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May 2015

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Practice Marketing

How to Reduce Dental Patient No-Shows by 41%

A missed or cancelled appointment is like a dagger – not to your heart – but to your billing. Across a variety of healthcare fields, the cost of a missed appointment can range from $50 to over $1,000.  And combined, no-shows cost the US healthcare system more than $150 billion a year.

As a practitioner, it’s a three-fold loss.

For one, you can’t get the time or money back.

Also, patients who would have otherwise showed up, get unnecessarily bumped to a later slot.

And you’re still on the hook for all of your fixed costs like electricity, rent and staffing expenses.

While you probably can afford to absorb a few missed appointments, some practices have no-show rates over 25%. It’s inevitable that some appointments will go unfilled, but bringing down the rate of your no-show appointments is one of the fastest ways to raise profitability across the board.

We’ve compiled three steps that can help your practice minimize the number of missed appointments you have to deal with:

1.       Make an appointment reminder call.

If you do nothing else, instituting a reliable system to remind your patients of upcoming appointments can have a big impact – so don’t skip this step.

How big of an impact?

A study by the American Journal of Medicine found the normal no-show rate of 23% dropped to 17% for those patients who received an automated appointment reminder, and fell further to 13% when patients received a personal call from a practice staff member. That’s a 41% drop in no-shows, or 10 fewer no shows per 100 appointments (!), which could add up to hundreds of thousands of dollars a year in saved revenue.

You can also email and text your patients to remind them the day of the appointment to ensure a complete communication strategy. If you choose an automated reminder solution, make sure it includes a way for patients to let you know if they can’t make the appointment.

2.       Institute and stick to a well-communicated cancellation policy.

Communicate your cancellation policy to patients, and tell them exactly how to cancel . You should give them as many reasonable options on how they can contact you to do so as possible – whether that’s by phone, email, text or via an online calendar. Information on cancellation should be on every appointment reminder card, bill, and communication you send or give your patient online or in person.

If the shoe were on the other foot, and you inevitably need to cancel or reschedule an appointment, be sure to follow your own rules as well. It’s only fair to hold your patients to the same standard that you also practice. For example, if you have a 48 hour cancellation policy, hold yourself to it.

When a patient does follow your cancellation policy and gives you the notice you require, be sure to thank them– it’s an opportunity to remind them of how much you appreciate the courtesy of cancelling in a timely fashion.

3.       Know when to walk away.

Patients who habitually miss appointments or show up late can cost you more money than they’re worth. Your practice is a place of business, and in business terms, you need to cut your loss leaders and focus on your profit centers. No-shows constrain your ability to help people who truly need it.

The tricky part is knowing under what circumstances you should fire a patient. For some fields of practice, it’s not always possible to terminate a patient immediately. If the patient is in acute distress, or in the middle of treatment or otherwise compromised medically, you may have to wait until they’re healthy to terminate. But if the patient is stable and not in need of immediate care, then a no-show patient is usually safe to let go. Always follow the rules and regulations of your field and double check to make sure you can actually terminate a patient before you do so.

Just as with your cancellation policy, you should come up with a termination policy. Let new patients know about your policy and strictly enforce it. Some doctors have a 3-strikes and you’re out policy. Some have a 1 strike and you’re out rule. Whichever policy you choose, if it comes time to terminate a patient, make sure you do so in a professional manner. Either you or your office manager should call them to break the news, and then send a follow up letter via first class mail reminding them of your policy and their missed appointments. In the letter include a list of other doctors you recommend they take their business to. Urge them to call your office for clarification or assistance in finding a new doctor.

Doctors sometimes charge patients for missed appointments or put them on a probationary period where they have to pay for appointments up front. Use these punitive measures carefully. Patients who habitually miss appointments aren’t likely to cave to monetary punishments. What’s the message you’re trying to send? Is it worth creating a variety of new billing paperwork and scheduling policies to accommodate irresponsible patients?

Your efforts will likely be better spent bringing in patients who will keep their appointments than chasing down no-shows.

