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Developing a no-show policy for your new practice


One of the major concerns of a new independent practice is the patient no-show rate, which can impact the practice’s finances as well as the patient’s health and well-being. With no-show rates typically between 7% and 20%, establishing a policy right away can help reduce potential losses. There are some practice management considerations for a new practice in developing a no-show policy, including ensuring that the policy is written and communicated appropriately for patient retention.

A no-show occurs when a patient fails to show up for a scheduled appointment without notifying the practice ahead of time. There are a number of reasons for a patient to skip an appointment, including forgetting about it, facing a schedule conflict, and miscommunication or lack of communication with the provider’s office. The patient may also have an issue with transportation or decide on their own that they no longer need the appointment.

No-shows can impact the patient’s health, given the delay in diagnosis and treatment. A no-show appointment also affects efficient practice management, as it takes up time on the provider’s schedule that could have been used to see other patients. The result is a negative impact on the practice’s resources and revenue stream.

When developing a no-show policy for your new practice, consider how the policy will be received by patients and how you will implement and reinforce it consistently. A progressive practice management approach will ease patients and staff into the new policy, while emphasizing the need for both to communicate effectively and frequently throughout the process.

A progressive no-show policy consists of:

  • An initial, gentle reminder of why it’s important for the patient to keep the appointment, including the effect a missed appointment can have on the individual’s health and well-being.
  • A warning that missed appointments, without appropriate notice, will result in a service charge being billed to the patient.

It’s important to note that Medicaid patients cannot be charged for no-shows and, although Medicare patients can be charged, Medicare cannot be billed for the missed appointment.

As you develop your no-show policy, reinforce the importance of keeping appointments and of notifying the practice when an issue does arise. Establish a timeframe within which patients must let the practice know if they will be unable to keep the appointment.

Set guidelines for determining whether a situation may have been a situation that kept the patient from coming in when scheduled through no fault of their own. For example, they may have experienced car trouble on the way to the appointment or had a family crisis at the last minute.

Once your policy is developed:

  • Communicate with your patients regarding the policy, including any fees associated with missed appointments.
  • Post the policy on your website and include it in all patient paperwork, especially new patient intake forms.
  • Place a sign regarding the no-show policy at the check-in desk, so that it is clearly visible and readable.
  • Provide your practice staff with a script that will help them politely and clearly explain the policy to patients.

Be proactive about scheduling in a manner that reduces patient wait times and the frequency of rescheduled appointments. A patient may get frustrated with the long wait time or think that if the practice reschedules their appointment frequently, then the appointment is not that important.  

Elation Health’s electronic health record (EHR) solution offers you the online patient appointment scheduling and appointment notifications and reminders you need for effective and efficient new practice management.

Communication will be the key to reducing and potentially eliminating no-shows in your new practice. Assign a staff member to be responsible for sending regular and frequent reminders of the upcoming appointment as well as the no-show policy. Set up an automated system that alerts patients as the appointment time nears. Reminders have been shown to reduce patient no-shows by half or more.