How I…

Charging No-Shows (Or Not)

Erinn Morgan

Other businesses—from dentists to day spas—often charge fees for missed or "no-show" appointments. Can ECPs follow suit by charging patients part of the fee for appointments missed or canceled with less than 24 hours' notice?

We checked in with offices across the country to find out how they handle this sticky subject.

TO CHARGE…

Many ECPs say that appointment no-shows and late cancellations are a real issue for their business—one that loses time, money, and manpower hours. "No-shows happen all the time," says Chet Steinmetz, OD, with Visual Effects Optical in Chicago. "It's so frustrating because it does mess up our schedule."

Adds Deb Pelz, manager of Fox Optical in Rochester Hills, Mich., "We do have no-shows and it can be an issue, especially if it's a family of four on a Saturday."

Why do some people have a relaxed attitude about their scheduled slots? "Because of the way the chain stores operate, it's become a walk-in industry," says Tom Hyde, an optician at Lossman Optical in Lake Zurich, Ill., which has five locations in the Chicago suburbs. "So, many people just don't feel they need an appointment."

This trend has caused some offices to instate charges for no-shows and late cancellations of less than 24 hours. Fees can vary from office to office based on policy. A solid ball park amount for a no-show fee would be about 40 to 50 percent of a full appointment fee.

…OR NOT TO CHARGE

Still, most report that their offices do not charge a standard fee for those patients who aren't diligent about their pre-made appointments.

"We don't charge for no-shows but we should." says Hyde. "You end up losing the money you would have made off that patient."

Before setting a steadfast policy on no-shows and late cancellations, consider how such an act could affect your patient base. "You can try to charge them, but the chances are they will never come back," says Pelz. "We just don't want to alienate anyone in today's economy."

Some ECPs say they have adapted to reworking their schedules to account for cancellations. "My book is never that busy that I couldn't work it out," says Steinmetz.

THAT IS THE QUESTION

The logistics of charging fees for no-shows and late cancellations also present challenges. Do you send a bill for half of the appointment fee? Do you charge the patient's credit card on file?

"What are you supposed to do with a new client—say, ‘Give me a credit card number so I can charge you if you don't show up?’" asks Steinmetz. "I'm just not sure it's something you could do."

In the end, it's possible you might not get paid the fee anyway. "You can threaten them with a charge all you want, but you'll never get it," says Pelz.

One possible resolution to the no-show conundrum is to suggest in your company literature and website that there is a standard fee for late cancellations and no-shows.

This may inspire better patient attendance on the front end, meaning that you'll have to worry less about how to handle those missed appointments. Then ECPs can determine how to employ charges on a case-by-case basis. EB