What is the no-show rate for medical appointments in Colombia?

It depends on the network, the service and the year, and there is no single figure. An article in DYNA, the Universidad Nacional's journal, compiles figures of 13% in Bogotá in 2016, 8.7% in Bogotá's public network in 2017 and 12.3% reported by an EPS in early 2018. As an international reference, a review of 105 studies published in Health Policy found an average of 23%, with 27.8% in South America. The most useful step is to measure your own IPS's rate by service and site.

Do WhatsApp reminders reduce no-shows?

Probably yes, although the strongest evidence is about text messages in general. The 2013 Cochrane review, with eight trials and 6,615 participants, found attendance of 67.8% without a reminder and 78.6% with a text message, with an effect similar to that of phone calls. WhatsApp works as a text message and adds buttons to confirm or cancel, but that review did not evaluate it separately. That is why it is worth measuring the confirmation rate and the no-show rate before and after you turn it on.

Can an IPS fine a patient who misses an appointment?

No, for most patients in the system. Article 55 of Law 1438 of 2011 prohibits charging any kind of fine for scheduled medical appointments to contributing members and beneficiaries of the contributory and subsidized regimes and to the población vinculada. The response to no-shows has to be operational: reminders, simple cancellation, a waitlist and measurement. If you see private-pay patients or patients under other regimes, check with your legal advisor which rules apply in those cases.

How far in advance should you send a medical appointment reminder?

No regulation sets it, and the most common practice is to combine two reminders. One at 72 hours leaves time to cancel and to offer the slot to the waitlist; another at 24 hours reminds the patient when the appointment is close. The Cochrane review on mobile phone reminders asks studies to report the timing of the message relative to the appointment, precisely because that evidence is missing. That is why the timing should be configurable and you should measure the confirmation rate for each reminder.

What do you do with a slot that opens up at the last minute?

Offer it to the waitlist, starting with the people who can use it. The slot is filtered by service, site and acceptable time, held while candidates respond and assigned to the first one who accepts; the others are told it has already been taken. The DYNA article on no-shows in the Colombian system proposes precisely this: notifying waiting patients when an appointment is canceled. If the slot opens up with very little notice, nobody may be able to make it in time, and that is also worth measuring.

How do you calculate an IPS's no-show rate?

Divide the number of no-shows by the sum of attended appointments and no-shows in the period. Appointments canceled with notice do not count as no-shows, and those with no attendance record should be kept separate, because they hide the real figure. Then it helps to segment by specialty, site, day and lead time. A study in Bogotá with 23,384 records found more no-shows for Saturday appointments and for those booked more than 10 days ahead, so those cuts often show where to act first.

How much does Omcall cost?

Omcall is billed as a license per agent per month plus AI and channel usage, such as voice minutes and messages. The price depends on how many people handle contacts, how many sites and channels you connect and which AI agents you turn on, so it is sized in the demo with your real operation, and that produces a specific figure, not a range. Each WhatsApp reminder adds Meta's charge per delivered template. IPS that join as design partners get a 30-day pilot at no cost. You can book the demo.

How to reduce patient no-shows

Every missed appointment is a slot another patient needed; knowing in time that someone will not come is what lets you reassign it.

Updated October 15, 202610 min read

A missed appointment leaves the clinician without a visit and another patient waiting for a date they could have had. There is no single figure for Colombia. A systematic review of 105 studies found an average no-show rate of 23%, with 27.8% in the studies conducted in South America (Dantas et al., 2018). For the country, an article in DYNA, the Universidad Nacional's journal, compiles figures of 13% in Bogotá in 2016, 8.7% in Bogotá's public network in 2017 and 12.3% reported by an EPS (the health insurers that manage Colombia's mandatory health plans) in early 2018.

If your IPS (instituciones prestadoras de salud, Colombia's healthcare provider institutions) books appointments by chat, the guide to WhatsApp appointment scheduling covers the step before this one.

In short

The figure: the international literature averages 23%; the available Colombian data ranges from 8.7% to 13%.
The causes: forgetting, a long time between booking and the appointment, and access barriers.
No fines: Ley 1438 de 2011 (Law 1438 of 2011) prohibits charging them, so the lever is operational.
Reminders: in the Cochrane review, attendance rose from 67.8% without a reminder to 78.6% with a text message.
Slots back: easy cancellation and an active waitlist let you reassign the slot.
Detailed measurement: the rate by service, site, day and lead time shows where to act.

