 20+ years of medical scheduling experience and working with top rehabilitation providers across the country to help providers overcome the challenges of appointment no-shows and cancellations and increase their practices profits.

aN average of

10-15%

of SCheDuleD aPPoiNtMeNtS

eND uP aS a

No-ShoW

1. KNoW the WarNiNg SigNS of a No-ShoW

There are many reasons for no-shows and cancellations. Knowing the warning signs will help you proactively overcome no-shows from happening.

Forgetfulness: Sometimes a patient simply forgets their appointment. Low Priority: Often, its a question of priorities and choosing between going to an appointment or attending a personal event, like a grandsons soccer game. Fear of Pain: Fear that the treatment is going to being painful, or if a patient has phobias, can lead to no-shows. Finances: Finances can be a major factor for some patients. Some patients are in a position where its difficult to pay their co-pay. Some patients dont have insurance or have lost their insurance. Frustration with Progress: If a patient feels theyre not making progress with their treatment, they can quickly become frustrated and give up on their treatment. Lack of Transportation: In some cases, a patient has lost their ability to drive, like after a car accident, and rely on caregivers to provide transportation. Bad Experience: If a patient has a bad experience, like a long wait time or dissatisfaction with their therapist, theyre more likely to not show up for their next appointment.

WarNiNg SigNS
forgetfulNeSS loW Priority fear of PaiN fiNaNCeS fruStratioN With ProgreSS laCK of traNSPortatioN BaD exPerieNCe eMBarraSSMeNt

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

 Embarrassment: When a patient feels embarrassed for not completing their home exercises, or any other reason, they will avoid coming in for their next appointment.
When your entire staff is on the lookout for these warning signs, you can stop them in their tracks before they become a problem for your practice.

2. Before you CaN heal the BoDy, you MuSt traiN the BraiN
When you know why patients are missing their appointments, you can begin to address the causes. Researchers writing in The Annals of Family Medicine1 interviewed actual patients who have not shown up for their appointments and discovered some interesting reasons why patients dont show up for their appointments. Here are three examples of what was discovered in their research:

Set

aPPoiNtMeNt exPeCtatioNS

froM the

get-go

overCoMe fear
If you want a patient to keep their appointments, you must help them overcome their fears. In the research conducted, roughly two-thirds of patients said their negative emotions about going to the clinic outweighed the benefit of keeping their appointment.

aND youll

No PaiN No ProBleM
For many patients, if theyre not experiencing pain, they perceive that as not having a problem. As one of the interviewed patients put it, When my feet were swollen it was on my mind. As soon as the swelling went down, I forgot about it. Many patients dont understand that just because they are free of symptoms, does not mean they no longer require care.

See

PoSitive reSultS.

ruNNiNg a BuSiNeSS
Many patients dont understand the negative consequences a missed appointment has on a practice. Nearly half of the respondents did not know what actually happened in a clinic if there was a missed appointment. Many think theyve actually given their therapist a much-needed break in their day when in fact, its actually lost revenue for the provider. To help overcome some of these misconceptions, its important to break bad habits and thoughts your patients may have. Have a conversation with new patients and set expectations. Start repeating the same message consistently throughout the patient experience, otherwise patients will forget.

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

When patients are in the clinic, they need to hear the same compliance message when theyre greeted at the front desk, when theyre working with their therapist, when theyre reviewing their payment options with your billing department and finally before they check-out at the front desk. In addition, patients need to continue hearing the same key points after they leave your office. Provide them with take-home material, or direct them to your website and make sure its filled with useful information. If you dont already have a website for your practice, set up a site with useful patient information and a patient portal. Finally, make sure to remind patients before their next appointment. You have a business to run and have every right to charge a fee if a patient decides to just not show up. When you set these types of expectations from the get-go, you will see positive results.

