Hello and Welcome! Decreasing Your No-Show Rate

KELLY H. BUCHHEIT, CPA

Every medical practice has its share of “no-shows,” when a patient misses an appointment. No-shows differ from cancellations. A cancellation occurs when a patient calls, allowing the practice to reschedule and possibly fill the gap with another patient. A no-show is when the patient does not show up at all, leaving a hole in your schedule.

Related Read: Patient No-Shows? No Problem

Doing the math

No-shows also slow down your cash flow. Various medical specialties, from dentistry to primary care to pediatrics, can have no-show rates ranging from 15% to as much as 30%. Because the average visit value for a practice can range from $125 to $350, no-show costs can add up.

For example, imagine you have a modest 10% no-show rate, your average visit value is $150 and you schedule 400 appointments a month. That comes to $6,000 per month or $72,000 in missed income per year. And it could amount to much more.

Minimizing the number

To minimize the number of no-shows, here are seven tips to consider:

1. Ask patients who miss appointments why they did not show up and record this information. You might start noticing chronic repeat offenders or a pattern. For example, urgent care, self-pay or new patients could be more likely to skip appointments than other types of patients.
2. For patients with two to three no-shows, ask a staff member to call and find out what is causing the missed appointments. Common reasons include forgetfulness, financial concerns, anxiety and last-minute conflicts. With a little extra attention, you might be able to solve the problem.
3. Remind patients of the importance of keeping their appointments by mentioning it in your brochure and on your website.
4. Be sure that staff is providing written reminders to patients as they leave the office. Use automated texts and emails, linked to your practice management software, to allow patients to verify that they are planning to attend their appointments. “Patient-centricity” is increasing in health care right now. This means that practices need to communicate with patients on their preferred channels.
5. Keep a time slot open for new or emergency/urgent patients.
6. Consider charging for no-shows. However, this is a complicated issue. And, currently, while about a quarter of practices charge some sort of no-show fee, they typically see only small improvements in missed-appointment rates.
7. For chronic offenders (more than four no-shows, for example) strongly consider refusing service.

Diminishing the impact

No-shows are a fact of life for any medical practice. But you can still act to diminish their impact on your scheduling and find ways to decrease how often they occur.

For more information, contact Kelly H. Buchheit at [email protected] or 312.670.7444. Visit ORBA.com to learn more about our Health Care Group.

Your Provider Relief Fund Checklist

JASON FLAHIVE, CPA

If you received any funding from the Provider Relief Fund (PRF), chances are that you have already had to report your use of funds in either reporting period one or two and you are aware of how complicated the process can be. In fact, according to the 2022 BDO Healthcare CFO Outlook Survey, 35% of the respondents identified the CARES Act/PRF reporting as a regulatory concern.

Related Read: Relief for Health Care Businesses Under the CARES Act

Read on to learn how you can make sure your reporting is accurate and ensure that it is as smooth a process as possible: 

Know Your Deadlines

The best thing that you can do to prepare for PRF reporting is to start early. Do not wait until the last minute. There is no option for an extension, so if you run into any issues close to the deadline, you will not have additional time to solve them.

Keep this table on hand to quickly reference important reporting dates:

*As indicated by the Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution section of the 2022 Compliance Supplement

Check Yourself

To make sure that you understand your reporting requirements, use the following checklist:

• Lost revenue has been calculated through June 30, 2022.
• Lost revenue that was already accounted for in reporting periods one and two has not been included in the calculation for reporting period three.
• Lost revenue has been counted on a quarterly basis.
• Any quarter with revenue gains has been counted as zero.
• Incremental costs related to COVID-19 have been calculated quarterly.
• Clinical and nonclinical full-time equivalent hours (FTEs) have been calculated quarterly.
• Patient days or visits, both in-patient and out-patient, have been calculated quarterly.
• Number of beds has been calculated quarterly, if applicable.

Success Tips

PRF reporting is complicated, but there are some success tips that can make it easier:

• Talk to HR at the Beginning
  One of the biggest challenges providers face in PRF reporting is coming up with the data for the operational statistics (FTEs, patient days or visits and number of beds). Fortunately, your human resources department can help. Reach out to them at the beginning of the reporting process to get the data you need to calculate these statistics.
• Beware of Last-Minute Requirement Changes
  In the first two reporting periods, requirements were amended immediately before the reporting portal opened. So far, no substantial changes have been reported for period three, but you should still keep your eyes peeled for possible last-minute announcements.
• Use the Excel Workbook Provided by HRSA
  Each tab of the workbook represents a separate screen in the portal. If you complete the workbook correctly, you will be in a good position to simply plug the information into the reporting portal.

Audit Considerations

If you received more than $750,000 of PRF, there might be additional audit requirements for you. Entities with a fiscal year end of December 31, 2021, with more than $750,000 of PRF across periods one and two are required to have a Single Audit or Generally Accepted Government Auditing Standards (GAGAS) Financial Audit performed and submitted by September 30, 2022.

If you have questions on PRF reporting or the applicability of the audit requirement, please contact Jason Flahive at [email protected] or 312.670.7444. Visit ORBA.com to learn more about our Health Care Group.