Should You Have a PT Patient No-Show or Cancellation Policy?

Let’s face it, as staff physical therapists usually rejoice over a last minute cancel or no-show.  This means they now have down time to get caught up with any paperwork they have to do; or time to go to the bathroom and grab a snack.  But as private practice owners, we look at this in a completely different way.  If patients aren’t being treated, we are losing money.  I think a lot of times there is a disconnect between the owner(s) and the staff therapists regarding the outcome of patients that cancel and no-show.  Both parties need to be on the same page in order to have a successful practice.  

Staff therapists need to understand the consequences for having an open slot in their schedule.  This happening over and over could lead to less hours available, or even worse, no more job.  Owners need to also take some action to assure that therapists have enough time (within reason) for documentation; take a good, hard look at the documentation and systems you have in place and see if there is any way to train your clinical team to be more efficient or somehow improve your flow and your systems.  Are your documentation systems easy and fast to use, while creating thorough and audit-proof charting?  As the owner, you may not be treating patients on a day to day basis and your expectations may be unrealistic for what the reality for your therapists are. Learn more about documentation options here.

So let’s find out how much each slot is worth in your practice.  Count up the amount of available slots you offer during the week.  Let’s say you offer 100 slots per week for therapy patients.  Now take your weekly operational and staff costs and divide it by the slot number; in this case 100.  Let’s say it costs me $5000 to -operate Monday through Friday. 5000/100 = $50 per slot.  Make sure your entire team knows this number.  Make sure they understand that you lose $50 every single time you have an open slot in the schedule.   So instead of celebrating, they should be doing something to help you fill those slots.  Contact me for some insight on what kind of tasks they should be doing to help.

Do you charge a fee for patients that don’t show up?  If you don’t, you really should.  Doctors offices of many kinds have charged for many, many years.  My primary care doctor charges $100 if you don’t cancel within 24 hours of your appointment.  Why do they do this?  They may not be recouping the money they lost on being able to bill for that appointment, but they do it to teach you a lesson.  The lesson isn’t to punish you. It’s to show you that every appointment matters, and if you gave more of a notice, they could have filled the spot with someone else that really needed to get in.  Why should physical and occupational therapy be any different?!  

If you currently don’t charge any type of fee, start small.  Start with $10 if they don’t give you 24 notice.  Of course they are going to be some exceptions, like the patient went the ER; take those case by case.  Make sure your patients understand just how important it is that they regularly attend their appointments.  As long as they are aware of your policy up front, you shouldn’t get much push back if/when this policy must be enacted upon.  

Start keeping track of your <24 hours cancels and no show rates and I promise you will want to start taking action on creating a policy for this.  If you need more help, contact!

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