Cancellations and No-Shows a Problem? Here's Why
It’s becoming an all too common occurrence at your practice. Patients call an hour before they’re supposed to be in the chair to let you know they can’t make it after all, or even worse, they just don’t show up. Your office immediately goes into panic mode, as your Scheduling Coordinator scrambles to fill the holes in the schedule in a desperate attempt to salvage the day.
Yes, cancellations and no-shows lead to plenty of stress and frustration, but have you ever thought about how much money broken appointments cost you each year? We’re talking about tens of thousands of dollars in lost revenue. Just to give you an example, if your practice averages two cancellations/no-shows a day, at a value of about $100–$125 each, you’re losing more than $40,000 a year. And that doesn’t count the thousands of dollars in lost production you never even had the opportunity to diagnose!
Now that I’ve got your attention, let’s talk about why this is happening. You understand your patients are busy trying to juggle work, family and friends, but you also understand how important it is for them to maintain their oral health. The problem is, they don’t. If your patients are constantly cancelling or just plain forgetting they had an appointment with you, chances are they don’t see the value in that appointment.
If you want to drastically reduce cancellations and no-shows, you have to create value, and you do that by focusing on patient education. Not only are educated patients more likely to show up to their appointments, they’re more likely to accept recommended treatment as well. Here’s how you can improve patient education and reduce cancellations/no-shows at your practice.
Look for opportunities. Every time you or a team member interacts with a patient, think of it as an opportunity to educate. Provide education chairside, and reinforce this with educational materials in the waiting room and at the appointment desk. When you send a patient a statement, or any piece of mail for that matter, include patient education materials such as a pamphlet on periodontal disease or oral cancer, or maybe a copy of an article about a recent oral health study. Sending an email? You guessed it, use it as an opportunity to educate the patient about the oral systemic link, the advantages of catching oral conditions early, or any other oral health related topic. You can also teach your patients about the value of dentistry over the phone. Consider implementing an informational on-hold program that educates patients about oral care every time they call the office.
When you turn every patient interaction into an opportunity to educate, you create value for your patients, and that means they’ll be less likely to end up on your no-show list. Stress the importance of treatment and prevention. Patients look for reasons not to go forward with treatment, and usually come up with plenty of excuses on their own, from I don’t have the time to I just can’t afford it. If you leave them with the impression there is no hurry to pursue the treatment you’re recommending, you’re just giving them an easy out. After all, why should they be worried if you’re not?
If you want patients to keep their appointments, you have to create a sense of urgency. Stress the importance of proceeding with treatment, and make sure patients understand what could happen if they choose to ignore the problem. Once patients truly grasp the possible consequences, they’ll be far more likely to keep any future appointments.
The same is true for routine hygiene visits. During these visits, hygienists should take the time to educate patients about the importance of systemic health, periodontal health, oral cancer screenings and, of course, their oral condition and the importance of coming to scheduled appointments to either improve or maintain their oral health. Providing this information raises your patients’ dental IQ, enhancing their perceived value of routine care. The more they know, the more important those routine dental appointments become, and the less likely they are to cancel.
Provide a summary of the visit. Most patients don’t realize everything that happens during a routine exam, and therefore don’t think much of it when they cancel at the last minute. To help give them a better understanding, consider providing a brief written summary of the visit. Include a list of all the services performed, such as a periodontal exam and an oral cancer screening, a review of the hygiene evaluation, home care instructions and a reminder about specific areas the patient should pay attention to between now and the next visit. Also outline your recommendations for follow-up treatment, and list every free product he or she left with, complete with an estimated value.
This might seem like a lot to prepare, but you can easily set up a standard template that allows you to fill in the details for every patient. You can have this summary waiting for patients as they check out, or you can send it via email as a way to follow-up. Patients will be surprised to see how much actually happens during their appointment, creating more value and a better understanding of why they can’t just blow it off.
While you’ll never completely eliminate cancellations and no-shows, educating patients and making sure they understand the value of their appointment time will help reduce the number of broken appointments you have to deal with every day. And that, of course, will lower stress levels in your office while raising production numbers and increasing your income.
Next week, 9 ways to reduce cancellations and no-shows.
For more information on this topic and more, visit my blog: The Lighter Side
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Estimating Your Patients’ Portions
Do some of you remember the days before insurance? Patients simply “paid” for their services. There were no terms such as out-of-pocket, co-pay, deductible, maximum, not allowed, not covered, missing tooth clause, waiting periods and all the other terms that your Business Coordinator has to deal with now. It would appear that you need to be an “insurance expert” to simply ask the patient for the anticipated portion. And even then, with all the technology and tools that your Business Coordinator has, it is still an educated guess. This article is a brief overview of one way to approach the patient regarding their benefits.
Where Does Benefit Information Come From?
How Accurate is the Information?
1. Who you speak with at the insurance company. You may get a different response from two different agents at the same company for the same plan!
Honestly, it seems that patients think your computer is somehow connected to their dental plan. They assume you have “instant access” to accurate information and can tell them exactly how much their plan is going to pay. We only wish it was that easy, right?
