Guest guest Posted August 18, 2012 Report Share Posted August 18, 2012 Try automated reminders. Lots of companies offer these services. My system is unique to my EMR so it’s unlikely you could use it. What it has produced is very few missed appointments. Often less than one a week. The EMR emails patients about 7 days in advance, sends text messages 4 days before appt. then a voice message two days and one day before. Granted it sounds close to overdoing it but no one complains. When I ask patients if they want fewer reminders they always say no. An important part of a good automated reminder system is giving patients plenty of advance warning about canceling so you can schedule other patients. Appointments scheduled less than seven days in advance still get all three flavors of reminders compressed into a shorter time. Neighbors, MDHuntsville, Alabama Solo using FlexMedical EMR/Billing since 2/2009Attested MU in 2011 From: [mailto: ] On Behalf Of ArdianaSent: Friday, August 17, 2012 7:01 PMTo: IMPSubject: Missed appointments So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating Ardiana M. Teran Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2012 Report Share Posted August 19, 2012 it's how much they value or even know what's more important.... pts dont bat an eyelash paying either $100 but give you issues about copays sigh grace > > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > Ardiana M. Teran > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2012 Report Share Posted August 19, 2012 Follow-up visits for silent conditions like HTN, high cholesterol, just don't have the urgency of a good set of nails and a nice hairdo before a date. Whaddaya think? Now, if patient was having unstable angina that would probably beat out the nail-salon visit. It's a competition between asymptomatic vs. symptomatic conditions. Visual/cosmetic vs. non-visual, non-cosmetic Humans - very simple and superficial animals at times. Pamela Wible, MD 3575 St. #220 Eugene, OR 97405 www.idealmedicalcare.org " (S)He is the best physician who is the most ingenious inspirer of hope. " ~ Coleridge > > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > Ardiana M. Teran > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2012 Report Share Posted August 19, 2012 adolfo, i am always running late so i tend to be easier on people. you should call them on it. esp the next time you see them, tell them i missed you this last time and waited for you to show up.. etc.. when you come across mad, then you end up being the bad guy again... i do have personnel call to remind. and people dont forget but repeat offenders i do discharge. new patient no shows esp may not be booked again. grace > >> > >> So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > >> > >> Ardiana M. Teran > >> > > > > > > > -- > > > >    MD >    >    > ph   fax > http:/// > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2012 Report Share Posted August 19, 2012 Exactly! During the town hall meetings, patients pretty much designed their own ideal clinic and they wanted massage in the waiting room and other not-so-expensive perks. If we actually allowed patients to design their own medical home (rather than designing it FOR them and then calling it a Patient-Centered Medical Home), I bet we'd see some different behavior. I have offered free massage during appointments. And it is actually quite cheap for me when I hire a massage students who needs the hours of practice to graduate from massage school. Patients love it. No no-shows! As for seeing patients outside the office setting, I'll do that too! Have seen folks in the grocery store, YMCA, DMV . . .I'll pretty much go wherever. Almost did a Pap in a field full of livestock. But that's another story for another day . . . BTW, most of these stories coming out in my book next month (and they are illustrated with HILARIOUS cartoon). Will send y'all copies. xoxo ~ Pamela Pamela Wible, MD 3575 St. #220 Eugene, OR 97405 www.idealmedicalcare.org " (S)He is the best physician who is the most ingenious inspirer of hope. " ~ Coleridge > > > > So, I do not understand how people remember their hair and nail > appointments but DO NOT remember their doctors appointment ???! Frustrating > > > > Ardiana M. Teran > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2012 Report Share Posted August 20, 2012 Adolfo, , and others:If your anger is truly at not being able to see other patients because of their disrespect, I think this is a fine policy in terms of getting the dead wood out of your practice. But it has its hidden costs. If it's more about the loss of income (plus maybe some annoyance at the disrespect), you might ask yourself if the $75 no-show fine is adequate compensation for your lost opportunity to see a different patient. If not, then consider simply raising the fine to an amount where it becomes adequate compensation and drop the 3 strike clause. Why? Well, if it truly is adequate compensation, why be offended? The threat to fire them on top of the fines (assuming they willingly pay them) seems gratuitous and is likely to lead to a much more hostile working relationship with all of your patients. Think about it: threats like those are threats we generally reserve for children, and if there's one thing we resent as adults, it's being treated like a child. If you leave it in business terms (you lose money because of their carelessness, but we're all human and humans make mistakes; they can make amends and preserve the relationship by paying you for your lost opportunity to see someone else), you give them the opportunity to save face and compensate you while maintaining a mutual level of respect. The threat to fire people can be reserved for those who insist on acting like children anyway and are not willing to make it up to you when they screw up.My own $.02,Ken Agree 100% with all of above, and do all of above. 