Patient scheduling seems pretty straightforward. The patient calls in and the person who answers the phone makes the appointment. Wouldn’t it be great if things were really that easy?

How you manage your patient appointment scheduling can have significant positive and negative outcomes for your practice. This is true whether you use an electronic schedule system or still use a book. For example, having an optimized scheduling process can:

• Boost patient satisfaction
• Reduce patient no-shows and cancellations
• Improve staff productivity
• Maximize provider billable hours (and your practice’s revenue).

On the flip side, implementing the wrong patient scheduling type will reduce patient satisfaction, drive up no-shows and cancelations, waste staff time, and minimize your provider billable hours (and your revenue). It can also make your practice seem unorganized and chaotic, driving patients away to other practices that seem to better meet their needs.

Decision Making Factors

Before you dive in and choose a patient scheduling type (or change the one you have), there are several important factors you must consider.

1. Specialty: The nuances of your specialty will play a large part in the scheduling type that you choose. For example, primary care practices tend to leave more same-day appointments available in the schedule than specialty offices. This method of scheduling can increase your risk of your schedule being full of holes. However, it meets an important need for primary care patients.
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2. Onsite vs. Offsite: Do your providers see patients in your office all day, are they unavailable due to surgeries, do they see patients at another location part of the time, do they go to the nursing home, etc.? Having a solid handle on exactly where your providers are and when they are available to see patients is essential to an effective schedule.
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3. Physician Timeliness: There are always providers that just can’t stay on schedule. They habitually run late. Or maybe there are certain types of visits at your office that you know are going to take a larger amount of time.
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4. Complexity of Appointments: Are your appointment time standardized or do they run the gamut? If they are not standardized, this would be a great place to start before even thinking about changing your scheduling processes.
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5. Patient Population: If your practice typically sees geriatric or pediatric patients, you probably have longer office appointment times than a general surgery practice that is providing consults and follow up appointments.
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6. New vs. Established patients: Obviously a new patient visit takes longer than one where the provider knows the patients and have an understanding of their health.

Patient Scheduling Types

You probably won’t choose just one of the appointment types below. To select a patient scheduling process that perfect for your practice, take the best of each depending on individual circumstances based on the items in the above section to ensure success.

1. Advanced/Open Access: Offering advanced or open-access slots to patients requesting to immediately see the doctor of his or her choice is one way to meet the request instead of directing the patient to an urgent care facility. This can be done in cases where you’ve caught up on your appointment backlog. This method can be time-consuming to adopt, so weigh the benefits and compare them to staff time and implementation before doing so.
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2. Wave scheduling: Assigning two patients in the day’s first time slot, with the first one signed in being the first one to see the physician, can help minimize wasted time, with a catch-up period at the end of the hour. A modified version of this would be to book two patients at the top and middle hours. While wave scheduling can minimize wasted time by the physician, it might slightly increase waiting time for some patients and not allow for late patients or last-minute emergencies.
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3. Cluster appointments: Using cluster appointments for shorter appointment slots, such as patient return visits, can help other patients have shorter waits to see a provider.
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4. Overbooking: If your practice identifies a high percentage of no-shows or same-day cancellations or for specific days, another scheduling option is to overbook your appointments. This will help resolve the immediate problem, but if you find this is happening regularly you should root out the cause and solve it.

With the patient scheduling overbooking method, an additional patient is present in the event of a no-show. Consider starting by overbooking a similar percentage as your trend indicates or start with a lower percentage and increase if necessary once you’ve identified a trend.

While overbooking can help ease the impact of patient no-shows, it can create new problems in its place, such as a crowded waiting room, longer-than-normal wait times, and less catch-up time for the staff. Again, the benefit overbooking and being able to see more patients must be carefully considered against the risk of increased wait times and angry patients.

5. Wait lists: A cancellation wait list allows you to fill in no-shows and late cancels, plus you’ve met the needs of the patient on the wait list. Wait lists are usually well received by patients. However, they can complicate the scheduling process, increase incidents of errors, and create more work for the staff.
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6. Telemedicine appointments: Over the last two years, telemedicine has exploded in practices all across the country. These visits can be particularly beneficial for follow-up appointments or acute conditions depending on the patient base and type of practice. For the patient, they tend to be less expensive and more convenient than in-person office visit. For your practice, it allows you to fill in no-shows and late cancels.
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   Note: How you bill for telemedicine appointments seems to change almost every day. This include new virtual services that you weren’t able to get paid for previously. For more information on ensuring that you get paid correctly for all of the allowable virtual services you provide, checkout this upcoming online training: Collect More for Phone Calls, New 2022 CMS Telehealth Rule.
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7. Online scheduling: Survey after survey indicates that online patient scheduling is preferred by most patient populations (although not all). Not to mention that they can make an appointment at their convenience (outside of regular office hours).

The benefits of offering online patient scheduling depends on your patient base and how you deliver it. If your practice already offers a patient portal, and you have patients actively using it, adding an option for online self-scheduling for patients can be quick and easy for everyone. However, underuse of this tool can cost your practice time and leave a less-than-satisfactory impression on patients. The schedule online must be in real time, otherwise you risk duplicate appointments, and angry patients.

No-shows not only cost your practice money they can also add a serious legal risk to your practice.  Get practical, step-by-step instruction from attorney, Jeana Singleton, JD, on how to reduce your legal risk and revenue due to no-shows in her online 60-minute training: Patient No-Shows: Reduce Legal Risks and Lost Revenue.

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