How can you charge me for a session not provided, even though I didn’t turn up?
I will tell my referring doctor that you have such practice!
Those were the words of an irate customer as I gently explained how she has to pay for not showing-up for the third time, and that she’s not getting away with her usual excuse that “it’s all our fault for miscommunicating to her”.
So I had the opportunity to deal with an irate customer recently, who has a penchant for making appointments and either
- turning up very late, and wanting a full session though there are other patients scheduled after her
- turning up at unknown hours, claiming that she has an appointment for her
- not turning up at all for her appointment
And her standard answer to me?
Oh it’s miscommunication from your end. AKA – it’s never my fault.
If it happened once, fine. Maybe we did miscommunicated to her. But if it happened for three times, then it becomes a trend, and the common denominator is her. You see, for every appointment made for therapy, we always send out a reminder SMS 24 hours before their appointments, and patients are required to inform us if they can or cannot make it. If they can’t make it for the appointment, they’ll have to notify us 12 hours in advance so we can schedule someone else in, so that the slot won’t be wasted.
To put things in perspective, one of my businesses is a professional health company providing physiotherapy, hand therapy, traditional chinese medicine and sports massage, where we work closely with physicians and surgeons to help clients improve their function and get back to life and sports. We are primarily a healthcare service provider, and we provide service in slots of appointments.
Hence every appointment made and executed is a revenue generating event, and every no-show or cancellation is a revenue loss event, actual or potential. My job as owner is to ensure that there is consistent flow of clients appointments, both new and old, and the clinician’s job is to ensure patients get well and is happy.
So patients who do not inform us 12 hours in advance are billed the full amount for the missed session, simply because the slot is wasted where it’s preventable. However, we do understand that life happens. Sometimes, urgent things do crop us, so we do enforce this policy with a pinch of salt.
And here, when patient has poor attitude to timing and is tardy, we reserve the right to enforce this policy, as we had waived off the first 2 occurrence, which in my opinion is more than fair and in their favor.
So when the third incident happened and she claimed the same-old “company’s miscomm”, I decided that that wasn’t a good enough response to the company. It’s not good enough that patients who are tardy and want to get away with making my therapists and team members wait, and wasting other patients’ time as well.
I launched an investigation, to see if what she said was true, if it was truly a mistake on our part. I wanted to get to the bottom of the matter, and finetune processes. And digging through information, I found that our staff had spoken to her on the phone and had verbally reminded her, plus sent her a reminder text 24 hours before her appointment.
She hadn’t even bothered to reply.
Our text reminder states to call or SMS back to the text to indicate if they can’t make it for their appointment, and her defence was that “that statement means that if she don’t call or text back, that means that appointment isn’t confirmed.”
The evidence I’ve found doesn’t point in her favor, and concluded that it’s her nonchalance to the event that led to the no-show. Then I had a mini-dilemma –
- do I send her a bill for the no-show and potentially cause her ire and lose her as a client?
- ….or would she just take it as her mistake, pay for it and become a good client?
- …or would she fight tooth and nail to not pay for her own mistake?
- …or do I suck up the problem and see what happens next?
I weighed the pros and cons, and decided that I didn’t agree with the way she blamed the reception, stood up the therapists for the third time, and her lack of responsibility.
So I sent her a text, gently explaining who I am, and that I am doing investigation to follow up on the no-show, to tighten processes. I further explained that “upon investigation, unfortunately, we believe that there has not been a miscommunication from our side with regards to the no show from you. There was an SMS reminder to you the day before, and as there is no cancellation by phone or SMS by yourself, it is a confirmed appointment. As there was no notice of cancellation, not only our therapist was waiting for you, but the time was too short to slot another patient in, and I will proceed to bill you a full session for yesterday’s no-show. Moving forward from here, please note the 12 hours cancellation policy.”
The client then called in, obviously unhappy, but as I was engaged with another client, she couldn’t get to me. She spoke to the front counter reception and left a message for me, which I had used to start this article:
- How can you charge me for a session not provided, even though I didn’t turn up?
- I will tell my referring doctor that you have such practice!
I then replied her message, that we respect the time of our clients and schedules (including her), as well as reserve time for patients and it’s an exclusive appointment. I went on to explain how the 12-hours cancellation policy is not something new to Phoenix Rehab Physiotherapy, and certainly not new to the industry, as well as we’re very open and transparent with is – plus it’s indicated in multiple-documents and contact points
- it’s written in the new patient form with her signature
- verbally indicated to all patients
- in every SMS reminders
- in every email reminders
- in the website
I continued by explaining that we respect client’s timing and schedule, and I ask for her to respect ours.
She didn’t reply nor call back, and for her next appointment, when a SMS reminder was sent, she sent back a rude “NO” in full capitalization, no explanation, no nothing.
Undaunted, I replied her reply with “Great! Thanks for the heads up” to thank her for replying and indicating that she won’t be able to make it, regardless of her attitude.
Obviously, she’s upset with it.
I feel her pain – I too don’t wish to be billed for something I hadn’t received…where humanly possible. However, she needs to understand that our appointment schedules are exclusive and highly sought after, meaning that we push patients away when the slots are taken.
It is a first come, first served basis.
For clients who do not respect my team and their time, especially when they don’t show up time and again despite multiple reminders – I don’t extend waiver anymore. Plus, I believe what riles me more is when clients who try to twist my elbow to get their way, where she tries to threaten me by “threatening to tell the doctors” – please go away.
That implies that doctors are unaware. Multiple-contact point information indicating this already notifies not only patients but our doctors, but also shows her lack of attention to something so blatantly obvious despite verbal and print reminders.
It’s obvious that all clients are different with different levels of importance. I am comfortable pruning my patients, because not all are suited to see us, as we provide premium one-to-one services, with results, skill and experience, and not everyone can appreciate this level of services.
I do this not just because I can (though I can stand on this, but that’s evil). I do this because of the principles behind it – I stand for my team. I will take flak for them, I will protect them, I will provide them the best practice environment that I can for them. On top of doing marketing and providing admin support and leverage for them – this is my promise, without compromising legality, ethicality and morality. And their promise to me must be patients must get well and is happy.
What do you think you would have done? How would you approach this problem?
Update: This patient complained to the referring doctor, who got in touch with me. I decided to stand my ground and explain the situation to him, and he accepted it because some patients are just not respectful of other people’s time and appointment. We are still serving the doctor to date.
I’m the founder and writer here at NigelChua.com; as well as serial entrepreneur, therapy business entrepreneur, digital entrepreneur, investor and also happy husband, father and Christian.
Started and sold off a business for 7-figures; built another 7-figure one and growing it further, plus building/investing into other businesses and investments as well as advisory works.
Nowadays I share and teach entrepreneurship, financial independence, retiring early as well as building and living a life you love.
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