Physical Therapy Practice: How cancels can hurt :/

We all know that when a patient cancels their appointment at the last minute, or no shows completely, it hurts.  But do you know just how much it actually hurts?  It is so important for the owner and the rest of the team to thoroughly understand how much this can hurt a business.  You’re not just missing out on that one appointment, but there’s a trickle-down effect that involves so much more.  

How do most practices keep track of their cancel and no shows for each day?  Some tally it up with pen and paper, some have to refer back to the schedule to see which patients didn’t actually come in, and some are fortunate enough to have software that keeps track of statistics like this.  If you’re a practice owner, make sure you staff know these numbers on a routine basis.  It’s useless to track if your team is in the dark about what percentage of patients came vs canceled.  Without knowing, how can anyone take strides to improve the compliance of our patients?  So your first step is to make this a routine to alert your entire team on the overall patient compliance.

Do you know how much each patient slot costs you?   This is a really important piece of information to know.  When someone cancels or no-shows for their physical therapy appointment, you are able to gauge exactly how much money was lost.  You must factor in fixed expenses, such as rent, electric, phones, etc.  And then add in employee costs (therapist, receptionist, biller, etc.).  Use these expenses and calculate the total cost per 30- or 60-minute slot in your schedule.

Now keep in mind, you’re not only losing money directly for that spot, but you are also losing out on results with that patient.  Now that their consistency for attending physical therapy has declined, they make take longer to meet goals and progress with their condition.  This then gives them more of an opportunity to ween off and think physical therapy isn’t helping them.  We don’t want a no-show to escalate into something more. 

Charging a no-show or last minute cancel fee is a good way to deter patients from making last minute changes in their personal schedule.  Doctors offices have been doing this for forever, so why can’t physical therapists and occupational therapists follow suit??  The amount of money you charge for a fee doesn’t really matter, because most likely you can’t recoup the cost of that slot anyway.  It’s more of a slap on the wrist for leaving you high and dry.  

So to recap:

  • Strategically track your <24 hour cancels and no-shows on a daily basis – this shouldn’t take more than 10 seconds if you’re using a good software program.
  • Make your staff very aware of what no-shows cost you and how often it’s occuring – train them on how to talk with patients to avoid this from happening.
  • Change a fee for those patients that don’t respect your rules and time.


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