Medical Billing Services

Charging Patient No-Shows

Charging Patient No-Shows

Despite your best efforts to remind patients of their appointments, you’re still likely to encounter one or two patient no-shows every day, approximately 5 percent to 7 percent of total monthly appointments. If the average office visit generates a $25 co-pay and a $90 reimbursement, just two missed appointments per day can cost your practice nearly $60,000 per year. In this estimate, we excluded the administrative and payroll expenses required for scheduling and rescheduling that appointment. Many medical practices started to realize the loss of revenue missed appointments impose on their businesses. A pediatric practice experienced 389 no-show appointments from 310 patients. At an estimated $112 lost per appointment, their total came to $43,568 in lost revenue that year. The practice administrator estimated a $25 no-show fee would recoup $9,725, but that assumes a 100% payment rate. Another practice from Midwestern had an 8.7 percent no-show rate in 2010. They started requiring patients to sign appointment agreements as part of a formal plan to fix the issue. As a result, in the year 2014, their patient no-shows rate dropped to just 1.7 percent. Medical practices across the country are wising up to the loss of revenue missed appointments are reaping on their businesses. Taking a cue from the hair salons and hotels of the world, healthcare establishments are charging patients no-show fees for blowing off appointments or canceling at the last minute.

Charging for Patient No-shows

Ideally, patients should attend every appointment unless there is a genuine reason for a no-show. Patients are more likely to skip out on a medical appointment than they would be to dodge a rental car reservation. It requires practices to introduce a policy that makes it clear to patients, a physician’s time, effort, and services cost money. Charging a no-show fee is the only way to earn back even a fraction of that lost revenue. A blanket $20 fee for every missed appointment may not recoup anywhere near what your practice would have earned in the actual encounter, but in today’s healthcare environment, every extra dollar helps.

If your payer contracts allow it, you can collect a patient’s credit card information while booking his or her appointment, communicate your no-show policy as you do, and automatically collect your charges when a scheduled visit gets skipped. Part of the point of having a policy in place, though, is hoping you don’t have to enforce it. The threat of the fee may be all it takes to get patients who would otherwise stay home to show up. Patients must be aware that no-shows mean lost revenue for the provider. One practice reported moving from a 17 percent no-show rate to less than 1 percent after instituting a fee. 

Things to Consider

For any provider-patient satisfaction is the most important thing. Patients often have legitimate, unavoidable reasons for missing appointments or canceling at the last minute. A rigid fee policy can disturb busy patients. No-show fees will project an image of inflexibility to your patients. Charging for no-show fees could be upsetting, and your patients could be expressing their dissatisfaction over an internet review, social media, or with friends, family, colleagues. So, is a partial reimbursement on lost time and revenue worth potentially upsetting your loyal patients? There is no right answer, that’s up to you to decide. 

If we consider the example of one practice, they compared chart transfer requests and no-show charges and found out that a significant minority of their patients transferred their care after receiving a billing statement that contained a no-show charge. The expense of mailing a bill for the missed-visit charge and the hassle of repeatedly requesting that a patient pay up may be more trouble than the fee is worth. Plus, unless you have a credit card on file as discussed above, it can be difficult to get a patient to pay his no-show fee at all.

To Summarize

It’s every provider’s call whether to introduce no-show fees in policy or not, they know their patient very well. You could introduce no-show fees but waive patients for the first few missed appointments. Clear communication should be made that it won’t be waived every time. We hope that you will find the points discussed in this blog useful. For more such blogs on practice management, medical billing, medical coding, and industry updates, read our latest blogs section.

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