You’ve been there. Waiting for a client who just doesn’t show.
And the frustration that follows:
You’ve lost time and money that you can’t get back.
The impact of missed appointments on medical practices is widely known. Research from the BJGP reveals that:
- 15.2% of practice appointments are typically missed
- Missing appointments was most often attributed to work or family obligations, forgetting, and transportation issues
This figure might not look like much, since you only anticipate a few appointment no-shows each week.
But think about this scenario:
If you charge £50 for an appointment in your practice, two no-shows a week can cost your business over £5,000 annually.
And that figure doesn’t account for the operational and salary costs associated with planning and postponing that clinic visit.
Many healthcare practices are now charging no-show fees for missed appointments or cancelling at the last minute, or levying a 100% termination fee if a customer fails to appear.
What is a “No-Show” Appointment?
Any client who fails to show up for a planned appointment is referred to as a “no-show” or “DNA” (Did Not Attend).
When a client cancels less than 24 hours before their scheduled appointment, it is considered a “same-day cancellation.”
“Late arrival” refers to any client who comes 15 minutes after the scheduled appointment.
What is a Cancellation Fee?
If a patient fails to show up for an appointment they are charged a cancellation fee.
Costs of cancellation are treated like any other contract condition.
In order to book an appointment with you, a patient must agree to your requirements, so specify these in your T&Cs or your consent forms.
Generally, more precise terms are easier to enforce.
Can I Really Charge for a No-Show Appointment?
Cancellations and no-shows are big problems for private practices.
Besides taking up your time, they also have a negative effect on your finances.
If your client signed an agreement, or entered into an agreement by making an appointment with you after reading your terms and conditions, then you can legally demand payment from them.
Financial Impact of No Shows
Missed healthcare appointments have a significant financial impact in the UK. No-shows cost the healthcare system about £150 billion annually, with each missed slot costing physicians around £200 on average.
Specialty practices like gastroenterology can lose up to £312,000 annually due to no-shows. The NHS faces around 7.8 million missed appointments each year, costing millions.
If we put that into real-life terms, lets’ say a private practice schedules an average of 20 patients per day. With a no-show rate of 10%, the clinic loses 2 appointments daily. If each appointment is valued at £200, this results in a daily loss of £400. Over a year (assuming 250 working days), this amounts to a revenue loss of £100,000.
Measures such as automated reminders, flexible booking systems, and better patient communication are being implemented to reduce these losses and improve healthcare efficiency.
Benefits of Charging No-Show Fees
With no-show rates ranging between 5% and 8%, collecting no-show fees may seem like a no-brainer.
Fees for no-shows have the following benefits:
Increase Practice Revenue
Let’s say your appointments cost £50 for one hour of treatment time.
You might not want to charge non-attendees the full whack if they don’t turn up, but 50% would be reasonable.
Although a £25 no-show charge does not entirely compensate for the missed appointment, it does help to lessen the damage.
There are a couple of ways you can bill them for this:
- You can notify your clients of your no-show fee policy at the time of booking, and issue an invoice to them if they don’t show up (or add it to their next bill).
- You can take a 50% deposit from them when they book, and make them aware that this is non-refundable if they do not turn up, or if they cancel within 24 hours of when the appointment is due to take place.
This means you’ll also cover some of the service, staff, rent, and utility costs you may have incurred for the appointment.
Reducing No-Shows
In almost all cases, a no-show charge will encourage your patients to keep their scheduled appointments.
Patients will appreciate your time, and nobody likes extra expenses!
Encouraging Patient Responsibility
Patients sometimes don’t understand that not showing up for an appointment could be inconvenient for their clinician.
If you are treating patients for a one-off complaint, and they wouldn’t need to come back and see you again, this can also make it a lot easier for clients to simply not turn up.
When you introduce a no-show fee and a 24-hour advance cancellation policy, patients will perceive your practice differently, and take their appointment booking more seriously.
Cons of Charging for No-Shows
Although charging no-show fees has numerous benefits, it is not a perfect option for everyone.
There are a few disadvantages to consider, including:
Administrative Challenges
If you can’t take a payment in advance, it can be a nightmare collecting no-show fees for missed appointments.
One way around this is to automatically bill them as per your practice’s terms of service if you have access to their credit card information.
You could also add the charge onto their next invoice if they come back.
Potential for Patient Dissatisfaction
A no-show charge may reduce the number of missed appointments, but it may also result in losing a certain type of client.
If the policy changes suddenly, it could be a deal-breaker for busy patients who miss their appointments all the time.
By charging a no-show fee, you may push them elsewhere rather than encouraging them to keep their appointments.
Although rare, there may be times when a client has had to cancel due to a genuine and serious emergency.
To get around this one, you could consider giving first offenders a second chance, or a reduced fee to what you would charge to second or third offenders of your policy.
Best Practices for Implementing No-Show Fees
Clear Communication of Policy
Ensure patients are fully informed about the no-show fee policy. Clearly explain the reasons for the policy, the amount of the fee, and the circumstances under which it will be applied. This information should be communicated during the scheduling process and reinforced through appointment reminders.
Including No-Show Fee Policy in Terms and Conditions
Incorporate the no-show fee policy into the clinic’s terms and conditions. Patients should acknowledge this policy during their initial visit or registration process. This legal inclusion helps protect the practice and sets clear expectations.