It’s a testament to the healthcare profession that the no-show rate is as high as it is for so many doctors. People take advantage of the helping-field and think they can always re-schedule. This type of truancy is really unacceptable in any field, and it’s worth taking the steps to let your patients know the value of your time. Doing so will increase your profitability and let you focus on helping patients who can be bothered to show up.

Have any tips for decreasing no-shows? Leave them in the comments field below!

Practice Marketing

Free Whitepaper on Improving Profitability

Running a dental practice is a full-time job, and it can be difficult to step back and look at each of your key profit drivers to see what’s working, and what’s not.

This white paper examines the three inputs of what grows and impacts your bottom line, and how you can track, measure and ultimately improve these inputs to increase your profitability.

Get your free copy of this white paper and see how some small changes can yield big dividends for your practice.


Practice Marketing

How to Avoid a Potential Negative Review

As a doctor, you have a unique and fragile opportunity to help your patients navigate their insurance plan. Do it right, and you’ll be their hero.

You have this opportunity because you share some common interests with your patients. You both want a positive health outcome, and you both have a financially adversarial relationship with the insurance companies you deal with.

Insurance companies are in the business of keeping payments to your practice low while keeping premiums they collect from your patients high.

Those premiums are not insignificant. According to a study by the National Conference of State Legislatures, the average monthly health insurance cost (including vision, medical and dental) is over $467 for a single person, and over $1,300 for a family of four.

Your patients are acutely aware of these costs. They want to get the most out of their expensive plans – and it’s within your power to help them.

You just have to take a few simple steps to cement yourself as a true champion in the mind of your patient; you can be the practice who is helpful and knowledgeable of insurance rules and loopholes. The flip-side is, you’re also a few steps away from appearing unhelpful and disinterested.

I recently discussed the issue with a patient who had a bad experience with their doctor.

Jane* went to get a check-up,  and opted for a more expensive (but more convenient than the alternative) procedure after hearing that her insurance “may” fully or partially cover it.

After the procedure was completed, she was presented with the bill and found that insurance covered none of the expense. “They told me it wasn’t medically necessary,” Jane said.

She was irritated that the doctor’s staff seemed disinterested in whether she would have to pay out of pocket for the procedure, and didn’t go through the additional steps to see how much, if any, of the expense would be covered.

Jane said, “I wouldn’t have opted for the more expensive procedure if they hadn’t told me it may be covered. I was annoyed.”

In defense of the practice, they’re under no obligation to spell out insurance terms to their patients – and patients, of course, should verify what’s covered and what’s not.

But consider an alternative outcome – where the practice’s staff told Jane that while the procedure “may” be covered by insurance, it’s likely that it wouldn’t be, and the total out of pocket cost would be $178. Maybe the staff member could have recommended a cheaper alternative procedure.

Which practice do you think Jane would be more likely to return to, refer to friends and family or leave a positive review for?

Which practice is likely to get the dreaded “negative online review?

The skill of the doctor or the treatment provided isn’t an issue in this case, but the doctor could receive a scathing review anyway.

So, what can your practice do to ensure optimal experiences when dealing with patients and their insurance plans?

1.       Be able to answer basic questions.

Your practice’s staff should be knowledgeable enough about various accepted insurance plans to answer basic questions about coverage. In the event that they don’t know the answer, staff should always be straightforward in how they respond to a question about what’s covered and what’s not covered. Always err on the side of caution and answer questions with something along the lines of, “I don’t know if that procedure is covered, but if it’s not covered it will cost you $X out of pocket.”

Even better: If the option is available, discuss alternative options the patient could take advantage of that may be covered by insurance.

2.       Be upfront about billing procedures.

Always be crystal clear about your practice’s billing procedures. While you can’t control the insurance companies, you can be very up front about how much, when and in what matter your patients are expected to pay you. Every staff member should understand your billing procedures inside and out. A surprise bill or sticker shock over how much you charge for a procedure or service should be avoided at all costs (no pun intended).

3.       Inform patients of requirements or follow-ups.

If your patient’s insurance requires any special follow-up forms or reimbursement, take time to remind them of that fact, and be prepared to point them in the right direction on how to fulfill those terms so they get the best possible financial outcome.

