Roadside Live |16 min read

How to Handle Missed Appointments in 2021 [VIDEO]


The patient who cancels their appointments. All. The. Time… Every dental office manager’s pet peeve 😤

How do you handle missed appointments in 2021?

Angela and Bridget (former practice administrator and dental consultant) discuss that very topic on Roadside Live, including:

  • If you should make a patient sign a written policy.
  • Whether you should charge patients a cancellation fee.
  • How to prevent cancellations and missed appointments (even during COVID).
  • The foolproof script to use when someone cancels over the phone.

Angela: Hi everybody! Bridget, thank you so much for joining us today for another Live version. So nice to see you. And we have a topic, I think, a lot of people are going to appreciate because it is one of the challenges I know – as the account management team, we’ve talked to dental offices a lot – this is one of their pain points that we hear from them, and that is missed appointments. Especially coming into 2021.

It may look a little bit different than our previous years, but I think it’s a very noteworthy subject to chat about. So you have had a lot of experience helping dental offices in the past with creating systems, implementing policies, really becoming efficient with their front desk organization. So let’s kind of tap into some of your experience.

So one of the questions that we had was, do you think it’s important for a practice to have a written policy for the patient to sign or to be presented to them?

Bridget:  Yes and no. So it can be the discretion of the office.

I’m so glad we’re talking about this because you’re right. This is a weird year. So you may have all the stuff that we’re going to talk about, you may have to bend it a little bit to conform to your practice. And, you know, I think we’re hearing from offices that are short-staffed.

There are some offices that are actually welcoming cancellations, unfortunately. In a regular setting, you wouldn’t.

I remember the days of answering the phones at a dental practice and seeing the name of a person that was on the schedule for that day pop up on the caller ID. And you’re just filled with dread. Are they going to cancel?

This is all about kind of alleviating that and just helping you navigate.

As far as putting it in your policy for your patients to read it, it is up to you.

There is a benefit of having it in there, but you don’t want to have it in these bold letters. You don’t want it to be like the largest print on your policy that says, “You will be charged $100 dollars if you don’t cancel within 48 hours.”

Instead, I prefer a nice message that says, “Hey, we reserve this time for you. We try not to interrupt your time when you’re being seen. We want to give you our undivided attention. We’re not going to stack appointments on top of each other.”

Having said that, you want to make sure that you respect their time as well. Is the doctor getting interrupted like eight times during an appointment? Does he have to get up eight times when you’re doing that crown appointment? The case may be easy, getting interrupted for phone messages.

You have to establish that respect from the very beginning. And that means having not just that written policy for the patients, but it also means having that policy in your office in general, that just says, “okay, we need to respect our patients’ time.”

We want them to respect our time. So we have to do it to them.

Angela: And that’s such a good point. A mutual respect is always a good reminder because you can get in the day-to-day business of doing your job and forget the other perspective.

So that reminder of respecting their time, respecting their appointment, and then with that, hopefully, they will give more validity to the time that they booked with you and not cancel on you.

So when a patient does cancel, cause that’s going to happen, do you think that dental offices should be charging patients a missed appointment fee or cancellation fee?


In my opinion, as an office manager and as someone who did accounts receivable, I don’t.

If I think back on all the times I went through accounts and had to delete missed appointments or send them a statement – my doctor would, in the beginning, make me send a statement and try and collect them – this is such a waste of time, you know?

In the end, when they left the practice, I would just end up writing that off. And you really can’t send it to collections, you know? No judge, if you even get to the point of standing in front of a judge, no one is going to say, “Yes. You have to pay that missed appointment fee.”

There was no service rendered. And so I honestly, in my opinion, I don’t think that you should. You can in certain circumstances. But this year and last year, it’s impossible.

So short answer is no. And I’ll explain why when we talk about an actual policy. But yeah, that’s my experience with it.

Angela: So let’s talk about prevention for a second. What are some ways that a practice can prevent appointment cancellations or prevent missed appointments?

That is probably a little more, definitely was a challenge in 2020, and even going into 2021. We know that the pandemic is not over, so it might look a little different as the year unfolds, but what are some ideas you have to help them try to mitigate and reduce the cancellations or prevent them?

Bridget: There are so many things that you can do and they range from having that written policy all the way to posting on Facebook. And I’ll explain that in a second. But you know, we talk about COVID and we’ll talk about what that looks like:

See if you can get them to fill out some kind of COVID questionnaire ahead of time, and you can use the same platform that you’re using to remind them of appointments.

If you don’t have an automatic platform to remind them of their appointments, which most offices do now, please get one. As soon as this is over, please get one. Text messages are the most effective way. We know that. It’s even the most effective way to collect money through text messages.

