It has been proven that sending out multiple reminders for an appointment is much more effective than just sending out one reminder. Sending out a reminder several days prior (we recommend 3) to an appointment gives your patients a chance to cancel or reschedule an appointment. Sending another one out the day before the appointment can serve as a friendly reminder. Keeping this in mind, I would recommend including options to confirm, cancel, or reschedule the appointment in the “3 day reminder” and not including these options in the “day-before reminder”.

For example, your 3 day reminder could say “please reply 1 to confirm, 2 to cancel, or 3 to reschedule…”

and your “day-before reminder” could simply not include this info.

However, if you do not have the resources to check replies, you can simply say something along the lines of “There is no need to confirm this appointment, if you need to cancel or reschedule, please call….”

In a randomized trial conducted by John Steiner from Kaiser Permanente, they compared no show rates between over 60k patients receiving either one reminder three days prior to the appointment, one reminder one day prior to the appointment, or a reminder both three days prior to the appointment and one day prior to the appointment. The study was published in the American Journal of Managed Care.

The study determined that sending out both reminders resulted in lower no show rates:

• People that received one reminder 3 days prior had a no show rate of 5.8%.
• People that received one reminder 1 day prior had a no show rate of 5.3%.
• People that received both reminders had a no show rate of 4.4%.

Although a difference of approximately 1% may not seem like much, when calculated over a large amount of appointments this can be quite significant.

Including the cost of a missed appointment in your reminders can persuade your patients to keep their appointment. At the very least, they may be more encouraged to actually call you to cancel or reschedule the appointment.

For example, you can include the following message in your reminders…

“$50 charge for missed appointments” or “$50 charge for appointments not canceled 48 hours prior”.

According to this study that combines several collegiate and health resources conducted by Michael Hollsworth, the effectiveness of including a specific message about the charge for a missed appointment dropped no show rates from 11.1% to 8.4%. The study essentially used 4 different text reminders, one of which included a charge for missed appointments.  These reminders were sent to over 30k patients in one or more of the following specialties: rheumatology, ophthalmology, gastroenterology, neurology, and cardiology.

Studies tell us that the outreach method itself, whether it be calls, texts, or emails, is not nearly as important as your ability to reach people and to give them the appropriate information. This study that compared call reminders vs text reminders and found no significant difference between the two methods for effectiveness.

Text messaging is now the most widely used and accepted form of receiving appointment reminders. However, there are some instances where you cannot reach someone through a text message. They may not have a mobile phone, or their phone cannot accept text messages. In rare instances you may only have an email address for your patient.

In cases where you allow your patients to choose their preferred outreach method, you should send the appointment reminder using that method.

This being said, we recommend in most cases, sending out text messages first and if they fail, rolling them to phone calls automatically. Most appointment reminder software that you use should provide this roll-over free of charge and not charge for failed text messages.

As well, when you do send phone calls, make sure that they originate from your office caller ID and not some random number.

It is always a good idea to add your practice or doctors name to the appointment reminders.  This allows your patients to quickly and easily see who the reminder is from as well as a way to contact you if needed.  Even if you are providing a way to confirm or cancel the appointment through the reminder, many patients prefer to call and speak with someone. I believe it as also good practice to put the name early in the reminder so your patients know right away who it is from.

Make sure that you are never adding any PHI (Protected Health Information) to your appointment reminders.  See our posting on HIPAA Compliance When Sending Appointment Reminders for more information on this.

It’s very important to monitor the replies to the reminders and follow up quickly with any patients that need it. We recommend automatically sending your reminders out early in the day and then checking the replies in the afternoon. This gives your patients adequate time to reply to text messages or check any email or voicemail messages that were left.  Also, mornings are typically busier than afternoons, so your staff may have a little bit more time to check the replies and follow up a bit later in the day.

These appointment reminder template techniques will help you to significantly lower your no shows.  You may want to evaluate for your specific scenario and customize them as needed.  You can always try a few different techniques to see what works best.  Also, you may want to ask your patients how they like the reminders? Are they getting them? Do they like them? What would they want differently?

Keep track of your no show rates before and after adding appointment reminders to see and evaluate how they have improved your no shows.  If you don’t see substantial improvement, tweak them and keep trying new techniques to see what works best!