File: Office Binder \ Front Desk


When a patient has missed an appointment by more than 15 minutes, the Front Desk CA should call them to remind them of the appointment. If the patient is not contacted and rescheduled for that day, the patient is a “missed appointment” and should be handled per the policy on "Loss Control System." Write the patient’s name on the recall log and handle accordingly. The CA should try to contact the person at least three times the first day and three times the second day. If no contact is made, the patient should be sent a post card and the patient file given to the doctor. If the patient does not reschedule or cannot be contacted, their name should be given to the treating doctor to contact the person directly.

Many different types of dialogue work. The following is a good script for handling missed appointments.


"Hello Mrs. Jones, this is ______at Sample Health Care Center."

"You had scheduled an appointment to see Dr. Sample at ____ (time) today and I’m calling to find out why you couldn't keep your appointment."

Usually, the patient will reschedule the appointment for later that day or they will offer some reason why they can't make it in.

If the patient offers any reason why they can't make their appointment, the CA must stress the importance of following through on the schedule of care outlined by the doctor.

Naturally you will receive all kinds of responses. Just keep in mind that the reason doesn't usually matter so much -- what is important is to get the patient back on their appointment schedule outlined by the doctor.

Having this type of attitude depends entirely on your faith and confidence of chiropractic. The CA calling should be confident that the best thing for the patient is to keep their appointments. Now there are many things that one can say to convince the patient to come in. The most important thing is to understand the patient and tell them that you understand. Try not to make the patient wrong by arguing with them or by being overbearing.

"Mrs. Jones, I understand that it's Friday and you are getting ready for a weekend trip. I must stress to you the importance of your keeping your appointments. Dr. Sample has prescribed a precise program just for your particular problems, and when that program is interrupted it results in your losing ground on your progress. We have some free time left today and Dr. Sample would like you to come in."

If this is done correctly, the patient will feel compelled to come on in. Again, the results depend on the intention of the person making the calls. If the patient does not reschedule for that day, be sure to insist that they make up the appointment that same week.


"Mrs. Jones, I understand that your son is sick. We want you to stay on your appointment schedule so that you can stay healthy and get better. Dr. Sample has an opening at ____ today and he'd be happy to check your son too, to see if an adjustment might make him more comfortable or recover more quickly."

"Mrs. Jones, I understand that you're feeling better and that's great. Dr. Sample will still want to see you today to make adjustments to your back so that you continue to progress and don't slide backwards."

For patients that miss often and that you have discussed with the doctor:

"Mrs. Jones, Dr. Sample was just talking about your case and he said that your adjustments were critical at this point. He said that if you called he wanted me to stress how important it was that you follow through on your treatment program as it was outlined."

For the newer patient to your office:

"Mrs. Jones, you're pretty new to our office and I understand that your car is broken, but I want to make sure you know how important it is to stay on the schedule of care that Dr. Sample has outlined for you. When you miss appointments it retards your healing and takes you longer to get well. Is their some way that you could make it to our office today for your adjustment?"

For a patient that you know well, you can be friendly and firm:

"Betty, you know it's against our policy to accept cancellations. When can you get in here today?"

"John, this isn't going to help your low back. You need to get in today. How can we make that happen?"

"John, Dr. Sample is going to be real disappointed. You were making great progress and now that you're out of pain, you've started to miss your appointments. You need to keep following through. We'll squeeze you in. When can we see you today?"

All situations that a patient may present should be practiced and role-played so that the CA is comfortable handling them.

If the patient still refuses to schedule, or wants to stop treatment, the CA should handle this as per the policies on "Handling Patients That Cancel".

A clinic that has well educated patients, a caring doctor, and a staff that exercises good patient control should have a "kept appointment" percentage in the 90% range. If it is below that level, one of the above factors is weak and must be corrected.

Petty, Michel & Associates © 1998 Missed Appt Handling.doc – Revised 12/31/98Page 1 of 3