75$ no show fine, 3 strikes you are fired, and the letter says because I can't fill it, and have peole waiting to get in. CCote To: Sent: Sunday, August 19, 2012 12:27:09 PMSubject: Re: Missed appointments Adolfo -1) Charge a 50-75 dollar no-show fee2) Fire repeat offenders of those who refuseto pay 3) Don't feel sorry for them because theywill pay big bucks for dumb stuff likecigarettes and alcohol and brand-namesneakers4) When we value ourselves we willbe treated like we value by others.5) If we take this kind of shit then we will get more of it and willattract more disrespectful patients.My favorite slide from a keynote I gave tohundreds of docs:Patients fall to the level of dysfunctionwithin a clinic.I, seriously, think we do this to ourselves by being too nice and letting people get away with this type of stuff.Tough love.xoxox~ PamelaPamela Wible, MD3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org"(S)He is the best physician who is the most ingenious inspirer of hope."~ Coleridge> >> > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > > > Ardiana M. Teran> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2012 Report Share Posted August 20, 2012 I chose not to fine people because: 1) it’s not really collectable. You can’t charge for services not given. 2) Medicaid patients can’t be charged so it’s not the same for everyone. 3) It pisses patients off. That’s why I did the 3 strike method. It will apply to everyone equally. It won’t just be a charge sitting on an account. And it makes the point. I don’t want people to think it’s just about the money. I have had 1 patient say she would rather pay me for the missed appointment. But she has made all her other appointments or cancels with adequate notice. Kathy Saradarian, MDNJ From: [mailto: ] On Behalf Of Ken StoneSent: Monday, August 20, 2012 8:18 AMTo: Cc: Ken StoneSubject: Re: Missed appointments Adolfo, , and others: If your anger is truly at not being able to see other patients because of their disrespect, I think this is a fine policy in terms of getting the dead wood out of your practice. But it has its hidden costs. If it's more about the loss of income (plus maybe some annoyance at the disrespect), you might ask yourself if the $75 no-show fine is adequate compensation for your lost opportunity to see a different patient. If not, then consider simply raising the fine to an amount where it becomes adequate compensation and drop the 3 strike clause. Why? Well, if it truly is adequate compensation, why be offended? The threat to fire them on top of the fines (assuming they willingly pay them) seems gratuitous and is likely to lead to a much more hostile working relationship with all of your patients. Think about it: threats like those are threats we generally reserve for children, and if there's one thing we resent as adults, it's being treated like a child. If you leave it in business terms (you lose money because of their carelessness, but we're all human and humans make mistakes; they can make amends and preserve the relationship by paying you for your lost opportunity to see someone else), you give them the opportunity to save face and compensate you while maintaining a mutual level of respect. The threat to fire people can be reserved for those who insist on acting like children anyway and are not willing to make it up to you when they screw up. My own $.02, Ken Agree 100% with all of above, and do all of above. 75$ no show fine, 3 strikes you are fired, and the letter says because I can't fill it, and have peole waiting to get in. CCote To: Sent: Sunday, August 19, 2012 12:27:09 PMSubject: Re: Missed appointments Adolfo -1) Charge a 50-75 dollar no-show fee2) Fire repeat offenders of those who refuseto pay 3) Don't feel sorry for them because theywill pay big bucks for dumb stuff likecigarettes and alcohol and brand-namesneakers4) When we value ourselves we willbe treated like we value by others.5) If we take this kind of shit then we will get more of it and willattract more disrespectful patients.My favorite slide from a keynote I gave tohundreds of docs:Patients fall to the level of dysfunctionwithin a clinic.I, seriously, think we do this to ourselves by being too nice and letting people get away with this type of stuff.Tough love.xoxox~ PamelaPamela Wible, MD3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org " (S)He is the best physician who is the most ingenious inspirer of hope. " ~ Coleridge> >> > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > > > Ardiana M. Teran> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2012 Report Share Posted August 20, 2012 No show fees make good policy if they serve as a modest reminder you have a cost associated with  scheduled appointments. Some need this extra reminder, many probably don’t. I place my no show reminder in small print on all appointment cards and in a few other places including a small sign at checkout, my web site, etc. On my appointment card it reads, “If unable to keep appointment, kindly give 24 hours notice to avoid a missed appointment fee.