The Top 5 Reasons Patients Flake Out On Their Appointment Times
This isn’t how you envisioned the start to your day. The patient you were expecting to see at 9 a.m. called to cancel at the last minute, and now your Scheduling Coordinator is desperately trying to find someone to take the opening. You know the chances of her getting a patient in the chair on such short notice are pretty slim, leaving you with a gaping hole in the schedule and wondering how you’re ever going to meet today’s production goals.
That’s the problem with broken appointments. Not only do they lead to chaos and undue stress in your practice, they also cost you money. And I’m talking about thousands of dollars in lost revenue. This can be pretty frustrating, especially if you have no idea why so many of your patients are prone to flaking out.
While you’ll never eliminate them completely, I’m here to help you reduce the number of cancellations and no-shows you deal with each day. It starts with understanding why patients don’t show up in the first place. Here are five of the most common reasons and how to address them:
1. They don’t understand the value of the services you provide. This is where education comes in. If you spend time educating patients chairside about their condition and the importance of maintaining their oral health, they’ll be much more likely to value their appointment time. Give them brochures, play educational videos, answer any questions they have and address their concerns.
Remember, education doesn’t stop after the appointment is over. Think of every patient interaction as an opportunity to educate. Place brochures in the waiting room and at the appointment desk for patients to thumb through while they wait to be called back. Sending out patient statements? Include materials about general oral health topics or services you talked about during their last appointment. Send educational articles via email, maybe even through a monthly practice newsletter.
This will all help patients understand the value of dentistry and the services you offer, and that will go a long way in creating connections with patients as well as helping them understand why they should make routine dental appointments a priority.
2. There’s no sense of urgency. Patients are pretty good at coming up with reasons not to go forward with treatment. Maybe they don’t want to take the time off work, or they don’t think they can afford it. So if you give them the impression there’s no hurry to pursue treatment, guess what? They now have another excuse to put it off for as long as possible.
I suggest you take the same approach during routine hygiene visits. Train your hygienist to educate patients about the oral-systemic link, the importance of oral cancer screenings and why they need to make oral health a priority. When they understand how important routine visits are to maintaining and improving their health, they’ll be more likely to show up.
3. You haven’t developed a policy. What should be part of your policy? Ask patients to cancel at least 48 hours in advance so another patient has the opportunity to take the slot. Remind patients of the policy every time they make an appointment, and how last-minute cancellations throw off the practice’s schedule. You should see a huge drop in the number of broken appointments you deal with each day.
4. You don’t confirm appointments. Sometimes patients don’t show up simply because they forgot they scheduled an appointment with your office, which is why it’s so important to confirm with patients two days in advance. And that doesn’t mean calling and leaving a voicemail. You actually have to talk with patients. I suggest you ask how they’d prefer to confirm appointments, whether it’s via phone call, text or email, and then use their preferred method of contact.
5. You rely on pre-appointing. I know this is a popular practice, but it really is outdated. Patients have no idea what they’ll be doing in six months, so even though they scheduled an appointment with you, there’s a pretty good chance something else will come up between now and then that prevents them from being there.
To avoid this, I recommend implementing a hybrid system. What does that mean? Only pre-appoint reliable patients, and flag any patients with at least two no-shows as unreliable. Let these patients know you’ll call them as appointment times become available.
Broken appointments can be pretty costly. Following these tips will help you reduce last-minute cancellations and no-shows, boosting production and ultimately your bottom line.
Next week, Don’t let broken appointments wreak havoc on your day.
For additional information on this topic and more, visit my blog: The Lighter Side
Interested in speaking to me about your practice concerns? Email firstname.lastname@example.org
Dental Business Models and Patient Choices
Patients have the right to choose a dentist or dental care facility that meets their needs, desires and concept of patient care. If a dental practice shows they are primarily interested in how a patient is going to pay, this may be a red flag – especially to patients who are interested in finding out what you can do for them before the discussion of money enters the conversation. The dental team needs to define what business model they are most likely to fit into:
1. Third party payers/in-network providers, Medicaid, Medicare & other government programs
2. Fee for service/accept assignment of benefits from insurance/out-of-network providers
3. Fee for service/payment in full/patient files claim & receives insurance benefits
Strange as it may seem, dealing with who is going to pay for dental services outweighs the long-term benefits for health in the long run. No one wants to pay more than they think they should. Complicated issues arise when a third party, the government or an insurance company pays for services and the patient sees that role as defining their obligation to pay. Understand that Medicare, Medicaid and CHIPS are the government and PPO, HMO or Fee for Service are publicly or privately-owned business entities. Dentists and patients alike often equate insurance payment for services as acceptance and approval of services. It isn’t. It is simply what the employer has purchased. The more expensive the policy, the more benefits. In-network, the insurance company is being asked to pay for services that may or may not fit into the contract with the employer. If they don’t fit they don’t get paid, even if the patient and the dentist both agree that the treatment is in the best interest of the patient.
Many dental practices become absorbed in presenting treatment based on whether the patient’s policy will pay for the care or not. This is addressed to the patient during the visit as “we’ll check with your insurance to see if this is covered” before the patient inquires. But this sends a message that “if it isn’t covered, I shouldn’t need it”.
Medicaid will pay a deeply discounted fee schedule for minor dentistry for children who are eligible for care. Many dentists do not favor these Medicaid programs because it is difficult to create a fair profit for the practice. That is where larger dental organizations can survive by buying supplies in bulk and carefully managing costs.
Three Business Models
1. Third-party payer business models have changed the business models for dentistry. The system has its benefits; patients who cannot afford or who will not pay out of pocket for services end up getting some needed work, allowing the patient to be healthier and giving the dentist a steady supply of patients. Patients are more apt to continue to see an in-network care giver versus out-of-network.
Patients often accept or deny treatment based solely on whether it is covered 100% by insurance, which translates to zero out of pocket costs to the patient. Insurance benefits were never designed to pay 100% for anything other than preventive and diagnostic care, with applicable frequency limitations. Yet patients are more inclined to have treatment performed when there is a higher payout like 100% versus 80% or 50%.
Corporate dentistry or corporate dental chain stores base their business model on the third-party payer system.
2. Fee for Service is a second business model. This model started when the first dental “insurance” policies came to be. It was necessary to establish how the patient was going to pay. Fee for service meant the patient had to pay cash, check or credit card at the time of service. If you accept assignment of benefits the patient must pay the remainder.
In the 1970s, the benefit was between $1000 and $1500 a year. Today, it is $1000 to $1500. Why? Insurance companies base their benefit allowance on claim total statistics, and most dentists don’t bill for services after the maximum has been reached.
Dental employees, trying to get information for patients, are often left on hold for hours at a time. Insurance companies lose claims, deny claims, and request information already provided. It takes a tremendous amount of time, energy and employees for dental offices to collect for the patient's benefit.
Every dentist must figure out which business model most reflects his/her practice. The business model has a lot to do with the type of patients they will encounter and what these patients are expecting from the practice.
Need more help with business models? Call McKenzie Management for information about consulting and training programs that will help you manage the systems in your practice.
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