Reduce no-shows and recover lost revenue: Webinar recap

Missed appointments are silently draining thousands from your practice every month — between $38,000 and $81,000 annually for the average independent practice. 

Tebra’s recent webinar, held April 24, 2025, offers proven strategies to drastically reduce no-shows — helping you protect your revenue, enhance patient relationships, and improve operational efficiency.

In this exclusive webinar, experts Kristin Trick — a therapist and solo practice owner in El Paso, Texas — and Leanna Coy — a nurse practitioner experienced in high-volume clinics and telehealth startups — share actionable insights that combine technology with a personal touch.

This guide covers an overview of the essential strategies discussed. Plus, you can watch the webinar recording to start building a smarter, stronger schedule for 2025.

The financial impact of no-shows is increasing, with practices losing thousands monthly, according to Tebra’s 2025 no-show report.

“In just 2 years, there's been a 26% increase in practices losing more than $5,000 a month from missed appointments,” explained Andrea Curry, Director of Content at Tebra. “Our data shows that nearly 1 in 4 practices lose more than $5,000 every single month.”

This significant revenue loss, emphasized by Leanna, is unsustainable: “That's someone's salary walking right out the door.”

The key to improving attendance? Strong, consistent patient engagement.

Patients who trust your practice and feel supported are more likely to show up. Building that connection starts with:

Even highly engaged patients can slip through without proper systems. That’s why technology must support — not replace — the human touch.

In our webinar poll, most practices said consistent communication was their top tool for reducing cancellations — but only when reminders felt personalized and timely.

Kristin stressed automation’s role: “I don't have an admin team … so my approach is with the EHR, electronic health record system, that I operate on. I have automated reminders set up.”

If rescheduling feels harder than canceling, patients will simply walk away. Tebra’s survey shows 75% of patients are more likely to keep an appointment if online rescheduling is available.

Smart strategies include:

When you make it easy to reschedule without judgment or hassle, you protect both your revenue and your patient relationships. 

Kristin shared her flexible approach to no-shows: “When a client cancels late or no-shows completely, I try to make it conversational to understand the reason for the missed appointment. Oftentimes I will offer an open appointment time later this week — then I will waive the late cancellation or no-show fee.”

Boundaries aren’t barriers — they’re the backbone of a healthy practice. 

In the webinar, Leanna shared: “In my current practice, we have policies that are in place that are very clear from the start. It lets them know when they need to reschedule and what the fees may be.” 

However, it takes some time to train patients. Best practices to train them include:

Webinar polling showed that while most providers charge late arrival fees, about 66% start enforcing them if a patient is 15 minutes late — a reminder that even small delays impact revenue and operations.

Kristin said she offers a "one-time freebie," which entails waiving a late fee once to earn patient trust. She added: “I'm very clear in the initial phone call to a client and then I include it in my written informed consent form ... it's very overt that if somebody doesn't let me know with at least 24 hours notice or they don't show up at all for the appointment that there is a $50 fee that will be charged.”

Automation is critical, but so is empathy. Wherever possible, practices should automate processes to streamline reminders, confirmations, and billing, freeing up staff to focus on high-touch support.

Tips for balancing tech and human connection:

Automation should make engagement easier — not colder.

Kristin emphasized the importance of setting expectations around tech use, especially in the mental health space where patients may try to turn a message about scheduling into a session: “It is important to clarify with clients the purpose of this technology. It's not that you're having an appointment or session; it's that you're rescheduling or you're letting your provider know you can't make it.”

Leanna also added a practical example about how to keep patients in the loop when you, as a provider, are behind schedule: “When I'm running late in my current telehealth practice, the medical assistant will reach out to the patient to let them know I'm running behind.”

No-show prevention isn’t just about tech and policies — it’s about culture.

As Andrea emphasized in the webinar, "Be clear in your policies and expectations and stick to your boundaries. Find out what your patients want and meet them there but also nudge them to adopt your technology."

Practices that set clear expectations, respect their patients’ time, and hold patients accountable for theirs see better attendance and stronger patient relationships.

Kristin shared her stoplight approach for assessing patient behavior: 

To reduce no-shows through this approach, Kristin noted: "I try to fill my caseload with green light clients and maybe some yellow ones."

She also explained how she balances flexibility with boundaries: “At the 15-minute mark, if somebody's not appeared, I usually call them. The slot is reserved for them. To me, it makes more sense to try to connect with them. And that produces a session for them, but also the increased revenue compared to the $50 fee.”

Leanna offered creative approaches for accountability, particularly when late fees aren't an option: “We offered gas cards once a year to the patients as an incentive to get them to come to their appointment. And that was actually pretty effective.”

You can also download the webinar slides here for the top no-shows insights and tips on how to reduce them.