Your scheduling process is organized. You’re on top of Recall. You’re using block scheduling to balance the production mix. You’re using Web Sched to allow patients to schedule appointments online. You’re using eReminders and eConfirmations for appointments. Despite your best efforts, broken appointments are a reality, affecting not only your bottom line but delaying patient care. In this post, we will review the tools in Open Dental to handle missed/cancelled appointments to mitigate their impact on practice and patient health.

Processing Broken Appointments (Missed or Cancelled)

There are multiple options for tracking and managing broken appointments. The first step is to set up the Broken Appointment Automation Preferences.

• Broken appointment procedure type – Use this preference to determine if you want to use the Missed or Cancelled broken appointment procedures. Or use both. Or none. Procedure codes can have associated fees as necessary if your office charges a broken appointment fee. These can be used to track broken appointments in the Broken Appointments Report.
  • Missed – Charts procedure code D9986. Normally used when a patient was a no-show to an appointment or cancelled without advanced notice (e.g., 24 hours).
  • Cancelled: Charts procedure code D9987. Normally used when a patient cancels an appointment with advanced notice (e.g., over 24 hours).
• Make broken appointment commlog – Enable this preference to automatically create a commlog with appointment details when breaking an appointment.
• Make broken appointment adjustment – Enable this preference to automatically create an adjustment when breaking an appointment. This is helpful when your office charges a broken appointment fee. This can be used to track broken appointments in the Broken Appointments report.
• Broken appt default adj type – If using the ‘Make broken appointment adjustment‘ preference, choose the Adjustment Type you’d like to use for broken appointments.
• Force users to break scheduled appointments before rescheduling – Enable this preference if users must break an appointment before it can be rescheduled.

When an appointment needs to be broken, you can right-click the appointment to break it or select the appointment and click the Break button in the appointment toolbar. The Broken Appt Options window will open – available options depend on the Preferences you’ve enabled.

Best Practices:

• Broken appointments should be handled before the end of the day.
• Send broken appointments to the Unscheduled List, reschedule them, or delete them. Otherwise, incomplete appointments may get left in the Appointments Module. This can cause issues when trying to reschedule the treatment at a later time if procedures are already attached to another appointment.
  • If your practice has been leaving broken appointments on the schedule, you can find them by running the Broken Appointments Report, or with a specific patient selected, clicking on the ViewPatAppts button.

Act Quickly to Fill the Slot!

Life happens, but you can mitigate the impact that broken appointments have on your practice and your patients who are waiting to get care.

The ASAP List is the hero here, but you can catapult its effectiveness by adding Web Sched ASAP and Integrated Texting. Web Sched ASAP allows you to send ASAP messages about available openings so patients can schedule online. Integrated Texting allows you to use text messages to notify your patients of last-minute openings in a way that is much more likely to have them responding right away.

In your Appointments Schedule, right-click on the opening to text patients on your ASAP list. A blockout will be added to the schedule, indicating how many people were contacted and by what method (email or text). They will receive a link to claim the opening – the fastest responder claims the spot!

Identify Patterns and Restrict Scheduling

You may start to build some policies around cancellation timelines or fees, or requirements for scheduling (like collecting a deposit upfront) if a patient has a pattern of cancellations or no-shows.

Identifying Patterns

Here are some ways to see a patient’s appointment cancellation activity.

• Run the Broken Appointments Report to see broken appointments in a date range.
• View broken appointments from the Chart Module. In the View tab, easily filter to only see broken appointments by searching the keyword “Broken”.
• Create a custom Patient Field Def to manually track the total number of broken appointments.

Restricting Scheduling

• Manually check the box at the top of the Edit Patient Information window to restrict scheduling. If someone tries to make an appointment, they’ll get a warning letting them know scheduling is restricted for the patient.

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Broken appointments are part of running a dental practice, but you can mitigate the effect they have by utilizing these tools and strategies. Need help with anything? Reach out to Support.