Taking Deposits or Credit Card Holds
Consider taking deposits or credit card holds at the time of booking. This practice can deter no-shows and ensures that the clinic recovers some revenue if a patient fails to attend their appointment. Make sure to communicate this requirement clearly to avoid any misunderstandings.
Providing Flexible Options for Rescheduling
Offer flexible rescheduling options to accommodate patients’ needs. Allowing patients to easily reschedule or cancel appointments within a certain timeframe can reduce the likelihood of no-shows. Utilise online portals, apps, or automated phone systems to make this process as convenient as possible.
Other ways to reduce your no-shows
Reminding clients about their appointments by text message or email is an excellent way to reduce no-shows and late cancellations.
By doing so, you allow them to cancel in advance if needed. Plus: you can remind them about your cancellation policy at the same time!
Consider sending two texts prior to their appointment – one a week in advance and another a day before. This keeps upcoming appointments in their minds and reminds them to cancel if needed.
By setting up an online practice management system, patients will be sent automated reminders via SMS and email so you don’t even need to remember to do it!
Offering online booking is another great way to make sure your clients show up to their appointments on time.
They can schedule themselves in, pay in advance and save their appointment straight to their calendar. The booking system will even send out their reminder text messages for you!
Need more info on how to reduce your no-shows? Check out our recent webinar recording here:
FREE no-show policy templates
Make your cancellation and no-show policy clear by using one of our templates in your appointment confirmation and reminder emails:
Giving first offenders a second chance
If it’s their first offence, you might give the client a one-time, no-fee missed appointment, keeping in mind that some clients may have a genuine emergency:
In the event you are no longer available for your appointment, please provide 24 hours notice.
If you cancel within 24 hours, you won’t be charged.
Is this your first time?
We understand that emergencies happen. We do not charge a fee for first-time no-shows or late cancellations. After that, you will be charged a 100% cancellation fee for appointments missed or cancelled without 24 hours notice.
This allows us to continue offering the highest level of care to clients on the waiting list and ensure they can make an appointment.
100% no-show fee
If a client fails to show up for an appointment without giving at least 24 hours notice, you can charge them the full appointment fee:
If you miss or cancel your appointment without 24 hours notice, you will be responsible for 100% of the appointment fee.
If you are unable to attend an appointment, please let us know in advance so we can reschedule.
Thank you for your help with this matter. It allows us to maintain high service levels at the practice.
50% no-show fee
If you’ve looked at your finances and feel like you can meet the client halfway, you might charge a 50% cancellation fee.
The bonus here is that you’ll appear empathetic to your clients’ needs while covering some of your costs:
We’ll charge you 50% of the appointment fee if you don’t show up or if you cancel without 24 hours notice.
In the event you cannot make your appointment, please let us know in advance and we will be happy to reschedule for you.
So, should you charge no-show fees?
Thinking back to all of the benefits and drawbacks, should you charge your patients a no-show fee?
There is no one correct answer. This is an incredibly personal decision that is influenced by a wide range of factors:
Can you take prepayments for your appointments?
If not, the difficulty and cost of recovering the no-show charge may not be worthwhile.
How many patients fail to show up regularly?
If a lot of your patients frequently skip appointments, driving them away could result in you losing more money.
How many of your booked appointments are cancelled?
If the proportion is high, a no-show charge will significantly reduce the number of no-shows.
Conclusion
If your practice has a high rate of no-shows and appointment cancellations, it’s essential that you consider charging a no-show fee so that you can maintain the financial health of your practice.
Whatever option you choose, make your policies clear so clients won’t be surprised by a bill. Having to pay money that wasn’t budgeted can be really stressful.
Remember that you might lose out on significant benefits if your clinic management software doesn’t allow you to send timely and automated reminders to your patients letting them know about any no-show policy you have in place.
Having the right software in place will also allow you to take payments in advance of a client’s booking, so that you don’t need to chase it up afterwards should they not attend.
Don’t settle for mediocre practice management software that wasn’t built for the unique needs of healthcare providers. Choose our software to experience the unparalleled benefits of a solution that was designed specifically with your needs in mind.
If you’d like to know more about how WriteUpp can help you reduce no-shows and streamline the overall management of your practice, just grab us for a quick chat.
The button is just there in the bottom right corner of your screen.
FAQs
What is a no-show fee?
A no-show fee is a charge applied to patients who miss their scheduled appointments without prior notice. It compensates the healthcare provider for the lost time and resources.
How do I inform patients about the no-show fee policy?
Inform patients about the no-show fee policy during the scheduling process, include it in your terms and conditions, and reinforce it through appointment reminders. Clear communication ensures patients are aware of the policy and its implications.
Are there any legal issues with charging no-show fees?
Charging no-show fees is generally legal, but it’s essential to review and comply with relevant laws and regulations, including those related to Medicare and Medicaid patients, who may not be charged such fees.
What if a patient has a legitimate reason for missing an appointment?
If a patient has a legitimate reason for missing an appointment, consider waiving the no-show fee on a case-by-case basis. Establish clear guidelines for what constitutes a legitimate reason to maintain fairness.
How can appointment reminder systems help reduce no-shows?
Appointment reminder systems, such as automated texts or calls, significantly reduce no-shows by reminding patients of their upcoming appointments and allowing them to confirm, reschedule, or cancel in advance.
Can I waive no-show fees in certain circumstances?
Yes, you can waive no-show fees in certain circumstances, such as emergencies or unavoidable situations. It’s important to have a clear policy in place for when and how fees can be waived to ensure consistency and fairness.