These three steps can help you avoid negative online reviews while at the same time positioning yourself as a real advocate for your patient’s health as well as their checkbooks.

Further Reading:

If you’d like more information on how to deal with negative reviews with some specific ideas on what you should do to counteract them, you can download a free white paper on the subject.
Download “How to Combat Negative Online Reviews” to get detailed instructions on dealing with negative reviews, as well as when and how you should respond.

*Patient name has been changed to protect confidentiality

Practice Marketing

How to Respond to a Negative Review

It’s likely you have a plan for a variety of the “worst-case scenarios” your practice might encounter. For instance, insurance to protect you in the event of anything from fire to theft, malpractice and equipment damage.

But do you have a plan in place to deal with an inevitable bad online review?

Even the best doctors run into curmudgeonly patients who just can’t be pleased no matter how perfect your diagnosis and treatment.

The customer may always be right, but that doesn’t mean you have to let them tarnish your reputation online. Just like for any other calamity, you need a plan to deal with the potential fallout of a negative online review.

You should be regularly searching your reviews to see if there are any glowing testimonials you can grab to put on your website, or to nip any problem comments in the bud. Finding them is as easy as searching for your practice on Google, Yahoo or Bing. Reviews from all the major review websites like Yelp or ZocDoc will appear in a search engine query – so don’t worry about visiting multiple sites to track down reviews.

When you find bad reviews, it’s tempting to just ignore them and hope they’ll go away. While it’s important to avoid engaging in a public debate with your detractors, there are some steps you can and should take to mitigate the damage a negative review can do.

What kind of damage? Well, according a survey by the Journal of the American Medical Association (JAMA) 59% of people surveyed believe online reviews are “somewhat important” to “very important” in their decision to choose a doctor.  

One or two negative reviews aren’t likely to ruin your practice, but how you deal with them could make a big difference in how you’re perceived by potential patients.

Here are some guidelines to help you come up with an action plan:

1. Don’t take it personally. Your unhappy patient might be cranky, (and maybe a little childish) but you’re the professional – so you need to put their perception into perspective.

If the review is legitimate and it seems like the complaint is reasonable, consider posting a response – something like, “I’m sorry you had a bad experience at my office. I strive to provide professional treatment and service to all of my patients. I have a standing guarantee that if you have any questions, concerns, complaints or problems to contact my office so we can address your issue and get you the care you need.”

2. Know when to ignore. If the review is a jumbled mess of expletives and personal attacks, it’s probably best to report or flag it if it’s on a site like Yelp, or to simply delete it if it’s on a platform you control like your website or your Facebook account. Don’t ever get in a shouting match with someone with nothing to lose when you have a reputation and a practice weighing in the balance. It’s not worth it. Winning an argument on the internet with someone who is “wrong” might be cathartic, but it’s not a good use of time or energy.

3. Know when to make a change: Not all internet criticism is without merit. If you’re noticing a trend of people complaining about a specific employee, procedure, policy, expense or other feature of your practice – you should consider addressing it internally.

Some things, like insurance co-pays, are not completely in your control. Even in those cases, you can have a better communication strategy so that your patients are informed.

Fix the issue – and then reply to the negative comment and present yourself as the advocate for change they were asking for. You worked with the employee to be less crotchety on the phone, or you got rid of the annoying easy-listening muzak in the waiting room.

You can post something like, “I noticed many of my patients complaining about X – so I looked into this problem, and I took these 3 steps to fix it. I apologize for not realizing it was an issue in the first place, and I’m deeply appreciative to those of you who called me out on this problem. I appreciate your feedback and thank you for helping us become a better practice.”

Being friendly, professional and courteous is free – but it can have a positive impact on the way patients and prospective patients view you and your practice. The good news is that there’s almost always a large gulf between a legitimate complainant and someone who’s just trying to tear you down.

It’s easy to know when to apologize for perceived slights and when to address real issues. Use your best judgement to know the difference.

Make changes and/or write out a thoughtful response when necessary, and you might even turn your practice’s worst weakness into an authentic and effective marketing opportunity.

Have you ever received a bad review? How did you respond? Let us know in the comments below!

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