3. turN your froNt DeSK iNto the No-ShoW reDuCtioN DePartMeNt

The best place to set high expectations is where your patients get their first impression of your practice your front desk. Your front desk is the first and the last place a patient sees when they enter and leave your practice. Therefore, your front desk staff plays an important role in reducing no-shows. Transform your front desk to a no-show reduction department by having your front desk staff take the following steps whenever a patient arrives for an appointment: Upon arrival and departure, make sure each patient is marked as arrived and seen. This is important for going back later on and pulling accurate data out of your scheduling system. Ask the patient how theyre doing. This will help your front desk staff quickly determine if the patient is experiencing any issues. After the patient has completed their treatment for the day, make sure their next appointment is scheduled and confirmed. When confirming a patients appointment, small reminder cards have proven to not be an effective method. They dont make a significant impact; they can easily get lost in a pocket or wallet and can easily cause scheduling errors if the appointment information on the card is not legible or inaccurate. A better alternative to small reminder cards is to use a full-page sheet. This way, the patient cant easily tuck it into their wallet or put it in their pocket and forget about it. Theyre more likely to take it home and stick it up on their

Your froNt DeSK

Staff
PlayS aN
reDuCiNg
No-ShoWS. iMPortaNt

role iN

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

fridge or put it on their desk at home. To make the paper more valuable for the patient, include the following information: All scheduled appointments, sometimes patients have 10 appointments scheduled. Having all appointments on that one sheet will make it more valuable. Include important appointment instructions (e.g., bring your x-rays, wear special clothing, etc.) Additionally, automating your scheduling systems is strongly recommended for eliminating the common scheduling errors that occur when handwriting appointments into appointments books and on reminder cards. Finally, before a patient leaves, front desk staff should review the key sections of the patients letter with them to make sure they understand the dates and times of upcoming appointments, co-pays and your practices cancellation policy.

4. aDaPt your SCheDuliNg PoliCieS to the PatieNtS NeeDS

Develop scheduling policies that are designed around your patients needs. Often times, practice owners forget about the key events that take place during a patients visit, especially a new patient, and overlook building that extra time into the schedule. As a result, delays in the schedule mean longer wait times for patients. Scheduling key events that address the patients needs are an important part of building a positive, lasting relationship with your patients and prevent delays in the schedule. The last thing you want to do is keep a patient waiting. Key events that you should build time into your schedule include: Paperwork: Patients, especially new patients, need at least 15 minutes to complete paperwork. Its also important to let new patients know that they will need to complete paperwork on their first visit and ask them to come in at the time you actually want them to be there. For example, if you want the patient to come in for a 9:00 a.m. appointment, ask them to come in at 8:45 a.m., not 15 minutes prior to their 9:00 a.m. appointment. That way, theyre less likely to be late for their appointment and cause a domino effect of delays in your schedule for the remainder of the day. The no-show conversation: New patients need to understand your no-show and cancellation policy. Allowing time for your front office staff to have that conversation with patients is critical to the success of reducing no-

Avoid
loNg Wait

SCheDule

tiMeS

Key eveNtS iNto your SCheDule.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

shows and cancellations.

5. eNhaNCe PatieNt CoMPliaNCe With the Care PlaN

The patient-provider relationship is critical in reducing no-shows and cancellations. Set aside some time during each visit to emphasize the importance of compliance with the care plan. Explain the treatment goals with the patient so they understand what youre trying to achieve as a team. The more a patient understands his/her condition and the treatment thats needed to improve their health, the more they will see the need to attend every appointment. Here are some tips you can use to help enhance patient compliance in your practice: Use email to remind patients about their home regimen Reward compliance with a Patient of the Week award Recommend motivational articles and books that patients can read to stay motivated Always focus on the goal and keep the patient motivated with encouraging words like, Youre almost there! or Youre getting better!

autoMateD text, PhoNe

aND eMail

reMiNDerS

have BeCoMe

the MoSt effeCtive MethoDS

of reaChiNg

PatieNtS

todAY.

