What a no-show costs you
Monthly no-show cost = appointments missed per month, times the average ticket booked on those slots. Add the number of those patients who never rebook, times what a patient is worth to you across a first year. Every input is in your record system already. The part owners forget is the chair: a missed 45-minute filler slot at 2 pm cannot be sold again at 2 pm, and the provider was paid for it either way.
A worked example, labelled illustrative
Say your calendar shows 24 no-shows last month, the average ticket booked on those slots was $350, and a quarter of those patients never rebooked. In this illustrative example that is 24 times $350, about $8,400 of booked revenue that did not happen, before the first-year value of the six patients who disappeared. Replace every input with your own figures before you show it to your partner or your provider.
When no-shows happen
- The second visit. The first visit had a conversation behind it; the second was booked at checkout in ten seconds and nobody confirmed it.
- Consults booked from an ad. The patient clicked at 11 pm, picked a time, and has not spoken to a human. Half of the decision is still unmade.
- After-hours online bookings from new patients, for the same reason: no conversation, no deposit, no name attached to the practice yet.
- Monday mornings and the day after a holiday, when the weekend buried the reminder.
- Any slot booked more than three weeks out without a reminder sequence behind it.
Which deposit fits which appointment
A deposit makes the patient decide twice, once when they book and once when they pay, and the second decision is the one that holds. Pick the policy by how much chair time the slot ties up and how new the patient is, state it at booking and repeat it in every reminder. Refund and no-show fee rules touch consumer law and card-network rules in some states; confirm with counsel before you publish yours.
| Appointment type | Policy options | Where practices usually apply it |
|---|---|---|
| Neurotoxin, returning patient | Card on file, charged only on a no-show; or no deposit for patients who have kept three visits in a row | Patients with a kept-appointment history |
| Neurotoxin, new patient | A small deposit applied to the treatment at checkout | First visits, especially ones booked online or after hours |
| Filler, laser packages, any slot over an hour | A deposit that is a meaningful share of the service, applied to the treatment | Long slots the provider cannot refill the same day |
| Consults | A deposit credited to treatment if they book; or a free consult that is not held until the patient replies to confirm | Consults from ads and social media |
| Memberships | No deposit; a missed visit uses the month's credit | Active members, who already paid |
| Parties and events | A deposit per chair, applied to the treatment on the day | Every chair at a party |
The reminder sequence that works
- At booking: a confirmation text with the date, the provider's name, the deposit terms and the one thing to do beforehand. If the patient booked online, the desk calls within the hour to say hello.
- Three days before: a text that asks for a reply to confirm. No reply by the next morning becomes a phone call, not another text.
- The day before: a text with the address, parking and the provider's name. Add the line 'if you need to move it, reply and I will send two times.' A reschedule kept is not a no-show.
- Two hours before: one short text. 'See you at 2, Jess. The door code is 4471.'
- After a miss: the same day, a warm text from the desk offering two times this week. No scolding; the patient already feels it. A second miss gets a call from the owner and a deposit on the next booking.
How to measure your rate this week
- Export the last 90 days of appointments from your record system with their status: kept, late cancel, no-show.
- Count no-shows and late cancels separately. A cancel inside 24 hours costs the same chair but tells you a different story.
- Divide each by appointments booked. That is your rate, and the number to put on the wall.
- Break it out three ways: new versus returning patient, booked online versus booked by the desk, and by service. One of those three will be most of your problem.
- Repeat it monthly, on the same page as your bookings, so the deposit policy and the reminders can be judged by the number they moved.
What to do next
NorthCore's Fill the calendar solution builds the confirmations, the reminders and the same-day rebooking offer on top of the record system you already run. Scoped in writing and covered by the promise on this site: results in 90 days, or we keep working until you have them.
