Patient no-shows are a huge problem for any kind of practice. When a patient does not show up, it is a waste of your time, plain and simple… You are a nurse practitioner entrepreneur; your time is valuable. Your time = dollars. When a patient does not show up, they essentially stole your time, which means they stole money from you. It is CRITICALLY important that you minimize patient no-shows in your practice… ESPECIALLY a niche side practice that is cash based because you will have a lower volume compared to an insurance accepting practice.
How do you prevent no-shows? It can be difficult, especially for the cash-based practice. Patients can get “cold feet” sometimes when they process the fact that they will have to pay out of pocket for a niche service. It still blows my mind people think they can use their Medicaid for peptide therapies or IV infusions. Medicaid only pays if it is a medical necessity, not a life enhancement. But do not fear this, there are plenty of people willing to pay cash, even in “poor” areas. Don’t let naysayers or limiting beliefs convince you otherwise.
I have learned a few tricks for preventing no shows. If you have a trick of your own, please comment to help your nurse practitioner colleagues build a successful practice. Now, let’s get to it:
- Charge a retainer fee: Once a patient schedules an appointment, you could charge a “retainer fee” to hold the appointment. This should not be very much though, $20-$50 at most. This will lock in the patient. Ensure it is non-refundable for no shows. Have a policy in place that states you must cancel within 48 hours for a refund. Any cancellations after 48 hours or a no-show results in the retainer being forfeited. This strategy can work, but be aware, it can put off potential new patients if you have not built a considerable reputation yet.
- Put a credit card on file: This is extremely effective for telemedicine practices or if people have the ability to schedule through your website. You need to have a policy in place that states that if the appointment is not cancelled within 48 hours or if you do not show up for the appointment, that the full charge of the evaluation will be charged to the credit card on file. This might sound harsh, but it works! It separates the ass holes who are wasting your time from the people who are serious. I did this in my telemedicine practice, and my no-show rate went to almost ZERO from over 50%!
- Require patients to have lab work before the appointment: This is what I do in my men’s health practice. They must have the lab work completed before I ever see them. This locks the patient in. It is a commitment on their part. I believe I have had one patient that did not show up who had lab work completed first in over 2 years. It works. Schedule them to come in for labs or provide them the lab order to get them done elsewhere. That is it. Once they do them, then schedule them for the actual appointment. This is the same policy at my second location as well.
- Do a free phone consultation first: I recently started doing this in my men’s health practice and it is surprisingly effective in weeding out patients who are going to waste my time. Plus, it is a great time to sell your services to the patient. Offer free 10-15 minute phone consultations for new potential patients. Taking just 10 minutes out of your day to sell a new patient on your practice is worthwhile. I have never had a patient that was seriously interested over the phone that did not obtain their lab work or not show up for their initial evaluation.
- Appointment reminders: You should have automatic appointment reminders set up in your practice. Most EMRs have this function and it is easy to setup. If your EMR does not have this function or you are paper charting, then Setmore and GoReminders works well. Setmore has appointment scheduling just FYI. The payment processor Square has appointment reminders built into it also. Outside of automatic reminders, you also should call the patients. Honestly, I think calling the patient is one of the most effective ways to remind them about their upcoming appointment. Patients appreciate a real person.
Those are the top 5 strategies I have used to prevent no shows. Like I mentioned earlier, if you have any of your own, please comment to help your nurse practitioner sisters and brothers.
Take some time to implement a strategy to prevent no shows. One of the biggest frustrations when you first start a practice is having patients not show up for their appointment. It will drive you CRAZY. It is also very demoralizing. But do not let the negative emotions bring you down. Every single practice owner in this country must deal with no-shows… It is part of the game!