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If You Can’t Beat Them, Manage Them – Cancellation Management Part 1

Part 1 of a 2 part series on Cancellation Management.

900,000 ambulatory appointments are cancelled daily, resulting in wasted staff time and an annual loss of 27 billion dollars for healthcare providers. We at Luma Health have learned quite a bit from our clients and potential customers.

Here are a few ways practices cope with cancellation management:

Appointment Reminders

Some clinics manually remind patients, while others use an automated system. There are several reminder service providers that range in their level of sophistication. Features to look for include communication method options (phone, text message, and email), time customization, and real-time staff access to responses. Luma Health offers a full-featured reminder service.

Watch our on-demand webinar to learn more about how to leverage reimbursable HIPAA-compliant virtual visits to deliver care and minimize appointment backlogs and cancellations.

Cancellation Fees

Policies generally state that a cancellation fee is incurred if patients cancel within 24 hours of the appointment. We’ve found that these fees are rarely enforced and if they are, they leave a bad taste in a patient’s mouth. The exception is with patients who have a long-standing or personal relationship with their provider. Fields such as psychiatry see better results with this tactic.


Some clinics will book appointments close together expecting a few patients to cancel. This works well if you can predict who will cancel, but when they all show up, the clinic runs severely behind schedule with many patients waiting. With value-based care on the rise, and patient satisfaction becoming a more important factor, double-booking will become a risky tactic.

With value-based care on the rise, and patient satisfaction becoming a more important factor, double-booking will become a risky tactic.

Removal of Patients

Continual abuse of appointment scheduling can be avoided by having a policy of not allowing a patient who does not show up for three appointments to book another appointment. This, of course, is a loss of a patient. But if you are not using a smart waitlist, this patient is costing you.

Manual Waitlist

Clinics will capture the patient name, contact information and doctor. When a cancellation happens, staff will work their way down the list. We met one practice that had 70 patients on their manual list.

Special List

Patients who are prone to canceling are placed on a special schedule where they are intentionally double booked. Patients are informed of this and told that they may have to wait longer for their appointment based on the flow of other patients at the time.

Here at Luma Health we have taken the best of these tactics to manage your office’s scheduling needs. Click here to learn more about our smart waitlists, automated reminder system, or to share your experience with cancellation management.

Read our part 2 of this series, which explores how other industries confront high cancellations rates.

Tashfeen Ekram, MD, is a radiologist, self-taught coder, healthcare innovator and Co-Founder of Luma Health. Contact him on Twitter at @tashfeenekramMD.

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