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Appointment Reminder Systems:
Now “No Shows” Have No Excuse

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By Bradley M. Block, M.D., Family Physicians Winter Park

Going “High Tech” can have many benefits to a medical practice. About one and a half years ago, we purchased an automated appointment reminder system, which calls patients to remind them of their appointment date and time. Only invest in this if you want to improve your income.

The Basics
These automated appointment reminder systems are produced and sold by independent companies which provide software and small hardware devices that plug into a computer at the physician’s office. The system is then programmed to call patients and tell them they have an upcoming appointment. Programming options are versatile and allow for many customizations, such as using a recorded voice (versus a computer voice), how far ahead to call, how many times to call a patient, which number to call (i.e., home versus work or cell), exactly what information is given about the appointment, etc. Features and prices definitely vary from one system to another.

The Many Choices
Most computerized practice management scheduling software programs used by physician offices can interface with one or more reminder systems. Systems that interface with physician practice management scheduling software include PhoneTree and others.

Real Life Data
When our four-physician family medicine practice purchased an appointment reminder system about one and a half years ago, we were running an average of over 100 “no shows” per month.

	The income gained through reducing no shows by over 50 appointments per month is major... we are gaining at least $39,600 per year in income.

Our no show rate is down now by over 50 visits per month on average. For example, in April 2005 we had 108 no shows and 1379 patients seen; in April 2006, we had only 46 no shows with 1304 patients seen (a little less seen in April 2006 because of vacationing by doctors) — a 7.3 percent no show rate in April 2006 — less than one half of the no show rate by total number of appointments. This no show reduction is especially seen for preplanned appointments like well physicals and other chronic-care follow up visits.

Count the Dollars
The income gained through reducing no shows by over 50 appointments per month is major. At $52/visit (approx. 2006 Medicare rate for a 99213) for 25 visits per month, and $80/visit (for a 99214 at the 2006 Medicare rate or for a below average paying Well PE) for 25 visits per month, we are gaining at least $39,600 per year in income. Some of these appointments not missed could be worth over $100 of gained income each if they end up being a 99215, an average paying PE, or some procedural visit.

We are also more readily charging no show fees of $15 to $25 (depending on appointment type — for appointments where the system verifies that it indeed left a message or spoke to a person); if we average just $20 for 25 missed appointments per month, we also gain an additional $6,000/year.

We additionally have the non-monetary gain of improved patient satisfaction and better schedule flow. There is less confusion and fewer errors, like patients showing up at the wrong time (or wrong day) for their appointment, and, of course, fewer missed appointments altogether (which reduces the need to reschedule more appointments for future dates). The office flow is less chaotic, too, since patients are more likely to show up at their pre-planned time. And, we definitely get more same-day openings for sick visits and urgent visits because now patients call to cancel the day prior to their appointment.

The Final Low-Down
Our appointment reminder system cost the four of us about $4,000 total, and this has annual support fees of about $200 including full hardware replacement, unlimited assistance, and all updates. This sounds like a lot of money up front, but when you do the math, it worked out well in our favor quickly. Our system has been a great return on investment for us.

Excerpted with permission from the July 2007 issue of Central Florida Doctor. Copyright 2007 Central Florida Doctor. All rights reserved.

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