This post is the third installment of the "Review, Benchmark, and Improve Practice Revenue" series, where we dive into how to diversify your revenue, lower operating costs, optimize billing procedures, and outshine your competitors.

Your practice works hard to serve patients well. You've invested in quality care, skilled staff, and efficient operations. Yet every month, thousands of dollars disappear through missed appointments and no-shows.

You're not alone in this challenge. Tebra research found that more than a third of practices lose up to $7,500 monthly from cancellations and no-shows. 

Most practices fight back the same way — with additional appointment reminders. However, Tebra research shows there's a disconnect with how effective patients feel these are in reminding them of their appointment. 

To resolve this, you need patient engagement strategies beyond simple appointment reminders. In this article, we’ll provide strategies to reduce no-shows and cancellations, improve patient access, and improve patient-provider relationships.

If you’re trying to reduce how often patients don’t show up for their appointments or cancel them, try these strategies.

Most practices send appointment reminders, because they do work — to a point. About 70% of practices use additional reminders beyond the standard 24-hour call, which shows you're thinking about patient engagement. The issue is, only 40% of patients say these reminders actually help prevent cancellations.

This disconnect usually comes down to how the reminders feel to patients. 

Typically, generic messages get ignored or deleted, and patients tune out automated calls that sound robotic. What feels efficient to your practice might feel impersonal to the person receiving it.

The solution is to send better reminders:

Tebra's reminder system lets you customize messages by appointment type, so your colonoscopy reminders include prep instructions while your follow-up visits focus on what you'll review together. 

Once you set up these personalized templates, the platform handles delivery automatically while maintaining that personal touch patients appreciate.

Picture this: Your 2 pm patient arrived early and waited 45 minutes just to be brought back to the exam room. She keeps checking her phone, glancing at the clock, and shifting in her chair. You know that look — it's the same one you'd have if someone were wasting your time.

Our survey found that only about 65% of practices prioritize punctuality, and patients absolutely notice when you respect their schedules. The flip side is also true: chronic delays erode trust faster than almost anything else you could do.

Medical care doesn't run on factory time, and you can't control every variable. But you can control how you plan for the unpredictable. 

For instance, you can start scheduling your appointments more realistically — with 15 to 20 minutes per patient, instead of 10 minutes in a double-booked slot. This way, you get ample time to talk to your patients. And if you’re running late, let your patients know in advance and give them the option to wait or reschedule.

What if your patients could get care when they need it? Most practices are booking out weeks, if not months into the future.

Only 59% of practices offer same-day or next-day appointments, yet 71% of patients say this availability would reduce their likelihood of canceling. That gap represents missed revenue as well as frustrated patients.

It’s normal for circumstances to change because, let’s face it, life changes fast. The appointment that seemed reasonable 3 weeks ago might now conflict with a work emergency, sick child, or family crisis. This is where almost immediate appointment availability can also turn into successfully rescheduled sessions.

We recommend reserving 10–15% of your daily capacity for urgent bookings. Use your practice management system to release these slots each morning, making them immediately available for online booking. 

When patients call to cancel, your staff can immediately offer same-day alternatives instead of just accepting the cancellation.

When a practice offers extended hours, it's more likely to accommodate a patient's needs. But our survey found that only 33% of practices offer extended hours. 

You don't need to work nights and weekends — just think strategically about when your patients are actually available. 

You can start small and test it out first. For example, start offering 1 late evening session weekly for patients or early morning slots in case more patients request them. If you see a larger influx of patients, you’ll know this time frame works, and you can consider adding more slots in the future.

But make sure to review your cancellation patterns first. If certain days and times consistently see no-shows, those patients might be better served by alternative scheduling options.

Money talks, especially when it comes to commitment. When patients pay their co-pay upfront, they've invested in showing up. It's basic psychology — people protect what they've already paid for.

Only 14% of practices require advance payment, making this the most underutilized strategy on our list. Yet it addresses both the practical and psychological aspects of appointment attendance.

Beyond the commitment factor, an advance payment streamlines your entire workflow. Patients check in faster, you improve cash flow, and checkout becomes effortless. You don't have to deal with payment processing delays when patients are ready to leave.

Implement this gradually to avoid patient resistance:

Frame the policy positively: "We collect co-pays when you schedule to streamline your visit and reduce wait times for everyone." Most patients appreciate anything that makes their healthcare experience more efficient.

The best way to handle missed appointments is to prevent them from happening in the first place. About 57% of patients wait 3–7 days for appointments with new practices. In addition, 39% consider flexible or after-hours availability crucial when choosing a provider. 

Patients who can easily access your care are more likely to keep their appointments and less likely to seek alternatives. Here's how you can improve this.

