We’ve all had no shows or late cancellations. How should you handle this?
At the heart of a no show is the question “What are we worth?”
Whether you have a full private practice or a struggling one, ultimately, that time that you set aside for that person you didn’t take on new clients. Even if you’re not busy, you had the potential to take someone on during that time. What’s the standard you want to set for yourself?
I charge my full rate if someone no-shows, unless there is a car accident or someone’s really sick. I have the 24-hour notice clause that they have to give me at least 24-hour notice so that I can try to fill it. At the heart of it is that I could have filled that counseling session with somebody else and so why would I get $20 for showing up, for being here or for keeping that spot open if I could have filled it with a full rate client?
Accountability of a Counseling No Show
I found that I have a very low no show rate when someone does have to pay for their no show or their late cancellation. Now, there are times where someone calls the morning of. You can choose whether you’re going to be completely rigid and completely consistent or not. I don’t do it like based on client. “Oh, I like that person or not.” That’d be obviously unethical.
I think that there are situations when people say the week before, “Oh, my daughter might have volleyball that night. We’re going to have to let know.” Then you know ahead of time, “Okay, they might cancel the last minute or they might not.”
You then take on that risk, as well. I think charging the full rate really helps the client realize that you are busy or you have the potential to be busy and that someone else could have had that session.
Logistics of a No Show Policy
The way the logistics work is within my intake, I mention it. I also have it in my intake paperwork that they sign off that they’ll be charged the full rate. I don’t keep a credit card on file. Some people do that, but overall it’s seen as a best-practice to not keep it on file.
If someone then no shows, then in the next session, I charge. I may also email them ahead of time. If it’s a brand-new client, though, I don’t charge them for that because if you think of it from a sales perspective, you don’t want to start that therapeutic relationship or that business relationship on the wrong foot.
I may mention that I just wanted to let you know that typically with that no show or in the first session you need to cancel the hour before, I will have to charge you that full rate in future sessions. I just wanted to remind you of that and I’ll waive that this first time because you just don’t want to start that therapeutic relationship on the wrong foot and you don’t want to start them being double out-of-pocket even though you could have filled that session.
Why it Works
I found that when someone has to pay for that no show, it really reminds them, especially the teenagers with whom I work. I’ve had teenagers that just totally flaked out and their parents say, “You have to pay the full rate. I’m not going to pay it.”
Then, maybe that teenager had to work for a number of hours–it might even equal a full day’s work that they are paying. As a result, they take counseling a lot more seriously. I mean, if you no show on a doctor, you no show on a plumber or you no show on your furnace person, you have to pay him.
Here are some quick tips to improve your no show/late cancellation policies:
- Have your policy in your welcome email
- Have a written policy on the intake
- Charge your full rate
- Make it easy to pay via online payment
- Practice your explanation
- Tell yourself, “Every medical professional does this.”
Why would we change and change our expectations for people that are coming to us that want to reach their goals? Why would we be less holding them accountable? Those are my thoughts on no shows.
Man looking at his watch photo available from Shutterstock