Discussing Benefits with Your Patient
I always start by telling the patient with a sincere and sympathetic smile on my face: “Mrs. Jones, we don't know how much your insurance is going to pay. Based on our experience, I can estimate that your portion will be about $125. (Always “guestimate” on the high side). After we hear from your insurance company, we will contact you if there is any difference. How does that sound?”
Often I get a glare from front office staff when I suggest they admit that they don't know how much the insurance is going to pay. Some want to project to the patient that they are “insurance experts”. We find that patients will not hold you as responsible if you are honest and tell them that you don't know – because we don't know! The more we project to know, the more the patient expects us to know.
When estimating the patient’s portion, it’s important to round off so it doesn’t appear to be precise. I have not worked with a dentist yet who prefers to send a statement and try to collect the unpaid portion from the patient opposed to sending a refund check.
Are there situations where your Business Coordinator knows exactly what the patient’s plan will pay barring no unforeseen circumstances? Of course. And it is fine to request the exact amount from the patient. The goal in collecting “patient portions” is to avoid having to send a statement after the fact and then manage patient calls explaining why the insurance didn’t pay what was expected.
Ideally, your patients are so informed and "sold" on their treatment recommendations that they want the treatment regardless of out-of-pocket cost, and they understand your office team will do everything in their power to maximize the benefits. “Mrs. Jones, we will do our best to maximize your benefits, but please understand that we have no control over how they will handle your claim.” Maybe a simple way of stating this is to “under-promise and over-deliver”. I have never seen a patient who was upset that the insurance company paid more than anticipated, just like they are not upset when you didn’t need to perform a buildup, thereby reducing the fee they were initially quoted.
Avoid being an insurance benefits “expert”. Patients just want to know how much you want them to pay at their appointment. Keep it simple!
Being Yourself vs. Being a Dental Professional
Recently I heard the lament of a friend who had again been passed over for a promotion at her office. She was highly educated, trained and skilled in her field, but she felt no one took her seriously. She was dismayed to have recently been “written up” for insubordination. “I was not being insubordinate, I was speaking my mind and just being real.”
The honest sharing of thoughts, feelings, and experiences at work can be conflict in the making. Despite its potential benefits, self-disclosure can backfire if it’s hastily delivered, poorly timed, or not in sync with the cultural and organizational mission and vision of the practice. It can create gossip, thus hurting your reputation, alienating co-workers and patients, fostering distrust, and derailing the team’s focus. Many employers confuse team building with the thought that we need to all be equal and good friends or even family. This familiarity is difficult to understand for people who want a professional relationship.
With awareness, you can be friendly and professional at the same time, while focusing on team goals. You may like speaking your mind, but others might not like to hear it. Most workers have a tough time receiving negative feedback, especially when it's from someone they know, like and have perceived a “friendship”. To ease the situation, try implementing a feedback PNP. Start on a Positive note (“It is great when you are here on time for the meeting”), continue with the potentially Negative feedback (“It is important that you participate in the meeting by having the numbers ready”), and then end on another Positive note (“We can then get done with the meeting and go to lunch on time”). Here are some positive approaches to being yourself and a member of a team:
1. Observe how others are working. If your employer doesn’t look at her/his email every day, email is probably not the best way to communicate. Figure out how your teammates and managers enjoy working and try your best not to interrupt their productivity flow. Just because you have time between patients doesn’t mean it is a good time to discuss vacation dates with the Office Manager. Your manager may prefer you send an email or text to set up a time to talk. Bending to other people's processes will position you as a team player, not to mention making it easier for your ideas to be heard.
2. Recognize and prioritize conflict resolution. There is a cost every time you engage in a workplace conflict, and it's usually time. Schedules unravel, chaos ensues, morale declines. Decide what your priorities are and let go of the emotional baggage, even if you know you're right. The key is to know when you should push an idea and when you shouldn't. High achievers know success is less about being right, and more about contributing to a shared vision. Preserving relationships is a cornerstone to teamwork.
3. Acknowledge that you are part of a team. While the workplace can and should have multiple personalities and opinions, it's easy to forget that everyone is working toward the same objective. The Scheduling Coordinator may not complete a task in the same way you would, but that's no reason to be divisive. You're all on the same team, working toward the same goal, and strong opinions can be a sign that someone sees a potential problem that should be acknowledged.
4. Don’t be a know it all, respect others expertise. Most people just want to be heard and validated. Respect and acknowledge that your co-workers have an expertise that you don't. Understand not only that you don't know it all, but you can't do it all. You'll find it's much more enjoyable to interact with your co-workers and get things done. Try not to undermine people's authority or challenge their knowledge and instead, ask for their input, feedback, and advice when something comes up in their realm of expertise. They'll appreciate being consulted, and you'll learn something new.
Learn more about “what you don’t know” to operate a successful and profitable practice. Take a Dental Business Training Course customized to your needs. Call McKenzie Management today at 877-777-6151.
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