As you know, patient no-shows are tremendously expensive for healthcare providers, costing $150-$200 per missed appointment and $150 billion annually. To mitigate revenue loss—and save valuable staff time—healthcare managers need to adopt industry tools and best practices.
Tactics like automated reminders and telehealth waitlists can go a long way in recovering lost appointment revenue. Some studies reveal, patient no shows can be reduced up to 70 percent by healthcare organizations that actively implement the right strategies.
How to Define and Calculate “No-Shows”
A patient “no-show” is an individual who never arrived for a scheduled appointment and gave no notice.
Healthcare managers can calculate the no-show rate by dividing total scheduled appointments by total no-shows.
An accurate no-show rate can help managers evaluate lost ROI and benchmark success toward reclaiming revenue. Be sure to avoid the two most common mistakes:
- Including cancellations and appointment changes
- Marking a no-show as “canceled”
Why Do Patients Miss Appointments?
Understanding why patients miss appointments can help managers better address pain points. Patients tend to miss appointments for 5 reasons, according to Relatient:
- Forgetfulness
- Inconvenient appointment slots
- Demographic barriers such as age (i.e. an elderly patient who cannot drive) or language
- Anxiety about procedures, bad news, and physician disapproval
- The costs of copays, deductibles, and out-of-pocket expenses
No-showers also tend to fall into one or more of the following categories:
- Single/unmarried
- Under 34 years old or a senior citizen
- Carry no medical coverage
- Suffer a chronic illness
- Located 60+ miles from clinic
How can healthcare managers lower no-show rates and elevate revenue?
12 Best Practices to Reduce Patient No-shows
1. Automate appointment reminders
Automate your appointment reminders to ensure consistent and strategically timed communication. Software such as LeadSquared’s HIPAA Compliant CRM can be very helpful in managing patient availability and message distribution.
Benefits of automated reminders include:
- Reduced risk of communication errors
- Eliminating gaps in communication
- Conserving staff time
- Offering patients a convenient response format
When preparing messages—whether text, email, or phone—consider the following best practices:
- Include provider name and appointment date/time
- Offer easy response options, such as “confirm” or “cancel”
- Prioritize preferred receipt time
- Keep messages brief
- Personalize with patients’ names
This sample SMS text reminder from Practice-Web does a good job of illustrating best practices.
Practice-Web reminds John Doe of his upcoming dental appointment by providing a specific date and time and including several response options (confirm, change, cancel). The text is strategically timed, arriving just as John’s workday concludes.
This email template by Etactics is also a good example of a simple yet effective appointment reminder.
Etactics addresses the patient by name and confirms the specific doctor, date, and time for the appointment. The text also includes the provider’s address for ease of access.
2. Prioritize SMS texting
Place text messaging at the forefront of your patient engagement strategy. According to a study, appointment attendance sees a 67% increase when healthcare providers use text messages to connect with patients.
You can use texts for:
- Appointment reminders
- Follow-up care instructions
- Capturing feedback
- Office notifications and updates
- Bill payment
- Prescription updates
- Ongoing patient education
Klara Assistant’s sample text solicits feedback on patient experience. Klara thanks the patient for their business, includes a simple way to offer feedback, and a link to leave a longer review.
3. Reach patients where they’re most responsive
Not everyone checks their email. Some ignore calls. That’s why it’s smart to use multiple reminder channels—text, email, phone, or even WhatsApp—so you can connect with patients where they are most responsive and hence avoid no shows.
If you are looking for a tool to manage multiple channels at one place, then LeadSquared’s communication module is what you need.
It can help you:
- Send automated reminders through SMS, email, or voice
- Offer two-way texting for quick confirmations or reschedules
- Personalize reminders based on patient preferences
- Combine manual and automated follow-ups when needed
When planning your patient engagement strategy, timing is key. Also consider the most effective time to send messages—whether weeks, days, or hours before an appointment.
