Tobi Cloud

Dealing with No Shows in the NEMT Industry

The National Library of Medicine’s report on missed appointments in the Non-Emergency Medical Transportation (NEMT) Industry reveals that, on average, 62 appointments are missed each day.   

These missed appointments add up to a substantial annual loss of $3 billion for the healthcare industry. Clearly, “no-shows” can potentially have a severe financial impact on NEMT providers.   

This article explains what no-shows are, their common causes, their impact on the industry, how NEMT providers should document no-shows, and how to minimize them.  

What Are No-shows in the NEMT Industry?

In the NEMT industry, a no-show occurs when a patient does not utilize a scheduled transportation service or cancels it without prior notice. These missed appointments present some serious challenges within the NEMT ecosystem.  

Why do no-shows occur in the first place? Well, there can be various reasons for that, such as miscommunication, scheduling conflicts, or unforeseen circumstances on the part of the patient.  

Regardless of the cause, the consequences of no-shows can be detrimental to the NEMT service providers and the patients themselves.  

Do More with Less

Handle more trips with fewer dispatchers on your payroll with Tobi.

Start for Free

What Are the Causes of No-shows in the NEMT Industry?

Some causes of no-shows in the NEMT industry are because of the rider. However, other reasons can be beyond the rider’s control.  

Causes Under the Rider’s Control

Riders may encounter various situations that contribute to no-shows in the NEMT industry.  

Circumstances such as family emergencies or urgent personal matters often prompt patients to prioritize these obligations over their medical appointments.   

Similarly, sudden or worsening health conditions can prevent patients from attending their scheduled appointments, as immediate medical needs take precedence.  

Forgetfulness also plays a key role, especially for patients with complex medical conditions who struggle with memory retention.  

Miscommunication is another significant factor, where language barriers hinder the patients’ understanding of transportation details and appointment instructions.   

Causes Beyond the Riders’ Control

Some causes of no-shows are beyond riders’ control. Inaccurate route planning, inefficient dispatching that leads to delays, and longer travel times can cause patients to miss their NEMT trips.  

Poor dispatching can result in delays and extended travel times. Optimized route planning can reduce travel times significantly, improving patient experience and reducing the likelihood of no-shows. In addition, limited vehicle availability due to improper trip management can make it challenging for NEMT providers to cover all scheduled appointments on time.  

Inadequate vehicle maintenance can also result in unexpected vehicle breakdowns and clients potentially missing NEMT transport and being classified as a no-show.  

These factors highlight the importance of effective operations management, efficient logistics planning, and robust maintenance practices to minimize no-shows and ensure reliable transportation services.   

What Are the Impacts of No-shows in the NEMT Industry?

No-show incidents have significant consequences, resulting in a waste of time and resources. Patients who do not show up for scheduled appointments cannot receive necessary medical evaluations and treatments, leading to potential delays in their healthcare.  

This delay can push up the overall burden on the healthcare system and affect patients’ quality of life.

Plus, no-shows increase healthcare costs as resources such as the NEMT providers’ time, staff, and facilities may be underutilized or wasted.

When patients fail to show up, valuable resources go underutilized, leading to gaps in service provision and suboptimal use of available resources, including NEMT vehicles and staff.

Unless a NEMT contract includes contingencies for no-shows, chances are that NEMT providers will not get paid for trips that customers skip. This loss of revenue can significantly impact the bottom line of NEMT providers.

How Can NEMT Providers Document No-shows?

NEMT fleet owners can document no-shows in two ways: the traditional manual approach and the use of advanced NEMT software.

Documenting a No-show Manually

To manually document a no-show, NEMT fleet operators must record detailed information such as the patient’s name, appointment details, and relevant notes.  

They must also note the absence, document the reason if provided, and capture additional information about circumstances surrounding the no-show. Also, obtaining signatures or acknowledgments to validate the documentation is generally required.  

Standardizing and consistently following these steps can help NEMT fleets maintain accurate records, identify patterns, and improve their transportation process.  

Documenting a No-Show with NEMT Software

Utilizing NEMT software streamlines the documentation process for no-shows. NEMT drivers or dispatchers access the software, identify the specific appointment, and mark it as a no-show.  

Drivers or dispatchers can enter detailed information about the patient, appointment, and notes within the software.   

It’s essential to mark a no-show as a no-show and not a canceled trip, since this can identify patterns and also help NEMT fleets ensure compliance with Medicaid regulations. NEMT software simplifies the documentation process, ensures accuracy, automates notifications, and provides insights for optimization.  

What Are the Benefits of Documenting No-shows?

There are several advantages to documenting no-show incidents.  

By effectively documenting no-shows, whether manually or through NEMT software, service providers can track, address, and improve upon the issue.  

Documenting no-shows also enables NEMT providers to analyze trends and improve operations. These records serve as valuable resources for enhancing scheduling practices, improving communication, and reducing no-shows, ultimately ensuring better service delivery for NEMT patients.  

Operational Efficiency: Documenting no-show incidents helps manage resources and optimize scheduling, ensuring efficient allocation of vehicles and drivers.   

Service Improvement: Analyzing documented no-shows provides insights into patterns and causes, guiding improvements in communication, appointment reminders, and pickup procedures.   

Performance Evaluation: No-show documentation aids in evaluating driver adherence to procedures, assessing communication with riders, and identifying areas for improvement.   

Continuous Improvement: Analyzing no-show data allows for ongoing quality improvement efforts, addressing challenges and enhancing patient satisfaction.  

How to Handle No-shows in NEMT

NEMT providers can implement various strategies to minimize incidents of no-shows.    

Clear Policies and Consequences: Establishing transparent policies and communicating client responsibilities can deter no-shows. Clearly defining the consequences of non-compliance can emphasize the importance of honoring appointments.   

Innovative Technologies: Leveraging technology for better communication, using automated reminder systems to send timely notifications, and ensuring clients are well informed and prepared for their appointments can help NEMT fleet operators.   

How Tobi Helps Handle No-shows

Tobi offers a range of tangible benefits that can help minimize the incidents of no-shows.   

First, it provides streamlined appointment management and scheduling, enabling optimized resource allocation and efficient route planning. Better operations management can minimize the chances of delays or late arrivals to patient pickups.   

Second, Tobi facilitates seamless communication with drivers. Instant messaging lets dispatchers and drivers stay in sync and adjust to real-time changes, enhancing customer satisfaction and reducing the likelihood of no-shows by ensuring clear and timely updates.   

Additionally, Tobi’s comprehensive reporting and analytics capabilities enable service providers to gain valuable insights into performance, identify trends, and make data-driven decisions for service improvements.   

Tobi also offers a user-friendly interface, ensuring ease of use and minimizing the learning curve for staff members. 

With a secure and reliable cloud-based infrastructure, Tobi’s NEMT software provides a trusted solution for NEMT service providers, empowering them to maximize fleet efficiency and their bottom line.  


No-shows can be a significant drag on a NEMT business’s profits. However, manually documenting and tracking no-shows can be cumbersome for NEMT owners.  

Tobi’s NEMT software takes the burden off manual documentation and optimizes routes and schedules for each client seamlessly, efficiently handling no-show incidents. Embrace Tobi to unlock the full potential of your NEMT fleet and enable unparalleled efficiency.