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How to Deal with Canceled or Rescheduled Appointments

One of the most common problems doctors want help with is dealing with canceled or rescheduled appointments. If a doctor’s office has too much of this occurring it can wreak havoc on their daily production. Normally, when this is occurring it is a sign that the receptionist is not properly trained in scheduling appointments, managing the appointment book, or handling cancelations and rescheduling.

When you are getting a high volume of cancelations, you should ask yourself these questions:

  • Does your receptionist immediately reschedule a canceled patient/client?
  • Does your receptionist ask the patient/client to put the appointment in their calendar, phone, or day planner so they won’t forget?
  • Do you keep a record of the reasons behind cancelations for future reference and to implement any needed corrections?
  • Do you have any sort of policy regarding cancelations that is part of the “welcome to the practice” information given to patients/clients?
  • If you have such policy, do you enforce it?

Here are some other questions you should ask yourself as regards appointment no-shows:

  • What actions do you take when someone doesn’t show up for an appointment?
  • Do you call the patient/client after a certain length of time, e.g., 10-15 minutes?
  • Do you have any sort of policy regarding no-shows that is part of the “welcome to the practice” information given to patients/clients?
  • If you have such policy, do you show it to no-show patients/clients the next time they come into the practice?

The doctors we deal with are all asked these simple questions, and many more, when they are dealing with cancelations, no-shows, and reschedules. We recommend that you closely evaluate the management systems and training that you have in place with the staff members involved; then, fix or implement the proper procedures to reduce the number of patients/clients lost. This normally leads to increased production without any increase in marketing or staff expense, which, of course, leads to greater efficiency and net income in a practice.

If you would like more help dealing with canceled or rescheduled appointments or any other management topic, fill out the form to the right, and we will be more than happy to assist you.

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Vital Steps for Collecting Money Over the Phone

In any practice, Accounts Receivable exist. Whoever collects money in your organization needs to know that this particular job has a two-fold purpose:

  1. To bring the patient/client’s account current
  2. To maintain sufficient goodwill with the patient/client to ensure his continued patronage and support.

The statistics that can be used to measure how effectively the job is being done are:

  1. Money collected (Amount)
  2. Number of accounts brought current

TELEPHONIC COLLECTIONS PROCEDURES

Your telephonic communication skills are very important. Following are some guidelines and proven techniques that will assist you in being most effective in collecting outstanding payments from your patients/clients over the telephone. 

PRIOR TO THE CALL

  1. Study the patient/client’s account record, and all related documentation to ensure you have ALL the information necessary to make an effective and accurate collection call. Spotting a past due amount on your aging report and then picking up the phone to call the patient/client, without pre-planning, is not a very good idea, as there may be vital information of which you’re not aware. Placing the call without doing your “homework” could result not only in NOT getting paid, but in creating an upset with the client/patient or poor PR for the practice. So, study the file prior to making the call.
  2. Know the correct name of the person with whom you are planning to talk. Make sure that you have his/her complete name, spelled correctly. It is vital to speak with the person responsible for the account, so ensure that you have that data.
  3. Be in the right frame of mind when you place the call. Think positively. Believe that you are going to resolve the account. Do not call in anger, frustration or anxiety. You will get nowhere with your patient/client if you do so. Be both cheerful and professional.