Telehealth eliminates the most common barriers to keeping appointments. And some of the best practices are adopting this option. In fact, Tebra’s survey found that 69% of practices now offer telehealth options. 

Patients love telehealth for follow-up visits, medication checks, and consultations that don't require physical exams. A 15-minute telehealth check-in often accomplishes the same goals as a 30-minute in-person visit when you factor in patient travel time.

The key is knowing when telehealth works best — for example:

“Initially, the providers in my office were hesitant to start scheduling telehealth visits with their patients,” says Jesse P. Houghton, MD, senior medical director of gastroenterology at Southern Ohio Medical Center. “However, now we find them to be an invaluable addition to our office visits. Telehealth allows our providers to add patients at the end of the day when our staff has left, and also makes the best use of our time when we do find ourselves with office or procedure cancellations.”

Tebra's telehealth platform integrates directly with your scheduling system, making it easy for patients to book virtual appointments and for your staff to manage both in-person and remote care seamlessly.

When patients have pressing health concerns, they need care quickly — and if you can't provide it, they'll find someone who can. That said, only 55% of practices reserve time for urgent appointments, which means nearly half are missing opportunities to serve existing patients when they need care most. 

These urgent slots prevent revenue from walking out your door to urgent care centers and competitors. In this case, reserve 2-3 slots daily for urgent needs. You can even consider adding flexible scheduling to expand urgent capacity when you need it.

This also means you have to train your staff to identify what’s truly urgent and what’s not, so that only the right requests get pushed into urgent care. Spending a little more time educating the office staff here will pay dividends long term.

Patient loyalty to individual providers is changing. Many patients these days often prioritize convenience and availability over seeing the same doctor every time. 

Only 40% of practices currently allow patients to see multiple providers, but this flexibility can significantly reduce cancellations.

In short: patients appreciate having options. This is especially valuable for routine appointments, follow-ups, and non-complex visits where continuity of care is less critical.

As long as you maintain good communication between providers through shared notes and care plans, patients will feel confident, irrespective of who sees them.

That said, set clear guidelines about which types of appointments work well with multiple providers:

Revenue is about keeping patients long enough to build sustainable relationships. Acquiring new patients costs more than keeping existing ones, and loyal patients refer others to your practice.

Unfortunately, 47% of patients leave practices due to poor experiences with their provider. That's not a scheduling problem or an access issue — it's a relationship problem. Here’s how you can improve your patient relationships:

Long waits communicate that your time matters more than your patients' time, regardless of your intentions. So, start by measuring what's happening — for example, track patient flow from check-in to provider interaction.

Many practices discover their perceived wait times don't match reality. Once you have real data, you can address the actual problems rather than guessing at solutions.

About 74% of providers focus on reducing wait times, making this the most widely adopted relationship-building strategy. Try simple changes such as: 

When waits happen anyway, acknowledgment goes far: "Dr. Martinez is spending extra time with a patient who needs additional care. She'll be with you in about 10 minutes." 

“I find that a simple acknowledgement and apology to the patient for their wait time goes a long way,” says Houghton.

Only 62% of providers prioritize clear lab result explanations, according to Tebra’s survey. Yet this communication directly impacts whether patients trust your judgment and continue their care with your practice. 

To help patients understand their results, explain what the numbers mean and why you're monitoring these parameters. If everything looks good, say so clearly and explain what that means for their ongoing health. Providers often take for granted that their patients understand what they are looking at when they view their lab or imaging study results.

These days, patients want to access everything online. However, only 45% of practices provide easy record access, leaving many patients feeling disconnected from their own care.

When patients can review their visit notes, track their health trends, and understand their treatment plans, they become partners in their care rather than passive recipients. This engagement leads to better outcomes and stronger loyalty to your practice.

Patients expect digital access that works like other aspects of their lives, including:

Tebra's patient portal handles these features seamlessly while reducing administrative requests for your staff.

Healthcare teamwork often happens behind the scenes, but patients notice when it's missing. 

Sometimes, patients deal with conflicting recommendations from different providers and have to get duplicate tests. We found that 40% of practices actively coordinate with other members of their patients' care teams.

When you share relevant information before specialist referrals or follow up on specialist recommendations, patients recognize and appreciate these efforts. It prevents frustration and drives loyalty in the long term.

Lost revenue from missed appointments doesn't have to be part of running a practice. 

Start with 1 or 2 approaches that make sense for your practice. If most of your cancellations come from patients who work during the week, focus on same-day scheduling and extended hours. If communication gaps are the issue, improve your reminder system and result discussions.

Implementation doesn't require overhauling your entire operation. Small, consistent changes often produce the biggest improvements in patient attendance and satisfaction.

Ready to start reclaiming lost revenue?

Don't stop there — discover how Tebra's platform can help you reclaim revenue by taking a free tour today.