This blog post is part 2 of 3 in this Stop The Leaks! series for practitioners who have clients who either are:
“Same Day Cancellations”
or clients who call right before their appointment and say,
“Hey, I’m Running Late”.
You can read my 1st post here covering “No-shows”, and the 3rd post here, covering “Same Day Cancellations”.
Here’s The Scenario:
Client calls 10 minutes before their appointment start time, saying they’re stuck in traffic, car won’t start, kid just threw up on their shirt, still in a meeting, or the thousands of other reasons why people get stuck and run late.
Understand the Psychology:
There are a few reasons why they are calling you and I think it’s important to understand the psychology behind it. Here are a few reasons why different people call:
So, Once You Get the Dreaded “I’ll be late” Phone Call, What Do You Do?
“Thank you for calling and letting me know. What time do you think you will get here?” If they answer with a vague “I’m at the park, I’m leaving right now…” Re-ask, “so, about what time do you think you will be here?”
You need to know the time they estimate they’ll be to you, (not what time they are leaving, since you may have no idea if it will be 5 minutes or 25 minutes.)
They might ask, “ Will I be able to get my full session?”
The answer is, “Once you get here I will be able to let you know what we will be able to do.” You don’t want to promise anything, UNLESS you are sure you can do it. If you want to accommodate that client by giving them their full session, by all means do it.
Thank them again for calling so you’re not waiting. Reconfirm they’re still coming with an “ OK, drive carefully, I’ll be waiting for you, see you soon”. By stating you are waiting for them, they will feel more of an obligation to try harder to get to you.
Keep in mind though, if they say they’ll be 30 minutes late, and you promise over the phone or text that you can go over time, what will happen if another client calls at the last minute to get in to see you? You’ve just lost the opportunity to get that last-minute appointment.
To Make It Even Worse…
Imagine after their 1st call to you, they call a little while later, saying, “they’re still stuck and will be even later”.
Now they only have a short time left in their appointment time that you have reserved for them, but you probably still want them to come since even a little bit is better than no bit…
You could say, “It would be a bummer if you missed today’s session. As you know I have a 24 hour window to reschedule… (or what ever your window is but it is the same as your cancellation policy)
Then ask the client, “Do you have any flexibility in your schedule today? I can see what I can possibly do for you later today?”
Scenario # 1: You say “My calendar is completely booked, so please continue to get to me and I will work with you for the remainder of the time, once you get here.”
Scenario # 2: “I can get you in the next opening in my schedule which is at x time today.”
Scenario # 3: If they say something like, “I’m still 50 miles away, I won’t be able to get to you in time….”
You Have Options:
When you have an insurance-billed client, it gets much more tricky and sticky for missed appointments or partially missed session! If you are billing you already know there are codes to bill for 15 minute time increments, so you can only legally bill for the time you spend with the client, not for the time you reserved for them.
Depending on the type of insurance, you may be able to submit a claim with a code for a missed appointment. If it is a work comp case you can not charge the client for the missed session time. (Sorry this is not a billing blog post, so I can’t go in to all the details here.) but you can ask the client to acknowledge (at their first session) their responsibility to cover your fees for missed appointments or missed time, so you can be compensated for the full session.
Many practitioners make the mistake of not charging for the full session they have held for the client. In some instances, your client may call and tell you they’ll be 30 minutes late and tell you they want to ‘just switch the session from an hour to a 30 minutes session. The client usually does not even recognize that by doing this, they just basically cut your income in half! Practitioners forget that their lost time = lost income, so be prepared to know how you wish to handle these awkward, but inevitable situations.
When a client runs late and misses it all together, or receives a partial session, they miss out on all the goodness you can provide. It slows their progress and possibly diminishes their results. If you can and choose to accommodate them by extending the session time, you may feel put out, or taken advantage of. If you can not squeeze their full session into your day, in essence, you are really looking at the same situation as any same day cancellations. (Blog post #3 in this series to come covers Same Day Cancellations)
Although the client did attempt to show up for their session with you, when they can’t get to you, you are left with an open appointment time slot. Unless you have a long waiting list, you are most often unable to give the session time away to another client, therefore you lost the income from the missed session.
Over-all, a “Hey, I’m Running Late” client is an unfortunate situation for everyone. (And, we’ve all been on both sides of it). But, if you have planned out what you will do when it happens, you’ll not be caught off guard, and can remain cool as a cucumber!
I would love to hear what you think. Please share what you do when you’ve had a “Hey, I’m Running Late” client by posting in the comments below. Can you share any more tips for our other readers?
Business mentor, Educator and Inspirer to Clinic Owners & Solo Practitioners. Love to hear from you ~ Please share your thoughts in the comments below!
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I recently started a private psychotherapy practice for the first time. If the time allotted for the session is 60 minutes and the client notifies that they’ll be 30 minutes late, I have it in my practice policies that reserve the right to shorten the session time to adjust for the late arrival (e.g. in this scenario, only do a 30 minute session).
If the client is self-pay, can I still charge them for the full 60 minutes since that is the time I had reserved for their session?
If I’m charging the client’s insurance OR if the client will be submitting a superbill to their insurance company, can I still charge them for the full 60 minutes since that is the time I had reserved for their session?
Congratulations on taking the leap and going out on your own in a private psychotherapy practice!
You pose an excellent question and the answer is based on my concept of “Who’s Running Your Business?”