Aspects to weigh include:
- Lead time before appointment
- Prior communication received
- Desired patient action
4. Follow up when patients miss appointments
A missed appointment doesn’t have to mean a lost patient. A quick message like, “We missed you today. Let’s get you rescheduled”, can make a big difference. It keeps the door open and shows you’re still there to help.
To make things easier, you can automate these follow-ups and include a direct link to reschedule with the help of tools like LeadSquared.
For example, check out this sample follow-up email by Etactics.
Etactics conveys an empathetic and non-accusatory tone with “we’re sorry” and “looking forward to your next visit,” as well as a “warm regards” conclusion. The sample email also directs patients to the no-show policy and offers a convenient way to reschedule.
5. Implement proactive pay and scheduling
Implement a proactive scheduling policy to help manage patients’ time. Proactive policies require check-ins ahead of appointments, providing a subtle day-of reminder and preventing late arrivals..
Policies can include:
- Arrive 15 minutes before appointment
- Check-in online at least 1 hour before appointment
- Confirm attendance day-of via preferred communication method
You can also help incentivize attendance by allowing patients to pre-pay for appointments. For an additional incentive, consider discounting appointments for patients who pre-pay.
6. Keep wait times short
Short wait times are key to reducing patient no-shows. Studies show 76% of patients reported they would feel comfortable seeing a different provider within the same practice if it meant shorter wait times and better appointment availability.
Appropriate wait times help patients feel respected and valued. To align with the national average, providers should aim for 18 minutes or less.
You might also consider several methods for engaging patients while in the waiting room. Potential ideas include:
- Providing reading material related to visit
- Utilizing tablets for patient reviews
- Offering on-site surveys
7. Provide transportation options
Transportation can be a major deterrent to attending appointments. For required in-person appointments, consider providing public transportation options.
You can distribute public transit schedules via:
- Pre-appointment materials
- Regular patient communication
- Appointment reminders
- In-office materials, like posters or postcards
Rideshare partnerships can also be a strategic approach. Hennepin Health’s partnership with Lyft illustrates a potential ROI opportunity for healthcare providers.
In 2018, Hennepin partnered with Lyft to implement a 12-month pilot rideshare program. The program resulted in a 10% reduction in no-shows—from 31 to 22.5 percent—and a savings of $270,000.
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8. Build stronger patient relationships to reduce no-shows
Take time to acknowledge patients who consistently show up. Send them birthday or holiday wishes to show that you care beyond the clinical side. These small but thoughtful gestures can build trust and loyalty over time – such engagement strategies’ can ripple into fewer no shows. With tools like LeadSquared’s patient engagement software you can automate these reminders and more.
You might also consider some more strategies to show appreciation, such as:
- Discounting medical bills
- Hosting monthly giveaways
- Thanking patients on social media or via newsletter
- Designing a patient engagement program
9. Keep a telehealth waitlist
Filling last-minute no-show slots can be tough. As an alternative, consider offering telehealth appointments.
Start by compiling your telehealth waiting list. At each appointment, confirm patients’ typical schedule and create an “on-call” list for no-show slots.
An on-call telehealth list can help:
- Fill empty slots quickly
- Save administrative time
- Avoid no-shows altogether
10. Set clear expectations with a written no-show policy
Having a written no-show policy helps patients understand the importance of showing up or cancelling in time. It sets clear expectations, encourages accountability, and reduces last-minute drop-offs. When patients know what’s expected—and what the consequences are—they’re more likely to stick to their scheduled visits. Over time, this can help recover lost revenue and keep your schedule running more efficiently.
You can distribute your policy via:
- Website
- Patient communications, such as appointment reminders
- Waiting room
- Hand-outs to no-show patients
Short (1 page or less)—yet specific—policies are typically most effective. You can include:
- A definition of “no-show”
- Time parameters (i.e. 24-48 hours)
- Specific consequences for missed appointments
Check out UNC Hospitals Neurology Clinic’s policy for an example.
