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Automated Messaging Increases Revenue by
Decreasing No-Shows for The Salem Center
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Purpose:
The purpose for The Salem Center’s purchasing and installing a PhoneTree patient messaging system
was to decrease their number of no-shows and recover lost revenue.
Abstract:
Increasing Revenues Through Decreasing No-shows
Most practices make return appointments when patients complete visits, and these are often months in the future. Several studies report that over half of the patients who don’t show for their appointments simply forgot they had an appointment at all. Appointment reminder calls can decrease these no-show rates significantly and improve practice revenues.
Numerous studies document
the cost-effectiveness of using an appointment reminder system to decrease no-shows. One study by O’Brien
and Lazebnik(1) found significant increases (47.8%) in insured patients who showed up for their appointments
when they received appointment reminder calls. Another study by Dini, Linkins and Chaney(2) found 52%
of patients who received reminder calls kept their appointments, compared to 32.5% who did not receive
reminder calls.
Using office staff to make these appointment reminder calls creates several issues for the practice. First, this contributes to the personnel utilization and costs of the practice. Personnel are costly and they already have many responsibilities. This activity also takes up space and phone lines.
Second, calls are most often made during the day when the practice is open but when most patients are at work. The results are that patients can not be reached or messages are left on answering machines. Staff productivity can not be measured as there is no way to verify if patients get these messages. At best, using staff to make these calls during the day is costly and marginally effective.
Story:
Deborah Brown, RN, MSN, Practice Administrator and consultant to physician practices, evaluated appointment
reminder calls at The Salem Center, an internal medicine group that was using staff to make appointment
reminder calls. In 79% of calls attempted, a staff member left a message or did not reach the patient,
so it was impossible to determine if the patient actually received the reminder. The practice’s
no-show rate was 40 appointments per week, resulting in an average weekly revenue loss of $6,160 (calculated
by examining specific reimbursement for each visit type).
This practice installed a PhoneTree messaging system to make appointment reminder calls during early mornings two days before scheduled appointments and again in the evenings, so more patients would receive the calls. In messages delivered by the PhoneTree system, patients were given the options to "confirm" or "cancel" the appointments by pressing a key on their phones. Using the PhoneTree daily report, the staff could determine if the patient "confirmed" or "cancelled" the appointment. In addition, they could determine if the patient’s phone numbers had been disconnected. The practice opened the "cancelled" appointment times and those of patients whose numbers had been disconnected. They booked other patients into these slots. If the patients whose numbers had been disconnected did arrive, they were worked back into the schedule.
Results:
After using PhoneTree and the reports to work their daily schedules, this practice calculated the following:
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Notes:
This data divided the actual appointment reimbursement anticipated for scheduled appointments types to
determine the impact on revenue. The reimbursement increase was calculated using $136 per visit (the average
of the actual no-show appointments). The annual figure was calculated at a 46 week/year schedule.
References:
1. Telephone Call Reminders and Attendance in an Adolescent Clinic.
Grael O'Brien and Rina Lazebnik.
DOI: 10.1542/peds.101.6.e6
1998;101;6.
Pediatrics.
2. Effectiveness of Computer-Generated Telephone Messages in Increasing Clinic Visits.
Dini E.F., Linkins R.W., Chaney M.
1995;149:902-5.
Arch Pediatric Adolescent Medicine.
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