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How To: Determine If You Should Implement a No-Show Fee, or Not

By Patrick Ales posted 05-18-2012 11:26

  

One of your physicians storms into your office at 2:00 p.m. and rants about another no-show in their clinic. With great animation he says, “Every no-show costs me money. I want you to implement a no-show fee starting Monday”. It is time to take a deep breath and think. You are the administrator and as such, need to be the voice of logic and reason. Should your practice implement a no-show fee? After all, “everyone” is doing it.
This question is on the front burner in health care practices across the country as reimbursement continues to decline and cost pressures increase. While it is true that one missed appointment or procedure may not have a significant impact, one per day could. For example, the Medicare allowable for a level two established patient visit is around $42 while a level three new patient visit is around $105. This represents a revenue opportunity between $7,500-$19,000 per year 1. Clearly, this could be material to a given practice. Okay, you are the administrator and a decision is in order: implement a no-show fee or not.
The purpose of this “How to guide” is to help you, make the right decision for your practice.
To answer to this question requires appropriate analysis in two critical areas:

1. Current operational processes.

2. Solid analysis of historical data. Once this “self assessment” is completed, you can advise your physicians regarding a no-show fee.

Current Operational Process
Let’s start with current operational processes. This analysis will provide an assessment regarding processes in place, or not, to limit no-shows. Answer the questions below as a starting point:

1. Is patient access reasonable based on the given specialty? 

 

2. Do you utilize an appointment reminder system?

3. How is your appointment reminder system structured?

4. Do you collect appropriate contact information?

5. Do you have a process for accurately tracking no-shows?

Investigation of these areas, although not a complete list, is the first step in evaluating whether no-show fees are appropriate. Once you have this information, one additional step is necessary in order to make an informed and supportable decision regarding implementation of a no-show fee. That step is data analysis.

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