â€. Rarely do I charge the fee. Usually I instruct the front desk to wave the fee and earn bonus gratitude and loyalty. For serious offenders I charge the fee and in due course decide if they should be dismissed. In all fairness, a practice with an efficient reminder system will have few no shows. Ideally people should be more responsible and not forget appointments but human nature runs counter to this ideal. Really, who remembers everything they are supposed to do? What you want the patient to do is move your appointment in front of every other need calling for their attention. That’s what an efficient reminder system accomplishes. Although my automated reminder system is unique to my EMR  I see ads from companies that claim to sell somewhat similar add-on reminder software for a wide range of EMRs. Perhaps others using one of these generic add-on services will share their experience. Neighbors, MDHuntsville, Alabama Solo using FlexMedical EMR/Billing since 2/2009Attested MU in 2011 From: [mailto: ] On Behalf Of Ken StoneSent: Monday, August 20, 2012 7:18 AMTo: Cc: Ken StoneSubject: Re: Missed appointments Adolfo, , and others: If your anger is truly at not being able to see other patients because of their disrespect, I think this is a fine policy in terms of getting the dead wood out of your practice. But it has its hidden costs. If it's more about the loss of income (plus maybe some annoyance at the disrespect), you might ask yourself if the $75 no-show fine is adequate compensation for your lost opportunity to see a different patient. If not, then consider simply raising the fine to an amount where it becomes adequate compensation and drop the 3 strike clause. Why? Well, if it truly is adequate compensation, why be offended? The threat to fire them on top of the fines (assuming they willingly pay them) seems gratuitous and is likely to lead to a much more hostile working relationship with all of your patients. Think about it: threats like those are threats we generally reserve for children, and if there's one thing we resent as adults, it's being treated like a child. If you leave it in business terms (you lose money because of their carelessness, but we're all human and humans make mistakes; they can make amends and preserve the relationship by paying you for your lost opportunity to see someone else), you give them the opportunity to save face and compensate you while maintaining a mutual level of respect. The threat to fire people can be reserved for those who insist on acting like children anyway and are not willing to make it up to you when they screw up. My own $.02, Ken Agree 100% with all of above, and do all of above. 75$ no show fine, 3 strikes you are fired, and the letter says because I can't fill it, and have peole waiting to get in. CCote To: Sent: Sunday, August 19, 2012 12:27:09 PMSubject: Re: Missed appointments Adolfo -1) Charge a 50-75 dollar no-show fee2) Fire repeat offenders of those who refuseto pay 3) Don't feel sorry for them because theywill pay big bucks for dumb stuff likecigarettes and alcohol and brand-namesneakers4) When we value ourselves we willbe treated like we value by others.5) If we take this kind of shit then we will get more of it and willattract more disrespectful patients.My favorite slide from a keynote I gave tohundreds of docs:Patients fall to the level of dysfunctionwithin a clinic.I, seriously, think we do this to ourselves by being too nice and letting people get away with this type of stuff.Tough love.xoxox~ PamelaPamela Wible, MD3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org " (S)He is the best physician who is the most ingenious inspirer of hope. " ~ Coleridge> >> > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > > > Ardiana M. Teran> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2012 Report Share Posted August 20, 2012 I think a no-show fee is regionally acceptable. I get patients all the time who call to cancel more than 24 hours in advance, but they want to make sure they aren't charged a no-show fee. Our fee is $40, which we set because that was the highest copay we saw at the time. We have a grace period of one allowed no-show or late (less than one biz day notice) cancellation. When they schedule their next appointment, we advise them that they either didn't show up OR that they cancelled their last appt too late, and to please be aware that if that happens again, they will be charged a no-show fee. Adolfo, e-MDs will show this in their schedule history (not looking at it right now, but i think it shows at the bottom of the screen) if you are marking them as no-shows, and I added a cancellation reason that is " late cancellation. " We are successful in collecting the fee because it is 1) regionally the norm. 2) we advise patients about it when they are in jeopardy. 