MAKING THE CALL

  1. Introduce yourself and state the purpose of your call.
    Example: “Hello, Mr. Smith? This is Mary Jones from Dr. Nelson’s office. How are you this evening?  I’m calling you about your account. Do you have a few minutes to talk with me about this?”
  2. Be very deliberate in your statement about the account. Do not rush through this or be difficult to understand:“Our records indicate that you have an outstanding balance of $350, and I am inquiring as to when we might expect that payment.”Now give him an opportunity to respond.
  3. Do not make him feel embarrassed or as though he has done something wrong. Do not verbally attack him. Notice that in the above example it states, “Our records indicate…” Avoid statements such as: “I’m calling about the $350 that you haven’t paid us for four months!” This would definitely get you off on the wrong foot with him, and it would be quite difficult to resolve the ensuing conflict.
  4. The tone of your voice is very important. Do not be hostile or angry. Do not think of the client/patient as a “deadbeat” or a big problem. Think of yourself as a problem solver and come across that way. He will see that you are trying to help and will be more willing to help in return.
  5. After you have identified yourself and stated the purpose of your call, STOP!! Don’t say anything more at that point. It may seem like forever, but if you wait for the person to say something, it will go much more smoothly, as he is now having to originate a response to you regarding your inquiry.
  6. Listen to what he has to say. Don’t just hear it, but really listen and understand. It could be that he has already mailed the check, or maybe he was planning to mail it that day. If you come on with a harsh demand for payment, you could stop an already intended payment. So, give him a chance to talk.
  7. If he resists, registers an objection or is just generally uncooperative, let him say everything he has to say. Let him know that you understand, and then handle the objection, confusion or whatever it is by giving him an honest and realistic answer. If you do that, you will get a full picture of what his objections are, and you will have left him with little or no argument to fall back on once you have handled the objections he put forth.
  8. Don’t be brash or punitive. Understand that this is a tough position for him to be in. Don’t harass or attack him. Don’t make a threat (such as a lawsuit), except as a last resort and ONLY if you fully intend to carry it out.
  9. Go over with him the fact that it is to his advantage and benefit to make payment. Let him know that the advantages include: not getting turned over to a collection agency, feeling better because an agreement has been worked out, no harm being done to his credit rating, etc.
  10. Bear in mind that everything he has to say might sound very reasonable. But also remember that those “reasonable” explanations are the very “reasons” why he’s in a bind in the first place. The explanations won’t handle anything.

Fill out the form to learn the remaining 5 indispensable collection call techniques AND to find out the 5 vital steps to take AFTER the call (highly recommended). Scroll to top

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learn the remaining 5 indispensable collection call techniques AND to find out the 5 vital steps to take AFTER the call (highly recommended).









Getting Clients and Patients to Be Accountable for Cancellations

You need to put a system and policy in place to discourage your clients or patients from unnecessarily canceling appointments. First, you should have a company policy that is given to your clients/patients as part of their “Welcome to the Practice” handout, letting them know what is considered a no-show—usually less than 24 hours’ notice—and what happens when a no-show occurs. It is important to make sure that your clients/patients are aware of this policy before enforcing it, or you might create an upset.

Clients or patients who wish to cancel an appointment on short notice or who fail to come to a confirmed appointment need to be gently challenged on missing that appointment. An attempt should be made to get them to keep the appointment if at all possible, and if that doesn’t work, they should be notified of the $25.00 fee to be collected at or prior to the next visit. If the client or patient still wishes to cancel, he or she is to be rescheduled. The fee should only apply if the client/patient has already been given his/her “first-offense warning.” The idea behind the fee is NOT to anger the person or make the person wrong but to inform him or her that you are serious about the importance of appointments being kept and completing a course of treatment on time.

The script would be something like this: “You can’t keep your appointment? Oh dear! The doctor has this time set aside especially for you. Is there anything you can do to make it?” If that doesn’t work, move into the missed-appointment-fee handling.

  1. For the first offense, the office policy is to waive the fee. The client/patient should be notified of this, and it must be documented in the chart by the receptionist. The ideal way to approach the individual is by saying, “Mr. Jones, it is our office policy to charge $25.00 for late cancellations or missed appointments; but since this is your first offense, we will waive the fee. Now, let’s get you rescheduled. . . .” This message should be practiced so as to be said all at once and in one breath. The entire message should be delivered before the person can interrupt. This part is very important. You should have the client/patient chart in front of you so that you can be accurate in telling the person of his first offense and the waiving of the fee. If you do not have the client/patient chart in front of you, treat the person as if this were the first offense and note it in the chart.
  2. For the second offense, a client or patient will be called by the OM because a second failure may mean that the person is upset or unclear about something in the treatment. Please give the chart to the OM so the client/patient can be called that day. This must be documented in the chart.
  3. For the third offense, the client/patient will be sent a letter that will require a $25.00 payment for missing the appointment, plus a $25.00 payment to be held as credit for the next appointment, for a total of $50.00. This must be documented in the chart.

If you have any questions regarding this procedure or its implementation, fill out the form to schedule a free call and we would be happy to assist you.

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If you have any questions regarding this procedure or its implementation, fill out the form to schedule a free call and we would be happy to assist you. (highly recommended).









Discussing Payment with the Patient/Client: How to be Both Polite AND Effective

You should always assume that a patient/client can afford the recommended treatment when discussing payment with him. Don’t be shy, embarrassed or apologetic about the cost of your services. This can give the appearance that the treatment isn’t worth the fee being charged.