By that I mean it is your business so you set the rules and make the boundaries!
If you’re billing insurance, you can only bill for time with the client in the session. You can bill the client directly for the missed time if it was established in advance (and not workers’ compensation insurance)
If you’re billing the client directly, you can (and should) bill for the missed time that you held aside for them.
The superbill should reflect what actually happened. Use codes to designate which charges were for therapy and which were for missed time.
Let me know how it goes and if you need more support– these are the exact things we cover in my Academy where we can go over all the details of running a successful private psychotherapy practice.
“If it is a work comp case you can not charge the client for the missed session time…. but you can ask the client to acknowledge (at their first session) their responsibility to cover your fees for missed appointments or missed time, so you can be compensated for the full session.”
This is not clear to me. It sounds as if you’re saying you cannot charge them and then say it IS their responsibility to be sure I am compensated.
Can you clarify this?
Thanks for asking for the difference- sorry for any confusion.
With work comp, the client themself cannot be charged for any time you’ve reserved for them, that they don’t show for.
In other words, if they have a 50-min session blocked and show up 30-minutes late — your client can be asked to pay for the 30-minutes you held for them.
BUT… you cannot bill the client for fees that the insurance did not cover in full. Example: You bill $45 minutes for a modality and the insurance only pays $15. You cannot ask the client for the remaining $30.
(Some insurance will cover missed appointments and other companies won’t.)
Unless it’s an emergency or special circumstance, I require my clients to pay for any missed sessions.
Hope this helps!
I run a craft group and several creative workshops. For craft group we start at 10 and finish at 12 but people always come late sometimes even at 11. I always feel bad for the ones who come on time to start because I always ending up repeating myself for the late comers and end up giving more of my time and attention to them instead of the people who come on time. What do you suggest I do in this situation? I don’t want to start any later because then we would be finishing later and eating in to the rest of the day when I could be prepping for other things. Any advice on this would be really appreciated. Thanks
While it may be tempting to accommodate late-comers, you want to reward those who showed up on time, by giving them your focus and attention.
I suggest you make a decision to do 1 of these 2 things:
#1- lock the door and not allow in late-comers.
#2 – Allow them in, but do not go back and repeat things unless there is enough time to do so.
It may feel mean at first, but you’ll be teaching students to respect your workshop rules while honoring those who are on time.
(I do not want stragglers in my courses, so lock my doors promptly at 9:00am when class starts…
This is even for students who pay thousands of dollars!)
Good luck on the change!
Its always the same clients. Sometimes the excuses change sometimes they remain the same for EVERY appointment.
If it’s the same clients, please have a conversation with them about why they are late and how it impacts their care. Remember, the focus truly should be on them!
Irene – I love the idea of crediting part of the missed session fee towards their next session. It’s a good way to stand your ground without losing a client. I tell my late clients “we’re starting late,but we still need to end on time because I have another client showing up”, or just “I’ll still need to end on time”. This way they understand. I also let them know that since I’ve reserved the time for them, they are responsible for the full session fee, no matter how much time we actually do.
Crediting the fee is a little complicated but here is one of the tricks to make it work really well — be sure to put an expiration date on the credit… In other words, you can give them a 2 week window to re-schedule or the credit will be lost.
Also, be clear on what they can apply it to, in other words, you may not want the credit to apply towards a lower-priced option, or a product you sell.
HI there Irene, I do not understand crediting the fee towards their next session. YOu mean if they are late and the therapist still has to finish on time to serve another client- then the therapist can use the dollar amount of the missed session and apply it towards payment of another full session? Please clarify. Thank you.
Over five years later on, so you probably won’t read this, but someone else might:
I’m a client — I’d find it mildly insulting to be immediately given an unprovoked “I’ll still need to end on time”. You’re sending me a message: you think that I might believe I’m entitled to something of yours that doesn’t belong to me (your time), when it’s me that made the mistake.
Imagine I’m running a kiwi fruit stall, and the sign says “Freshly sliced kiwi fruits — 30p each”. You come up to me, ask me for a kiwi fruit, hand over your thirty pence, I peel, slice and hand over the fruit, and you accidentally drop half of it on the floor. If I then blurt out “I’m not giving you another half a kiwi fruit!” before a word has passed your lips, would you feel rebuked? Insulted by the fact that I’ve assumed you’re grabby enough to want me to lose out because of your mistake?
I’ve paid for your time from, say, 14.00 to 14.50. If I turn up at 14.30 and I’m cheeky enough to ask you to give me your time from 14.50 to 15.20 for free, or worse, I presume that you’ll give me that time, please deal with that as it comes up. Otherwise, please respect me by assuming that I respect you.
With your comment, you’ve shown me how little you think of my integrity, and this is from someone who knows me far better than a kiwi fruit seller knows their customer, so it cuts deeper.
We’re still active on this blog, so I did read your comment.
I so appreciate knowing your perspective.
The sentence, “I’ll still need to end on time”, is suggested to set the expectation for the client, specifically so they are not disappointed when the session ends on time.
Often the therapist IS able to extend the session so the client receives their full session.
Based on years of hearing from my coaching clients who report that many (not all) clients expect their full session even though they might be the cause of the late start.
I think some clients are simply not aware of how therapists have appointments stacked with not much wiggle-room.
As in everything — the way things are stated can make it feel genuine and caring or harsh… in this case, it is said with kindness and clarity.
Thank you for contributing.