3) we won't see them again unless they clear that fee. If a patient never sees you again, and they haven't paid their bill in 6 months, they are dismissed anyways. We also call the next day to find out what happened and reschedule them (unless it ws a new pt). Rarely they have simply forgotten because we also call to confirm appts 2 days in advance. We do have one female new patient that keeps calling - using the same DOB and phone # but completely different names - that scheduled 2 appts and no- showed both. I now have stickies with that phone and DOB so we don't schedule her again. Likely a seeker, and I heard she called last week again, so the staff referred her to urgent care. Pratt I chose not to fine people because: 1) it’s not really collectable. You can’t charge for services not given. 2) Medicaid patients can’t be charged so it’s not the same for everyone. 3) It pisses patients off. That’s why I did the 3 strike method. It will apply to everyone equally. It won’t just be a charge sitting on an account. And it makes the point. I don’t want people to think it’s just about the money. I have had 1 patient say she would rather pay me for the missed appointment. But she has made all her other appointments or cancels with adequate notice. Kathy Saradarian, MDNJ From: [mailto: ] On Behalf Of Ken Stone Sent: Monday, August 20, 2012 8:18 AMTo: Cc: Ken StoneSubject: Re: Missed appointments Adolfo, , and others: If your anger is truly at not being able to see other patients because of their disrespect, I think this is a fine policy in terms of getting the dead wood out of your practice. But it has its hidden costs. If it's more about the loss of income (plus maybe some annoyance at the disrespect), you might ask yourself if the $75 no-show fine is adequate compensation for your lost opportunity to see a different patient. If not, then consider simply raising the fine to an amount where it becomes adequate compensation and drop the 3 strike clause. Why? Well, if it truly is adequate compensation, why be offended? The threat to fire them on top of the fines (assuming they willingly pay them) seems gratuitous and is likely to lead to a much more hostile working relationship with all of your patients. Think about it: threats like those are threats we generally reserve for children, and if there's one thing we resent as adults, it's being treated like a child. If you leave it in business terms (you lose money because of their carelessness, but we're all human and humans make mistakes; they can make amends and preserve the relationship by paying you for your lost opportunity to see someone else), you give them the opportunity to save face and compensate you while maintaining a mutual level of respect. The threat to fire people can be reserved for those who insist on acting like children anyway and are not willing to make it up to you when they screw up. My own $.02, Ken Agree 100% with all of above, and do all of above. 75$ no show fine, 3 strikes you are fired, and the letter says because I can't fill it, and have peole waiting to get in. CCote To: Sent: Sunday, August 19, 2012 12:27:09 PMSubject: Re: Missed appointments Adolfo -1) Charge a 50-75 dollar no-show fee2) Fire repeat offenders of those who refuse to pay 3) Don't feel sorry for them because theywill pay big bucks for dumb stuff likecigarettes and alcohol and brand-namesneakers4) When we value ourselves we willbe treated like we value by others. 5) If we take this kind of shit then we will get more of it and willattract more disrespectful patients.My favorite slide from a keynote I gave tohundreds of docs:Patients fall to the level of dysfunction within a clinic.I, seriously, think we do this to ourselves by being too nice and letting people get away with this type of stuff.Tough love.xoxox~ PamelaPamela Wible, MD3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org " (S)He is the best physician who is the most ingenious inspirer of hope. " ~ Coleridge > >> > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > > > Ardiana M. Teran> > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 20, 2012 Report Share Posted August 20, 2012 I stopped being angry about this long ago, so I don't know where that came from. I have lost one patient over this fee, and the rest gladly pay it. Most try not to be late, so they won't get the fine. IN practice for 22 years, almost 10 as an IMP CCote To: Cc: "Ken Stone" Sent: Monday, August 20, 2012 5:17:49 AMSubject: Re: Missed appointments Adolfo, , and others: If your anger is truly at not being able to see other patients because of their disrespect, I think this is a fine policy in terms of getting the dead wood out of your practice. But it has its hidden costs. If it's more about the loss of income (plus maybe some annoyance at the disrespect), you might ask yourself if the $75 no-show fine is adequate compensation for your lost opportunity to see a different patient. If not, then consider simply raising the fine to an amount where it becomes adequate compensation and drop the 3 strike clause. Why? Well, if it truly is adequate compensation, why be offended? The threat to fire them on top of the fines (assuming they willingly pay them) seems gratuitous and is likely to lead to a much more hostile working relationship with all of your patients. Think about it: threats like those are threats we generally reserve for children, and if there's one thing we resent as adults, it's being treated like a child. If you leave it in business terms (you lose money because of their carelessness, but we're all human and humans make mistakes; they can make amends and preserve the relationship by paying you for your lost opportunity to see someone else), you give them the opportunity to save face and compensate you while maintaining a mutual level of respect. The threat to fire people can be reserved for those who insist on acting like children anyway and are not willing to make it up to you when they screw up. My own $.02, Ken Agree 100% with all of above, and do all of above. 