UNC defines “no-show” and provides different levels with “same day cancellation” and “late arrival.” Different no-show levels are assigned different time parameters.
UNC continues by defining a general policy of 24 hours’ notification for cancellations and establishing the clinic’s expectations around patient communication.
11. Educate patients on why regular appointments matter
Sometimes, a little clarity goes a long way. When patients understand why their appointments matter, they’re more likely to show up and stay engaged.
- You can talk about how regular check-ups help catch issues early and keep treatment on track.
- Let them know appointments aren’t just reactive, that they’re key to staying well.
- Reinforce this during visits, reminders, or onboarding.
- An informed patient feels more in control and that builds trust.
12. Offer extended care hours to fit busy lives
Not everyone can make it to a 9-to-5 appointment. Adding early morning, evening, or weekend slots can make it easier for patients to show up—especially those juggling work or family. This small change can have a big impact on reducing no-shows.
You can also ask patients what hours work best. A quick survey or casual feedback during visits can help you align your schedule with their preference. The more convenient the options, the more likely patients are to keep their appointments.
Wrapping Up
Patient no-shows disrupt care and cost your practice time and revenue. As we saw, tackling them takes a mix of clear policies and tools that keep both patients and your practice in sync. From flexible scheduling to clear, timely communication, every step plays a role in helping you connect with patients better and improve their attendance. Tools like LeadSquared’s Healthcare CRM bring it all together—letting you automate, personalize, and streamline the entire appointment journey.
Want to see how it works in action? Book a free demo today.
FAQs
What are the main reasons patients miss appointments?
There are a few common culprits—patients forget, run into scheduling conflicts, feel better and decide not to show, or don’t see the value in the visit. Sometimes, long wait times or a complicated rescheduling process can also push them to skip. Addressing these points proactively goes a long way in reducing no-shows.
Do reminder messages actually work?
Yes, they make a big difference. Timely reminders—especially those sent via the patient’s preferred channel (like SMS or WhatsApp)—can jog their memory and give them a chance to confirm, reschedule, or ask questions. The key is to be consistent and clear, not pushy.
What’s the best time to send appointment reminders?
A good practice is to send one reminder 48 hours before and a second one 24 hours prior to the appointment. That gives patients enough time to rearrange their schedule or let you know if they can’t make it
How can I encourage patients to cancel instead of just not showing up?
Make the cancellation process simple and judgment-free. Give them multiple ways to do it—text, portal, call—and remind them that cancelling helps keep things running smoothly for everyone. Policies work best when paired with kindness and flexibility.
Should I charge a fee for no-shows?
It depends on your patient base and local regulations. Some practices find success with a small, clearly communicated fee, while others prefer to use it more as a deterrent than a revenue stream. The important part is transparency—make sure patients understand the policy before they book.
Can a digital scheduling system really help reduce no-shows?
Absolutely. Digital tools let patients choose the best time for them, make changes easily, and get automatic reminders. It removes friction from the process, which often helps improve attendance rates.
How can LeadSquared help reduce no-shows in my practice?
LeadSquared’s Healthcare CRM gives you the tools to automate appointment reminders, personalize patient communication, and track confirmations or reschedules—all from one place. It takes the manual work out of the equation and gives your team more time to focus on patient care.
What’s the benefit of offering online scheduling?
Convenience. Patients today expect the same ease in healthcare as they do when booking a movie or ordering food. Letting them book or reschedule appointments online—without needing to call—makes it far more likely they’ll commit and follow through.
How important is staff training in reducing no-shows?
Very. Your front-desk or call center team plays a huge role in how patients experience your practice. When they’re trained to handle rescheduling, answer questions, and reinforce policies with empathy, patients are more likely to stay engaged and show up.
Does LeadSquared integrate with other systems like EHR or billing software?
Yes, it integrates seamlessly with major EHRs, insurance verification tools, and billing systems. That means you get better visibility across the patient journey—fewer data gaps, smoother communication, and fewer no-shows caused by miscommunication or missed details.