6. KeeP the aPPoiNtMeNt iN froNt of the PatieNt

In addition to a full-page appointment reminder, its important to reach your patient more than once, and in many different ways so theyll notice. Reminding patients about their upcoming appointments after theyve left your office is important. Many providers still rely on the traditional approach of a personal reminder call made by a member of the front desk staff. Simply stated, the front desk staff is busy and frequently interrupted throughout their day. Making reminder calls usually falls through the cracks because the front desk staff just does not have time to make the calls. While a personal phone call to a patient is a great way to add a personal touch, many times the calls are made during the day, when patients are not home. Ultimately, the front office staff ends up leaving a voicemail message and the personal contact is never made. There are many alternatives available today that have been proven to be more effective at reaching patients. Todays more popular methods of communication have shown to be successful in reducing no-shows and cancellations.

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

Automated phone calls, text messages and emails will free up your front desk, ensure all patients receive a reminder for their upcoming appointment and help you get the results you need. Heres how they work: Automated Phone Calls and Emails: Phone and email reminder systems merge patient information into a template and automatically deliver the message to the patient. Text Messages: Automated text reminders scan an automated schedule each day for patients who have requested this method of reminders and automatically sends the reminder. With more and more people texting including older generations text message reminders have become the most popular way to get directly to patients.

7. KNoW the SCore

Every practice setting is a little different. The reasons for no-shows and cancellations at your practice may be different than the reasons for missed appointments at the practice down the street. By tracking and knowing the reasons for no-shows at your practice, youre better equipped to solve your no-shows and cancellation problem. Track Missed Appointments by Type: Start by tracking no-show and cancellation rates along with the reasons for the missed or cancelled appointments. Its important to keep track of these separately in order for your results to accurately represent the amount of the different types of missed appointments in your practice. Track Missed Appointments by Practitioner: If your practice has more than one practitioner, or location, youll want to track those as well to see if theres something you can adjust in the way you treat your patients. Therapists who are engaged with their patients and provide hands-on care are less likely to have little to zero no-shows or cancellations. Understand the Reasons: Keep track of the common causes for no-shows and cancellations and make sure those reasons are not causing the missed appointment. For example, wait times can lead to patient dissatisfaction. If a

WheN you

KNoW the reaSoNS,

youre Better

equiPPeD
ProBleM.

to Solve the

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

patient is scheduled for half an hour and you take an hour-and-a-half of their time, theyre more likely to not come back for their next appointment. Keep track of these statistics in your scheduling system because youll never know why your patients are not showing up for their appointments unless you track it.

These seven strategies have been proven to help private practice owners and managers put an end to the appointment no-show and cancellation problem and improve revenue results. While it may seem overwhelming to take on these strategies in todays busy world, the results definitely pay off in the end. Implementing these strategies in your practice can be an easy process through automation. Implementing an automated all-in-one solution thats designed for private practice therapy can help you significantly improve the way you do business and boost your profits. To help you get a better idea of how much you can increase your revenue by decreasing no-shows and cancellations, use the Attigo Therapy Benefit Calculator located on AttigoTherapy.com.

attigotherapy.com | 1.800.279.8456

2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012

aBout MeDiServe
MediServes rehabilitation software solutions are designed to optimize the value of patient care in todays healthcare environment by automating the ineffective and inefficient processes that are inherent in a highly regulated, work-intense environment. With more than 20 years of experience and industry expertise, MediServes solutions address the workflow, compliance and documentation needs that are unique to the rehabilitation environment and produce results that significantly improve compliance, outcomes, revenue and efficiency. MediServe released its newest product, Attigo Therapy, in 2012. Attigo Therapy is an all-in-one, Web-based private practice therapy solution that provides documentation, billing, scheduling and practice management. If youd like to learn how MediServe can help you implement the strategies discussed in this article, call us today at (800) 279-8456 or visit us online at AttigoTherapy.com.

SourCe 1. Lacy, Paulman, Reuter and Lovejoy (2004, November). Why We Dont Come: Patient Perceptions on No-Shows. The Annals of Family Medicine, pages 541-545.

attigotherapy.com | 1.800.279.8456

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2012 MediServe. All Rights Reserved.

Whitepaper: No Shows & Cancellations [v5] 5/30/2012