To charge or not to charge? Preventing veterinary appointment no-shows

by By Stacee Santi, DVM

10 min read

Suddenly it seems that veterinary appointment no-shows have escalated to an all-time high. The reasons for no-shows can be vast, but it doesn’t change the fact that when a scheduled client no-calls/no-shows (NCNS) during a busy day at your practice, the impact to the business is felt like a foxtail in the foot. Maybe that’s because there is a backlog of clients waiting to get in, or because you had a plan and it got derailed. Regardless, we can all agree, it is less than ideal.

Veterinary practices have taken extreme measures in an attempt to mitigate these bad-behaving clients from wrecking their day and profitability.

Recently, practices have adopted the strategy of charging non-refundable deposits for the coveted appointment reservations.

Practices report this strategy has made a big difference in the amount of NCNS they experience. But, let’s break down the questions that practices need to consider before jumping in the deep end with this one.

1. Who will be required to leave the non-refundable deposit?

Will it be for all clients or only for specific high-risk situations? Whatever path you choose, it is critical to cover all the bases so your team understands why they’re asking for a deposit and avoids making “judgement calls,” and your clients understand why they are being asked for a deposit.

Most practices are choosing to apply this deposit to the highest risk group — the unestablished client. Defining high-risk clients can be challenging, but here are a few examples of how other practices are making this tough call:

  • Clients who have not been seen before
  • Clients who have not been seen in more than two years
  • Clients with an urgent situation who are being asked to book out longer than expected or ideal
  • Clients who have had difficulty paying for services in the past

To reduce the number of client no-shows, send an appointment confirmation via app notification, text, or email, and follow up with multiple appointment reminders in the weeks and days prior.

2. How will you (efficiently) accept the deposit?

This may be the hardest part of the process for practices that want to start requiring a deposit for appointments. While the policy is aimed at improving efficiency, the root of the process — collecting the deposit — will likely end up causing decreased efficiency in the front end. The receptionist will now have to:

  1. Explain why the practice is asking for a deposit
  2. Clearly review the reasons for no refunds
  3. Collect the credit card and run the deposit
  4. Ensure it clears and denote this somewhere in the practice management software as a credit

All of this requires team training so clients are treated consistently by all team members and everyone understands the workflow process. It’s also worth noting that collecting a payment over the phone (defined in the merchant world as “card not present”) will result in significantly higher merchant charges vs. a credit card swipe. Some practices require a deposit equal to the exam fee. Others require a percentage of the estimated cost of the appointment or a flat fee.

3. When will refunds be issued, and are there exceptions?

Despite all the clearest communication, the specific high-risk clients you’re targeting will most likely be the least understanding clients in the practice. This means someone is going to have to deal with the request for a refund on the deposit.

Come up with a game plan for how to handle refund requests, whether you establish a “no exceptions” policy, or a “treat others how you would want to be treated” policy. Ultimately, it will require a manager to handle these requests in a timely fashion as they arise.

4. How will you collect the final payment?

When a client shows up as expected, presuming a deposit was collected, the client’s invoice will need to reflect this deposit as part of the transaction. Many clients may be accustomed to this concept, which is commonly used at hotels, but remember — hotels will often treat the deposit as a hold on your debit card and not actually charge it until you check out.

Another scenario — perhaps your client wants to use a different method of payment for the initial deposit when it comes time to pay the full invoice. While this is not technically difficult, it is another process that you’ll need to plan for.

5. How will you measure success?

Ensure your practice defines what success is for the appointment deposit. Is it reducing NCNS by 50% or less than two per day? What is your current baseline NCNS rate? These are critical pieces of information needed before implementing a new workflow in practice.

6. Can you find the silver lining in no-call/no-shows?

Embrace the NCNS. I hear from every veterinary professional that they are overworked for the entirety of their shift. Instead of being angry at the NCNS, consider turning it into a positive. Take a few minutes to write up charts, sit in the cage with a patient and cuddle, visit with a colleague and see how their life is going, go to the bathroom, go outside for a walk, hop in your car and go get a soda from the gas station down the road, call your friend just to say hi, or catch up on a case you were wanting to research.

Personally, every time I get a NCNS, I am thrilled because it’s a cherished 15 to 30 minutes that I can do whatever I want. This helps get me rejuvenated for the next client who will show up.

While appointment deposits can help to mitigate veterinary appointment no-shows, technology can help, too. Schedule a demo of Vetsource’s solutions to find out how it can help you prevent no-shows.

Stacee Santi, DVM

Stacee Santi, DVM

Dr. Stacee Santi founded Vet2Pet, the only customizable, all-in-one client engagement system for veterinary practices, which was acquired by Vetsource in 2022. Since earning her DVM from Colorado State University in 1996, Dr. Santi has accumulated more than 20 years of clinical experience in small animal and emergency practice, has spent significant time serving on various industry advisory boards, and served as 2020 president of the Colorado Veterinary Medical Association. Considered a key opinion leader on mobile applications and veterinary reward programs, and selected as 2021 Continuing Educator of the Year—Practice Management by Viticus Group, Dr. Santi is passionate about helping veterinary practices better connect with their clients so pets get the best care and veterinary professionals enjoy more fulfilling, balanced careers.

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