Develop a No-Show Policy — and Use It

Patients who do not arrive for a scheduled appointment and did not cancel the appointment with at least 24 hours’ notice are considered no-shows. No-show appointments not only erode practice revenue but also can affect patient outcomes. Create a no-show policy for your practice and follow it consistently to reduce missed appointments in your practice.

  • Consider a progressive policy that will address initial no-shows with (1) a gentle reminder of why keeping appointments is important, and (2) a warning that the next missed appointment will incur a service charge for which you will bill the patient. Remember, however:
    • Medicaid does not allow you to bill Medicaid patients for missed appointments. (If transportation is a problem, help your Medicaid patients get free rides through a state program.)
    • The Texas Labor Code does not permit charging workers’ compensation patients a fee for missing an appointment.
    • You may charge Medicare patients a no-show fee, but you must apply it across the board to all your Medicare patients.
    • Always check your payer contracts before charging a patient for a no-show.
  • Communicate your no-show fee to patients on your website, in new-patient intake paperwork, with signs in your office, at appointment scheduling, and in patient appointment reminders.
  • Consider providing staff with a script to help them explain your policy politely but firmly.
  • Assign a specific staff member the responsibility of following up on missed appointments. Call patients to check on them and to explain why keeping appointments is important for their health.
  • Make exceptions only for emergencies and approval of management.
  • Always document missed appointments and follow-up calls in the patient’s record.

Periodically review your daily appointments to determine your no-show rate. Find out how one community-based health center reduced its no-shows by a third, and see additional tips for reducing no-shows.

Are no-shows a problem in your practice? Contact TMA Practice Consulting at practice[dot]consulting[at]texmed[dot]org or (800) 523-8776 for assistance in finding solutions.

Published Dec. 12, 2019


Last Updated On

December 12, 2019

Originally Published On

March 23, 2010