When making financial arrangements, your goal should be to collect the entire fee at the time of service via direct payment and/or verified insurance reimbursement. You should have a well-defined financial policy for patients to read and agree to with regard to payment of service.

It is important that the accounts manager does not give the patient/client the opportunity to say “no”. Never say, “Would you like to take care of that today?” Instead, give her options that are compatible with office policy. For example:

“Mrs. Smith, the fee for today is $50. Will you be paying with cash, check or credit card?”

With such an approach, “no” is simply not an option. Remember, if you make clear financial arrangements in the first place, you won’t have any trouble collecting the amount due.

Suppose there was a misunderstanding and the patient/client tells you she can’t afford to pay the entire balance at the conclusion of the visit. Your reply might be,

“Could you tell me how much you are able to pay at this time?”

The idea here is to get the largest payment possible. Now you need to secure the balance:

“Mrs. Smith, that will leave a balance due of $560. We need to work out an agreement on how that will be taken care of.”

When she agrees to a definite date for the payment of the balance, put the information on a financial agreement form and have her sign it.

If it becomes necessary to offer a monthly payment plan to a patient/client, adhere to the payment schedule as governed by office policy. Do not stray from the established policies.

Fill out the form to learn (1) what to do if someone REALLY can’t afford your service and (2) how to address insurance reimbursement issues with your clients/patients (highly recommended). Scroll to top

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Fill out the form to learn (1) what to do if someone REALLY can’t afford your service and (2) how to address insurance reimbursement issues with your clients/patients (highly recommended).








How to increase efficiency, productivity and net profit in a private practice

There is an impression with healthcare practitioners everywhere that all a practice has to do to increase production is to increase the number of new patients. More new patients is often the universal solvent for an under-producing office.

However, attracting new patients is only 1 of 7 areas of a practice that lead to the efficiency, productivity and the overall net of a practice. There are 6 other areas of a practice that a doctor/practice owner can improve on to increase the profitability and gross income of an office without seeing a single increase in new patients. This does not mean that attracting new patients should be ignored, but what it does mean is that the other areas of the practice should be addressed with just as much importance as the new patient area. In order to improve those areas one must, for starters, know what those areas are. Below you will see the basic actions of each of these areas.

Personnel: A practice owner should know how to hire the right staff and know when and how to fire staff that aren’t productive. Holding onto non-compliant and under productive staff, at a time when unemployment is still high in most areas of the country and the employment pool is more qualified that it’s been in 25 years, is both poor management and foolish. A practice owner can learn how to monitor staff productivity and not judge staff on “feelings” or what other people say about certain staff. Learning how to objectively manage is a key to a productive, efficient and happy office. Part of this is knowing how to train staff on their jobs with proper job descriptions. Having known and applied office policy can make a staff operate in a coordinated fashion and work together as a team resulting in higher productivity and morale. How you hire, train, monitor and take care of your staff is the basic concept of this area. Making this area work properly requires good job descriptions and office policies that are known and understood by all staff as well as having effective statistical monitoring systems for all areas of the office, a good internal communication system and good communication skills by those managing the practice.

Treatment: Exams must be comprehensive and relationships must be built in a very limited amount of time. Value must be demonstrated through excellent care and communication by all personnel involved in any aspect of treatment delivery. Five minutes of sincere, honest and meaningful communication is worth more than 30 minutes of superficial chitchat. Treatment must be top notch using up to date methods and equipment. This area is the province of the doctor and where the “Doctor Hat” is worn.

Enrollment: A practice can increase the quality of case presentations and show more value for the services they are delivering through very simple, basic communication and sales skills. There is still plenty of money being spent these days. A practice must be better at showing value than a competitor down the street. A successful practice never makes a patient feel uncomfortable or pressured through poor case presentation and sales skills. Proper case presentation results in patients/clients knowing what they need and wanting the service and willing to look at how to work out the economics of the service needed. Also, having a good recall system and an excellent patient reactivation program can increase a practice’s production by one third or more.

Part two of this article will cover financial management, marketing, quality control actions, personnel and your actions as an owner and executive that are vital to running a more efficient and viable practice.

Fill out the form to the right and receive “How to increase efficiency, productivity and net profit in a private practice – Part II” (highly recommended). Scroll to top

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Fill out the form to continue reading this article How to increase efficiency, productivity and net profit in a private practice – Part II (highly recommended).