Deciding whether “no show” fees are right for your practice can be a difficult decision. On one hand, you could potentially lose patients who are unhappy with the policy. On the other hand, too many no shows can have a real impact on production. There is no one right or wrong answer. Every practice’s situation and patient base will be different.

The impact of no shows at your practice

Determine how much time and production your practice is losing to patients who skip their appointment. Track every no show and take note of how long the appointment was scheduled for and the type of treatment. Do this for at least a few months to get accurate data and monitor trends. Only with a rough estimate of your real opportunity cost can you make an informed decision.

Are you certain that patients are at fault?

If you find that no shows seem to happen more often at your practice than at your colleagues’, it might be time to reassess your scheduling system to make sure the problem isn’t internal. Along with auditing scheduling protocols, make sure you’ve got a system in place to annotate which patients have missed appointments in the past.

Is losing some patients OK?

Implementing a “no show” fee necessarily means that a certain percentage of patients who are charged the fee will not come back. Only you and your team can know whether losing some of your more challenging patients would be a good thing, or if working harder to get them to show up, would yield better results.

Exhaust all other options first

Even if you decide in the end that the lost revenue from no shows warrants a fee, make sure you’ve exhausted other methodologies for fixing the problem first. Sometimes, a more advanced appointment reminder system, particularly one that sends SMS messages to your patients the day of their appointment, can reduce the number of no shows, or at least convert no shows into cancellations, giving you time to backfill the hole in your schedule at the last minute. It’s also smart to give patients at least one warning, as you wouldn’t want to lose a good patient over a one-time slip of the mind or an emergency. Try to arrange your “no show” fee structure in such a way that you’re only forced to penalize repeat offenders.