Handling Short Notice Cancellations & No Shows

ONE SENTENCE SUMMARY

Responding uniformly to patients that NS or cancel same day to ensure the proper message is being delivered with hopes to limit last minutes changes to the schedule.

BEST CASE SCENARIO IF WE ARE 100% CONFIDENT

If we are all providing patients with the same information, stressing the importance of the time reserved and the inadequate notice given, we hope:

1. They make it work on their end and keep their scheduled visit.

2. Are aware for next time and provide adequate notice.

WORST CASE SCENARIO IF SOME OF US ARE NOT

If we don’t make "a big deal" about it, patients think it’s acceptable to NS or cancel last minute. Our schedule continues to change drastically on the daily.

WHAT DOES 100% CONFIDENT MEAN?

1. We can decide if and what is acceptable when someone reaches out to cancel

2. We then respond appropriately

Hold on, wait a minute....back up....did the patient understand our cancellation policy to begin with?

If we don't verbally tell our patients our cancellation policy we can not expect them to know. Yes, we have it written on appointment cards, emails, and our outgoing YAPI confirmation messaging, however, it's not enough to assume they read that part of our message.

Let's first focus on providing the message right from the get-go.

When?

After we book an appointment (a week plus out) - in the office OR on the phone.

Why?

Reminding patients of our cancellation policy after booking an appointment shows them that it is important, and expected and that our time is valued.

How?

Let's ask them for a favour!

Perfect! Fred, I have time reserved with Dr. Meg for your fillings on the upper right on Monday Dec 1st at 8am. Fred can I ask you a small fovour?

IMPORTANT: wait for them to say... Yes!!

Great! If something comes up on your end and you're no longer able to keep the appointment can you please reach out at least 2 days prior?

Naturally, they will say yes of course!!

Having the patient verbally tell you that yes they will do you a favour - suggests an informal contract of sorts. They agree to respect our time by providing at least 48hrs notice to make a change to their appointment.

Obstacle

What if they say.... "well that's a long way out - maybe I should just wait till I'm due to book? I have no idea what my schedule will be like at that time!"

I completely understand! We do help remind our patients of their scheduled visits starting 2 weeks out - giving you plenty of time to check your schedule and ensure the appoinment still works for you. Does that sound reasonable?

Asking for a favour at the time the appointment is booked will also help with the messaging provided in the reminder emails, YAPI text confirmations and voicemail confirmations.

What are the messages we are providing via email, Yapi and verbiage for voicemails left?

Email 2 weeks prior:

YAPI text 10 days prior:

Call 7 days prior:

Hi Stacey! I'm calling from Smiling Dental in Ancaster. We have time reserved on Nov 5th at 9AM with Dr. Meg for a few fillings on your upper right. It's important we hear from you to confirm this day and time still work with your schedule. Please keep in mind we do ask for 2 days' notice should you need to reschedule. You can reach us at 289-768-9905.

YAPI text 5 days prior:

Call 2 days prior:

Hi Stacey! I'm calling from Smiling Dental in Ancaster. I hope you've received our email, text, and voicemail regarding your appointment just 2 days away - unfortunately, we haven't heard back. At this time we will be expecting to see you on Nov 5th at 9AM as we do ask for 2 days' notice to change an appointment. You can reach us at 289.768-9905 should you have any concerns.

Let's hope that doing the above will help to reduce the number of no-shows and last-minute cancellations that have a negative impact on our days.

Now, let's practice and role-play!
 

• "Patient" booking appointment will be to the left, SD staff member will be directly on right.

• After you are the staff member, you become the patient booking an appointment for the next team member to practice.

• continue with random scenarios until each team member has practiced providing the cancellation message 5 times each.

Let's Take Action...NOW!

Can I ask each of you a favour......can we make an effort to start implementing this directing after training?

Helpful Hint - put a sticky note by the computer (somewhere you will definitely see it as your booking an appointment to help remind you)

You will likely only need that reminder there for a week or two before it becomes a habit.

WHEN PATIENTS LAST MINUTE CANCEL

WHAT is considered a last-minute cancellation?

• less than 48hrs notice

WHY they may be canceling?

Acceptable

• sudden sickness

• family emergency

• accident

Unacceptable

• they call/text clearing after receiving their 2hr reminder text that they are sick

• called into work (not emergent services)

• "something" came up

• they slept in

Method patients may connect to last-minute cancel?

1. Phone / Voicemail

2. YAPI text

3. Email

Now let's look at how to respond to each type of last-minute cancellation

Let's keep it simple, should a patient last-minute cancel - regardless of the method our goal is to:

1. Speak with them

2. Have them keep their original appointment / Reschedule their appointment

3. Reiterate our cancellation policy

That means if they leave a voice mail - we call them.

That means if they send a text - we call them (if leaving a voice mail, follow up with a text)

That means if they send an email - we call them (if leaving a voice mail, follow up with a text)

HOW to respond to the patient when we deem their WHY unacceptable?

