Proven, Evidence Based Methods to Reduce No-Shows

Studies show that it takes a combination of strategies to truly reduce no-shows and keep them low in your medical practice.  A low no-show rate is defined as 10% or below. Implementing a single strategy to reduce no-shows alone is not enough.  You may run the most organized doctor’s office in the nation, but patients are still going to no-show on you.  We define a “no-show” to be when a patient misses their appointment without calling the office first.

Typical No Show Rates

Research show that, on average, between 23% to 34% of patients miss their appointments annually across the United States.  The top two reasons stated by patients who miss appointments are “I forgot” or “I was confused about the date, time or location of the appointment” (Source:

Appointment Reminders Will Help

The good news is that an automated appointment reminder can address these top 2 reasons patients forget their appointments.  A successful reminder must be clear, concise and contain the date, time and location of the appointment.  Patients prefer a reminder within 2 weeks of their appointment and tend to prefer either a phone call or text message.

 TESTIMONIAL: Our No-show Rate Dropped 50%

We are a very busy OB-Gyn practice who runs our schedule on Epic Systems. Our staff was trying to make manual appointment reminder calls, but sometimes just got too busy to make every single call. Since we started using 1-800 Notify for appointment reminder calls and texts for our patients, we have seen our no-show rate drop by 50% (down from 14% to 7%) in just the first month. We are also receiving 33% confirmations. Patients are happy with the new system (no complaints) and each patient now receives two reminders – a phone call 2 days prior and a text reminder 1 day prior. In addition, our staff is happy not to have to spend hours every day on manual reminder calls. I would definitely recommend 1-800 Notify to any practice looking to streamline their appointment reminders and reduce no-shows.

– M. Gilbert MBA CPC, Practice Administrator, University OB GYN Associates Inc., Syracuse, NY

However Appointment Reminders Alone are Not Enough

A study of almost 450 family practice residency programs across the U.S. revealed that those practices with the lowest no-show rates of 10% or below, utilize a combination of strategies together with appointment reminders to keep their no-show rates low.  (Source:

Bedrock Strategy: Define a Clear No-Show Policy and Follow Through

The bedrock of your no-show reduction efforts must be a clear and well defined policy for handling no-shows in your practice.  Each practice will need to define your own policies that fit your patient populations.  You might even want to consult an attorney as you define your own policy.  Critical to the success of the policy is to follow through with the policy with your patients:  “Do What you Say You’ll  Do”

A Successful No-Show Policy (Sample)

  1. Define the patient sanctions for missed appointments.  Depending on your patient population these might include: a clearly defined no-show fee and possibly a “3-strikes and you’re out” policy (3 missed appointments within 6 months results in the patient being dismissed from the practice).
  2. Make sure to track every no-show in your system.  Ideally, you should track no-shows in your scheduling system, but worst case is tracking using a logging method that the entire practice uses.
  3. Notify the provider / physician  of all no-shows.
  4. Make a telephone call to the patient after the no-show.
  5. Send a warning letter after the first 2 no-shows
  6. Send a dismissal letter after the 3rd no-show within a 6 month period.TIP: Practices with low no-show rates actually follow through with patient dismissal over 90% of the time.

Strategy: Constant Patient Education

Now that you have a clear policy put together, it’s important to educate the patient at every step of their journey.  When they book their appointment, when they are reminded about their appointment, when they arrive each time (a poster in the waiting room can work here), when they are waiting in the exam room (a poster works well here, too), after each no-show,  after repeated no-shows (the 2-no show warning letter mentioned above).

Strategy: Appointment Reminders

Important to tackle those top two patient reasons for patients who are no-shows.  Make sure you setup an automated appointment reminder system that includes the date, time and location of the appointment and is delivered within 2 weeks of the appointment.  1-800 Notify’s research shows that the best approach is to send 2 reminders within 3-1 days prior to the appointment and mix up the type of reminder.  For example, send a phone call 3 days prior and a text message 1 day prior.   And, if your scheduling system can handle it, send the reminder in the patient’s preference – and language.  For example a patient may prefer only text message reminders in Spanish – give the patient what they desire to show you care about their needs.

Strategy: Patient Sanctions

If you have stated patient sanctions as part of your no-show policy, then you must follow through on them to show patients (and staff) that you are serious.  It’s important that everyone from the provider, to the nurses, to the front desk staff all understand (and believe) in the seriousness of the sanctions policy.  Starting to deviate and create too many exceptions from the policy will start to erode it’s effectiveness and your no-shows will start creeping back up again.

Consistency, Consistency, Consistency

Whatever your strategy, having a consistent implementation approach, consistent and reliable appointment reminders and no-show follow ups are all key.

Reduce No-Shows Today with 1-800 Notify

Let 1-800 Notify implement automated appointment reminders to help complete your overall strategy of reducing no-shows in your office today!  Click here to learn more or request a demo.

1-800 Notify has rapidly grown to support millions of inbound IVR autopay by phone calls, two-way appointment text and call reminders, and patient wellness and broadcast messages. We’re the premier platform for HIPAA-compliant, automated phone payments, appointment reminders, billing reminders, and notifications.