Part B Insider (Multispecialty) Coding Alert

4 tips to deal with providers who chronically cancel appointments

If a physician in your practice routinely cancels appointments and doesn't provide enough advance notice, you could have a serious problem on your hands.

"Some physicians never [cancel appointments] except in an emergency," notes Elizabeth Woodcock, director of knowledge management for Physician Practice in Glen Burnie, MD. Yet "some physicians have an unfortunate habit" of canceling all the time.

When providers routinely cancel, they create bad will among their patients, says consultant Lee Cavanaugh with Cavanaugh Michaels in Mechanicsburg, PA.

Chronic canceling also creates extra work for the physician's staff, who must notify patients that the physician won't be available. Then staff must either reschedule or find a replacement physician, notes Woodcock. Time spent on these trivial tasks is time not spent appealing denied claims or coping with real problems, notes Cavanaugh. Try these four tips to cut down on the hassle of cancelled appointments:

1. Have a no-cancellation policy. If the physician wants to cancel an appointment, he or she should have to do so a month in advance, or a set number of weeks in advance, says Woodcock.

2. Make the indirect costs clear to the doctor. Someone needs to explain to physicians that when you cancel appointments without warning, "you're not only putting your patients off, but you're putting your staff into a position where they're doing a tremendous amount of work," says Woodcock.

3. Show how one doctor's actions drain everyone's bottom line. In a group practice, every provider shares the expense of having schedulers and receptionists on staff. If one doctor in a practice cancels appointments left and right, all the other physicians have to pay for the staff time to cope with the aftermath.

Many physicians may not have considered the wide-reaching impact of impromptu cancels. When she's consulting, Woodcock will point this out to providers, asking "Why do you think you have to hire another scheduler?" The answer, of course, is a chronically-canceling physician.

4. Penalize doctors who cancel. When all else fails, try charging physicians a penalty if they cancel their appointments, says Cavanaugh. This may be hard to do if a doctor is actually sick or dealing with a death in the family, but otherwise could be a good idea. Ask your attorney before assessing financial penalties, Cavanaugh adds.

Also, if the offending doctor is still a junior physician, let him or her know that unless this behavior stops, he'll "never make partner" in the practice, says Cavanaugh.