Practice Management Alert

Even a couple of unfilled appointment slots could cost thousands.

When a patient calls and cancels a scheduled appointment, medical practices need to be ready to jump up and act immediately, or risk lost revenue and diminished patient care.

The math: “Every patient has an effect on the practice’s bottom line,” says Erica J. Sprey, associate editor at Physicians Practice in Minneapolis. “Missing just two patients a week could potentially mean losing, for example, $150 of revenue a week. That’s close to $8,000 lost revenue annually.”

That’s not exactly chump change, and it’s certainly money you can prevent from flying out the door if you have some policies set for dealing with gaps in the schedule due to patient cancellations. Check out this advice from scheduling experts on best practices for maximizing your providers’ treatment time through careful pre-planning.

Try to Make “Short Call List” a High Priority

If a practice has the resources, it’s smart to keep an on-call list of patients willing to fill canceled appointments immediately.

According to Harlene S. Stevens, CPA, a manager at Nisivoccia LLP in Mt. Arlington, N.J., you should try to compile a “short call list” that includes any patient who is willing to take the next available appointment. (There are a number of ways you could formulate the short call list; for example, patients who call and ask to get in quickly should be presented the option of taking the next available open appointment. Tailor your method of recruiting short call listers to your patient population.)

Keeping this list might prove a challenge at first, but experts say it’ll pay off for the practice in the long run.

“In many areas of the country there are physician shortages,” explains Jean Acevedo, LHRM, CPC, CHC, CENTC, president and senior consultant with Acevedo Consulting Incorporated in Delray Beach, Fla. “In these cases, you’re almost guaranteed to be able to fill an appointment slot that becomes open, so keeping a list of patients who would like to be seen sooner if something opens up is a great idea.”

Caveat: Don’t go overboard with filling every open time slot that unexpectedly comes up. There is some benefit to leaving open appointment slots when someone cancels.

“Leaving gaps purposefully on a schedule can be a good thing. It allows practices to book urgent patients in the same day,” says Patrick Randolph, founder and CEO of QueueDr, a medical software company in San Francisco.  This style of more open scheduling is very prominent and effective for certain specialties such as pediatrics, Randolph says.

Sprey has seen many practices use open scheduling, where a certain number of appointments are left open for same-day patients. So if someone cancels and you employ open scheduling, you might not want to fill the slot. Consultation with your providers can help you make the decision on whether or not to fill an unexpected schedule opening.

Consider New Patients When Short Call List Fails

Even if you do have a set policy for filling unscheduled cancellations and a short call list, it won’t always result in filling the time slot. When your short call list is exhausted, experts say there are several actions a practice can take to maximize the extra time:

• You could use the opportunity to contact someone who is likely to receive a low-level service, such as an established patient reporting for a medication refill, and see if he can fill the empty slot.
• Staff could use the time to catch up on other work they have to do (paperwork, emails, etc.).
• If a new patient calls to make an appointment, you might offer that day’s open slot to her. This would “make a great first impression on a new patient calling for an appointment,” Acevedo relays. “How refreshing [would it be] to be told ‘Dr. Johnson has an opening at 1:00 P.M. today; would you like to see her then?”

Parting shot: How to fill open slots in the schedule is a “very difficult problem that seems easy to solve at a high level,” Randolph acknowledges.

When trying to create a solution, Randolph recommends you “have empathy for all the different people — patients, physicians, administrators — who are affected. Focus on the execution [of the plan] on a pragmatic level, not a theoretical one.”