When patients miss appointments, they interrupt the flow of patient care and impede clinic productivity. A missed appointment amounts to reduced billing and missed revenue. The rate of no-shows runs at thirty percent for the average Family Practice clinic. Worse, if the clinicians are part-time or full-time staff rather than contracted, they sit idle on the company clock. In this case, a missed appointment is not just a missed opportunity for revenue; it's lost money with each passing minute.

An effective office manager uses three strategies to protect clinic revenue:

1. Charge for missed appointment. – This strategy works well in terms of no-show reduction for ongoing cases but it is ineffective for missed intakes. Also, billing full service fees for misses is not possible for procedures covered by medical insurance. Moreover, billing insurance companies for services not rendered is a major felony that carries severe punitive action including both financial penalties and jail time.


2. Minimize no-shows. Recognize that any activity that reduces the frequency of no-shows is a revenue-generating activity. Use down time to
   
   
   1. Make reminder calls for upcoming appointments. It works best when reminders reach the consumers one to three days ahead of their appointments. Note that any degree of success is improved billing and money in your pocket.
   
   
   2. Follow up on recent no-shows. Call patients who failed to appear this week, survey them as to the reason for their missed appointment, and reschedule next appointment.
   
   
   3. Analyze no-show statistics.Feed missed appointment survey information back into patient scheduling system, alarming about the types of appointments that are most likely to be missed. Use this knowledge to target reminder efforts, or to change scheduling. For instance, waiting time for appointment is related to the likelihood of missing it. Specifically, both very short turn around times (one to three days) and longer waits (10 to 14 days) are associated with poorer attendance. Waiting periods of four to seven days positively correlate with best attendance.
   
   
3. Overbook. Overbooking is an effective strategy in terms of billing revenue protection. It requires good understanding of your no-show statistics and it rests on the premise of the interchangeability of clinicians. Identify the most vulnerable appointment type in terms of missed revenue and cluster them during periods of the day ("target periods") when you can have a pool of clinicians on site. You can implement this strategy by scheduling appointments on the quarter-hour rather than the half-hour increments during the target period.