Reaching the patient via phone, or answering the cancellation call

"Hi Fred, it's Stacey at Smiling Dental in Ancaster. I just got your voicemail/text/email and understand you're not able to make your appointment today at 3pm. I'm really sorry to hear that! Dr. Meg had this time reserved just for you and with this late notice it doesn't give us time to offer it to another patient - is there any way you can make it work on your end?

Not reaching the patient and leaving a voicemail, possibly following up with text or email (depending their method of last-minute cancellation)

"Hi Fred, it's Stacey at Smiling Dental in Ancaster. I just got your voicemail/text/email and understand you're not able to make your appointment today at 3pm. I'm really sorry to hear that! Dr. Meg had this time reserved just for you and with this late notice it doesn't give us time to offer it to another patient - is there any way you can make it work on your end? I'll follow up via text/email as well.

Text/Email follow-up

"Hi Fred, I'm following up with the voicemail I just left regarding your message to cancel your appointment with Dr. Meg today at 3pm. I was really hoping to connect to see if there is any chance you can make it work on your end as we had the time reserved just for you - with this late notice it doesn't give us an opportunity to offer the time to someone else.

As a reminder, we do ask for the courtesy of 2 days' notice to change an appointment."

Again the hope is that we can connect with the patient and they commit to the original appointment.  If we aren't able to connect, we need to:

1. BREAK appointment in schedule. FYI: Broken appointments get recorded and counted in OD making it easier for us to look back and see the previous history.

2. Make a note on the appointment line

• Oct26/22 SN CA via text - no reason given, lmom and sent text, added to DI for FU SM

• Oct26/22 SN CA via email - 2 hrs prior to apt, not feeling well, lmom and sent email, added to DI for FU SM

3. Send appt to the unscheduled list

4. Add to DI for follow-up in 1 week's time.

• SN CA via text - no reason given, lmom and sent text to respond SM NFU: call/text

Subsequent follow-ups

It's important to make a note in Dental Intel and on the appointment line to trigger the person that may be connecting with them next to reschedule the appointment.

"Great, I have time reserved with Dr. Meg on Dec 15th at 2pm. Fred, it looks like we are rescheduling an appointment you weren't able to keep a few weeks back, please keep in mind that we do require 2 days notice to change an appointment - does that sound reasonable?"

WHEN A PATIENT NO SHOWS

What is considered a no-show?

• exactly that - not showing up for their scheduled appointment.

HOW to handle a situation when a patient does not show up for their scheduled appointment?

Reaching the patient via phone

"Hi Fred, it's Stacey at Smiling Dental in Ancaster. Dr. Meg was expecting you for 3pm today - we had time scheduled for your fillings on the upper right"

Acceptable vs Unacceptable - you decided

IF unacceptable...

"I'm sorry to hear that. We do ask for 2 days notice to make a change and I do see we have connected by email, text, and voicemail to confirm and remind you of the appointment. We would love to have you back in but will need a commitment from you moving forward as we value your time and hope you do ours as well. Will you be able to provide us with notice should you not be able to keep a future appointment?"

Not reaching the patient and leaving a voicemail and following up with a text

"Hi Fred, it's Stacey at Smiling Dental in Ancaster. Dr. Meg was expecting you for 3PM today - we had time scheduled for your fillings on the upper right, I hope everything is ok! As a reminder, we do require 2 days' notice to change an appointment. It does look like we've sent confirmations and reminders regarding this appointment - please let us know if you haven't been getting them?"

1. Call

2. Text

3. BREAK appointment in the schedule

• Oct26/22 NS - lmom and sent text, added to DI for FU SM

4. Send appt to the unscheduled list

5. Add to DI for follow-up in 2 week's time.

• NS for fillings w Dr. Meg, lmom and sent text SM NFU: call/text

Subsequent follow-ups (same as short notice cancels)

It's important to make a note in Dental Intel and on the appointment line to trigger the person that may be connecting with them next to reschedule the appointment.

"Great, I have time reserved with Dr. Meg on Dec 15th at 2pm. Fred, it looks like we are rescheduling an appointment you didn't show up for a few weeks back, please keep in mind that we do require 2 days notice to change an appointment in order to avoid a fee - does that sound reasonable?"

Are we actually going to implement a fee for short notice cancellations or no-shows? No

Should this be a big issue with a patient/family there are other methods we will implement case dependant - same day only vs. deposit/prepayment prior to scheduling a next visit vs. releasing them from our office via written communication.

Now, let's practice and role-play!

• Patient calling in will be to the left, SD staff member will be directly on right.

• After you are the staff member, you become the patient calling in for the next team member to practice.

• Once everyone has had a turn practicing a short notice cancellation, run through practicing verbiage for a no-show appointment.

• continue with random scenarios for the duration of the time available