Email – people are going to complain about email. “I get so many!” Blah, blah, blah. “Well, you know, better safe than sorry, sir.”

It’s going to happen. It’s inevitable. I like to think a lot of programs allow you to adjust their personal settings, but that’s obviously a must to have that.

We talk about also using social media and when we say that, you want to connect with your patients in any way that you can. So again, we’re talking about respecting their time, which we mentioned earlier. If you’ve got this great connection with them over the internet, over social media, they’re going to love you.

We talk to offices all the time whose patients just love them and they’re active on social media. They respond to them. You’re on a first-name basis. They’ve been going to a practice for 10+ years. They’ve seen multiple generations come through because they have such strong bonds with their patients.

And that’s another thing that really reduces cancellations when you have such a strong connection with those patients. Believe it or not, people don’t realize that actually helps reduce those cancellations and missed appointments.

Angela: Going back to that mutual respect, having that relationship, having that trust, they’re going to be more mindful of your time with an office that they trust or with people they trust, know, and like.

I also think that it helps if you want to book someone out so far in advance, but knowing that there are more limits in the last year. This year, there could be possibly more of a time gap before they can get back in.

Make them rethink how quickly they cancel, you know, make sure they’re canceling for legitimate reasons. If unfortunately, they’re not able to get back in because, you know, the capacity could be limited.

Bridget: And that also plays into how much value are we putting into their visits? How much value are they taking away from when they do come in?

Are we really driving home care? What does regular care mean in return? Coming in on a regular basis. On educating them on why it’s so important. Not just on social media, but like when they’re there in the office and on social media. It is important as well, even on your website.

Then also making sure that patients feel comfortable during COVID when they’re ready to come in. Having that message – we have a lot of our clients, I think almost every one of our clients has a message on their website that talks about what they’re doing for safety protocols during COVID, and putting that on social and just making sure patients feel comfortable, so they know that they’re going to be okay.

Know that they’re going to be taken care of when they come in during this really weird time.

Angela: And I think that messaging is really important right after the pandemic was in full force and then life started to get back a little bit more back to normal in the summer.

We’ve heard some feedback from providers that they were kind of done with it. They’re kind of sick of talking about the COVID protocols and they assumed everyone knew, and then we have second waves and more shutdowns, and we’re starting to find out that everyone doesn’t know, and they’re still scared.

They’re still nervous about where they should be and where their safety is and what places you can go to safely. So continuing to update your messaging, like you mentioned, on social or on your website or an email blast, keeping that communication, that reassurance with your patients and your audience is so important. Don’t assume that because we know that the practice is safe, that they do because now, with the new waves coming around, people are starting to get a little freaked out again.

I think it’s really important to keep the messaging up to date to help your patients…

Bridget: And you can make it to – sorry, while we’re on the topic, it seems so relevant right now – we had a client that did like a video of them putting on all their layers. That was really fun. And that’s another way to connect.

Angela: Make them feel comfortable. Have a little fun with it. Have a little energy with it. So let’s go back to the policy and procedures portion. So what would you say an effective policy would look like?

Bridget: The policy, to me, is when your entire team is trained on how to handle it. Not just from a paper perspective. I’m talking about exactly what they’re going to say on the phone, how they’re going to act, the actual inflection of their voice, you know?

I can personally tell you, there have been times where I’ve been handling someone trying to cancel on the phone, and I didn’t even recognize myself because I was like, who is this person? I went, “Oh no! You have to cancel? Please. Don’t cancel.” We’ve all been there on the phone where we’re begging this patient not to cancel. Please don’t.

The most effective way has been – and when I’ve trained other people this way, it was really effective – when the patient first calls and they canceled the first time or it’s been like a year since they’ve been in and they have an appointment and they call to cancel, I like the three strikes and you’re not scheduled, not three strikes you’re out or three strikes we’re charging you, but the three strikes we’re just not going to reschedule you.

I like the three strikes, we’re not going to reschedule you.

You’ll hear why, but the first thing you want to do is sound really concerned. When your patient is on the phone and they’re like, “I need to cancel, I got called into work or my kid has to go.”

“Oh man, that stinks. Sally, the hygienist was really looking forward to seeing you. She couldn’t wait to catch up with you. Is there anything I can do to help you make this appointment?”

Then they’ll, sometimes, they’ll be like, “I need a babysitter or whatever,” you know? When you find out and they really are genuine or whatever the case may be, and you can’t really salvage that appointment, then say, “You know what? I understand stuff happens. I’m not going to charge you this time. We’ll waive the fee. Let’s get you back on this schedule.”

You can even put the patient on hold and look at their history. I don’t recommend jumping right into that conversation. Give yourself a minute to prepare because it’s worth it.