75$ no show fine, 3 strikes you are fired, and the letter says because I can't fill it, and have peole waiting to get in. CCote To: Sent: Sunday, August 19, 2012 12:27:09 PMSubject: Re: Missed appointments Adolfo -1) Charge a 50-75 dollar no-show fee2) Fire repeat offenders of those who refuseto pay 3) Don't feel sorry for them because theywill pay big bucks for dumb stuff likecigarettes and alcohol and brand-namesneakers4) When we value ourselves we willbe treated like we value by others.5) If we take this kind of shit then we will get more of it and willattract more disrespectful patients.My favorite slide from a keynote I gave tohundreds of docs:Patients fall to the level of dysfunctionwithin a clinic.I, seriously, think we do this to ourselves by being too nice and letting people get away with this type of stuff.Tough love.xoxox~ PamelaPamela Wible, MD3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org"(S)He is the best physician who is the most ingenious inspirer of hope."~ Coleridge> >> > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > > > Ardiana M. Teran> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 24, 2012 Report Share Posted August 24, 2012 I agree with this reasoning. We don;t either, but we have about 4 nos hows a year. Same day appointments solves many issues. From: [ ] On Behalf Of Kathy Saradarian [qualityfp@...] Sent: Monday, August 20, 2012 7:02 AM To: Subject: RE: Missed appointments I chose not to fine people because: 1) it’s not really collectable. You can’t charge for services not given. 2) Medicaid patients can’t be charged so it’s not the same for everyone. 3) It pisses patients off. That’s why I did the 3 strike method. It will apply to everyone equally. It won’t just be a charge sitting on an account. And it makes the point. I don’t want people to think it’s just about the money. I have had 1 patient say she would rather pay me for the missed appointment. But she has made all her other appointments or cancels with adequate notice. Kathy Saradarian, MD NJ From: [mailto: ] On Behalf Of Ken Stone Sent: Monday, August 20, 2012 8:18 AM To: Cc: Ken Stone Subject: Re: Missed appointments Adolfo, , and others: If your anger is truly at not being able to see other patients because of their disrespect, I think this is a fine policy in terms of getting the dead wood out of your practice. But it has its hidden costs. If it's more about the loss of income (plus maybe some annoyance at the disrespect), you might ask yourself if the $75 no-show fine is adequate compensation for your lost opportunity to see a different patient. If not, then consider simply raising the fine to an amount where it becomes adequate compensation and drop the 3 strike clause. Why? Well, if it truly is adequate compensation, why be offended? The threat to fire them on top of the fines (assuming they willingly pay them) seems gratuitous and is likely to lead to a much more hostile working relationship with all of your patients. Think about it: threats like those are threats we generally reserve for children, and if there's one thing we resent as adults, it's being treated like a child. If you leave it in business terms (you lose money because of their carelessness, but we're all human and humans make mistakes; they can make amends and preserve the relationship by paying you for your lost opportunity to see someone else), you give them the opportunity to save face and compensate you while maintaining a mutual level of respect. The threat to fire people can be reserved for those who insist on acting like children anyway and are not willing to make it up to you when they screw up. My own $.02, Ken On Aug 19, 2012, at 11:27 PM, magnetdoctor@... wrote: Agree 100% with all of above, and do all of above. 75$ no show fine, 3 strikes you are fired, and the letter says because I can't fill it, and have peole waiting to get in. CCote To: Sent: Sunday, August 19, 2012 12:27:09 PM Subject: Re: Missed appointments Adolfo - 1) Charge a 50-75 dollar no-show fee 2) Fire repeat offenders of those who refuse to pay 3) Don't feel sorry for them because they will pay big bucks for dumb stuff like cigarettes and alcohol and brand-name sneakers 4) When we value ourselves we will be treated like we value by others. 5) If we take this kind of shit then we will get more of it and will attract more disrespectful patients. My favorite slide from a keynote I gave to hundreds of docs: Patients fall to the level of dysfunction within a clinic. I, seriously, think we do this to ourselves by being too nice and letting people get away with this type of stuff. Tough love. xoxox ~ Pamela Pamela Wible, MD 3575 St. #220 Eugene, OR 97405 www.idealmedicalcare.org " (S)He is the best physician who is the most ingenious inspirer of hope. " ~ Coleridge > > > > So, I do not understand how people remember their hair and nail appointments but DO NOT remember their doctors appointment ???! Frustrating > > > > Ardiana M. Teran > > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.