Practice Management Alert

2 tactics help you solve empty appointment slots and lost income

If no-show patients cause a loss of revenue in your practice, now is the time to act to prevent further losses.
 
Last month we advised you on how to prevent no-shows before they happen with reminder calls and no-show fees (see "Prevention Makes No-Shows No Problem," October 2004). But when no-shows do happen, as they inevitably will, these two tactics can help you to guard against lost income.
 
1. Double up. You should try to schedule more than one patient per time block so that if one doesn't show, your physician has another patient to see. In a surgical practice, for example, you may want to schedule a new patient at 1:00 and also schedule short follow-up visits for suture removal or x-rays at 1:00 and 1:15. If all the patients show up, the physician should be able to juggle the whole load, but if one doesn't show, at least there are other patients to keep him busy.
 
Real-life scenario: "I've seen practices recently where no-shows were a huge problem," says Catherine Brink,
CMM, CPC, president of HealthCare Resource Management Inc. in Spring Lake, N.J. "One was a neurology practice treating patients with conditions such as depression, anxiety and Alzheimer's disease - and they were only scheduling one new patient per hour time slot." Patients with these conditions frequently miss appointments, resulting in lost revenue for physicians. This pattern can be devastating to a practice's bottom line, especially if it is an everyday occurrence.
 
Caution: You should make scheduling decisions based on the culture of your practice and physicians. You should sit down with your physicians to "decide how best to fill up all the time in their appointment schedule," Brink says.
 
"We don't like to overbook because that makes our patients wait," says Manny Oliverez, practice administrator with Farrell Pediatrics in South Riding, Va. Instead, his practice relies heavily on reminder calls the day before to ensure patients show up for their appointments.
 
2. Charge a no-show fee for contracted exams. If your practice sees patients for motor vehicle exams, workers' comp exams or independent medical exams through an attorney, you should build a no-show fee into your contracts, Brink says. These exams are all long and time-consuming, and you deserve to receive an automatic fee ($150, for example) if you block out the time for this exam and the patient doesn't come.