How do you handle No-Shows?

How do you handle patients who don't show for appointments or who cancel at the last minute (i.e. 7:45 a.m. on the day of the appointment)? Do you have a set protocol and does it apply uniformly or do you vary according to the patient and their individual history with the practice?
docsnides, Official Townie

It varies according to their history with the practice. I have one patient who is a chronic canceller, but I don't care because for one she is difficult to work on and I am actually grateful when she cancels. Secondly, she is a great referral source (her referrals generate about 20K per year). It all depends on the individual.
mauty, Official Townie

I only get really angry if they break a long crown prep or such. If I still plan to treat them and think they'll do it again I put them in at noon Fri. (I only work the morning.) If they show I go home a little later than normal, if not, an hour early. If the patient is not someone I want to follow up with, we ignore the broken appt and it's up to them to call...a lot of undesireables won't call, so if you don't make the call...they're gone.
david_f, Official Townie

If you know the patient, and know that this is not what this patient would intentionally do, well, we figure it can happen to anybody (forgetting an appointment, or some such). And we try not to get all into a twitter.

But if this is a patient whom we really feel doesn't care, then we also just don't call them. And if they call, we try to let them know that when they no-show on us that it DOES cause a disruption. I think many patients just think we've all got so many patients coming and going, that if they don't come in, we won't really miss them.

If someone does it a couple times, often we'll give them another appointment only AFTER they pay for their appointment 100% up front. This seems to have a way of making them not forget their appointment. We do have a couple families that constantly are late or no show. And for some reason, I just resist booting them out. And the funny thing is that I don't really know why. I'm usually pretty good about writing them a letter dismissing them, etc., but maybe I'm getting to be a wimp in my old age, huh?
Rod, Official Townie

Isn't this topic the biggest pain in the butt to deal with? Seems like whatever you do you lose. Our policy for recalls is to send out a card two weeks before apt and then to confirm a day before. Still get those no-shows a day before cancellations. If they cancel with less than 24-hrs notice they are given a "nice" warning and told the next cancellation will result in a $45 charge. Doesn't phase them. They still cancel/no show.

So now, if they have screwed us twice, FOR ANY REASON, we simply tell them we would love to have them as patients and appreciate that their loved ones keep kicking the bucket on their dental apt days (some are up to 3 or 4 sets of grandparents). Because they are so busy at funeral parlors we offer them this option: call us on the day you are available, preferably 30 minutes before you could be at our office. If we have an opening we would be thrilled to see you. If not, try again the next time you can squeeze us into your busy schedule. Some patients actually take us up on this and have filled in last minute cancellations (win-win for everyone) most others, however, have moved on to other dentists to disrupt their schedules. Eventually, though, if we all took this attitude it might finally sink in and some of these patients might learn to respect our time.
flyer, Official Townie

Try putting a charge of $100 for a No Show appointment on their ledger with a professional courtesy of $100. When they see that you do charge for No Shows's I promise you it will not happen again. And if it does let the next $100 stay on their ledger with NO professional courtesy. Works like a charm.
fritz, Official Townie