If you say, “Oh man, that’s a bummer. Can you hang on just one second? Let me finish checking out this patient.”

Put them on hold – and I know people are busy – but put them on hold and look up their chart real quick. See if you’ve got any leverage in there. See if there’s anything you could do to help salvage that appointment and then jump right back into the conversation.

“This is a bummer. We were really looking forward to hearing about so-and-so’s wedding.” Whatever the case may be. “Doctor’s going to be so bummed. He loves to do this procedure.” Whatever the case may be.

This really is the same thing for the second time that they cancel. Use the same kind of language use the same kind of concerns.

You have to fake it to make it, you know, cause this is not how you feel when you pick up the phone and someone says, “I need to cancel.” This is not like, “I’m not all chipper like this.” When someone calls, inside my head, I’m going, are you serious?

So same thing. “All right. I can waive the fee one more time. So let’s try this one more time.”

And when you say “one more time,” you are insinuating to them. You’re giving that impression, okay, we’re coming to the end here. We’re coming to the point where we’re not going to be able to keep doing this.

So when you get to that third or fourth time, depending on how graceful you’re being, “This is a bummer. This keeps happening. What a bummer. We’re just having trouble sinking up, you know? So in lieu of a missed appointment fee, I’m not going to reschedule you today, but I’m going to put you on a short call list or our last minute cancellation list. And so if we have a last-minute cancellation, I’ll give you a call. Would you like me to text you or email you or just call you?”

And when you say that, unless they’re in the middle of getting like a root canal and phases or like a crown or something like that, it’s very rare that you’re going to have to deal with this. It’s very rare that they’re not going to finish.

And I’ll tell you why in a second, but what you’re saying is “I’m not going to put you on the schedule. You’re not respecting our time. I’m not going to reserve any more time for you on our schedule. Let’s just put you on a short call list and move on.”

They can call the day of, and ask if you have an opening.

This works really well, too, for patients that get called into work. Every time they have an appointment. Every time.

“I got called into work.”

“Okay. Call me back when you’re not working, call me back when you have a day off and you can come in.”

No one is going to get angry about that because you still haven’t charged them any money. So you’re not making the mat. You’re just being completely reasonable with your schedule. Now you’ve got a job to do.

And so I liked that when you don’t charge them and instead you’re giving them the opportunity to call back and do it when they have time, they’re going to start to realize that you value your schedule and they can’t get away with it.

I’ve done it so many times. And it’s worked wonders. And sometimes, the patient gets it and they stop rescheduling so many times. And then sometimes, you never hear back from them.

And a couple of weeks later, you get a records request from another dentist. Totally fine. You don’t have to worry about it anymore. They’re not your problem anymore. I like that policy and it’s never failed me. It’s never failed me. Unless, the doctor gets involved and says, “No, no. We still need to see them,” which is fine.

That’s completely their discretion. But when you’re talking about hygiene appointments or something that’s not super urgent, it just works. Fantastic.

Angela: Those are some great suggestions. And I liked the kind of phased approach in that you don’t really toe the line or get stern with him until it’s been consistent, a habitual problem that they’re affecting your practice’s production because they’re continually canceling.

And at that point, there is a point where you have to just draw the line because it is a valued appointment, especially when practices are having trouble getting people in. If someone consistently is taking a seat and then not giving you notice, that does affect the production of the practice.

With COVID and with illness, they’re still in kind of this flux where we have to have more grace than we would have ever had in 2019. So there’s definitely respecting that there is a legitimate pandemic going on, but I think those are great ways to handle it and think it through.

So offices can find that balance between having their patients last-minute, ditch them all the time, and feeling like they got charged when something legitimate came up or when there really wasn’t an illness.

So those are great suggestions and great protocols. And I think a lot of our practices will have to revisit how they’re handling missed appointments in 2021 and decide what’s best for their practice.

Bridget: It’ll make life so much easier for them. I promise them it’ll be so much easier.

Angela: Absolutely. Yeah. Thanks for your time today, Bridget.

Bridget: Take care, everybody.

Angela: Bye.

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One thought on “How to Handle Missed Appointments in 2021 [VIDEO]
  1. Avatar for Melissa Bosshardt

    There needs to be mutiple easy ways to cancel. My phone broke and I tried multiple ways to contact the office (email address from their website, their Facebook page that has recent posts by them), yet the office manager claims no one monitors any of them. Earlier this year, I had trouble reaching them by phone and tried their Facebook page after several calls did not reach a person or voicemail. The office manager put the blame on me for a missed appointment instead of taking some responsibility for her office having a current Facebook messenger account that is on autoread and an email address on their website that is not monitored. They send an email requesting a confirmation click that I did not confirm. What is the point of that if it doesn’t let patients cancel?

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