Why patients miss appointments

The Cochrane review on mobile phone reminders identifies forgetting as one of the main causes (Gurol-Urganci et al., 2013). It is not the only one. In the Dantas review, the most frequently reported determinants were a long time between booking and the appointment and having missed appointments before; no-shows are also more common among young adults, people with low socioeconomic status and those who live far from the site.

In Bogotá, a study of Pap smear appointments among low-income women, with 23,384 records, found higher risk among younger patients, in areas of poverty, for Saturday appointments, during school vacations and with more than 10 days of lead time (Barrera Ferro et al., 2022). Its interviews add another cause: patients find it hard to navigate the system. DYNA adds that the longer the lead time, the more likely the patient is to forget or no longer need the visit.

What no-shows cost your IPS

Article 55 of Law 1438 of 2011 prohibits charging fines for missed scheduled appointments to contributing members and beneficiaries of the contributory and subsidized regimes and to the población vinculada (people not enrolled in either regime).

There is no cost per missed appointment that applies to every IPS: it depends on the rate, the contract with each EPS and the service. This is an example built on our own assumptions, not a measurement:

Example assumption	Value
Appointments booked per month	5,000
No-show rate	12%
Average value per appointment	COP 45,000
Slots lost per month	600
Value of those slots	COP 27,000,000

Recovering one in three of those slots (another assumption) would mean 200 more appointments attended per month. If your contract is capitated, you do not stop billing, but you lose capacity your population was waiting for, and that shows up in timeliness (oportunidad, the wait between the request and the assigned date).

The levers to reduce no-shows

Confirm at 72 and 24 hours

The 72-hour reminder arrives early enough for the patient to cancel or change the appointment and for you to offer the slot to someone else; the 24-hour one reminds them when the appointment is close. In the Cochrane review, with eight trials and 6,615 participants, text messages improved attendance compared with no reminder, with an effect similar to that of phone calls. The same review asks studies to report the timing of the message, so 72 and 24 hours are an operational practice, not a proven standard.

Make it easy to reschedule or cancel

If giving notice means calling a busy line, many patients simply do not show up. Canceling and rescheduling should be in the same reminder and the same conversation. When rescheduling, it is best to keep the original request date, which timeliness measurement depends on; validate that criterion with your legal advisor.

Waitlist and slot refilling

The waitlist holds people who want an earlier date, with their service, site and possible times. When a slot opens up, it is offered to those who fit, held while they decide and assigned to the first one who accepts. DYNA proposes exactly this: notifying waiting patients when an appointment is canceled. The order of the list must be explainable: wait time and the priorities your IPS defines.

Choose the channel

In two studies in the Cochrane review, the cost per attendance was 55% and 65% lower with text messages than with phone calls. WhatsApp adds buttons, but it requires approved templates, opt-in and Meta charges per template; for people who do not use it, a phone call is still necessary. The reminder should not include diagnoses or promotions: health data is sensitive under Ley 1581 de 2012 (Law 1581 of 2012), and Meta classifies a template with mixed content as marketing (Meta, categories).

Measure no-shows by specialty and site

The rate is no-shows divided by the sum of attended appointments and no-shows. Leave out appointments canceled with notice and separate those with no attendance record. Then segment by specialty, site, day, time slot, lead time and booking channel; the Bogotá study shows why Saturdays and lead time matter. Without attendance records in the clinical software, there is no reliable measurement.

The link to timeliness

Resolución 1552 de 2013 (Resolution 1552 of 2013) sets three business days for general medicine and general dentistry and requires measuring the days between the assigned date and the request and desired dates. Long lead times increase no-shows, and every lost slot lengthens the wait for others. The resolution asks EPS and IPS to analyze that information in their PAMEC (Programa de Auditoría para el Mejoramiento de la Calidad, the audit program for quality improvement), under article 5.

What a tool to reduce no-shows should have

Use this list to evaluate any option, including ours.

Configurable reminders with confirm, reschedule and cancel in the same message.
Responses that update the appointment in the clinical software, not a list someone reviews later.
The slot released on cancellation and offered to the waitlist, held while the patient decides.
A clear rule when two people accept the same slot.
An alternative channel for people who do not have WhatsApp.
Configurable sending hours and frequency, reviewed by your legal advisor.
Exportable reports on no-shows by service and site, confirmation and recovered slots.
A request date that does not change when rescheduling.
Visible cost per reminder, including Meta's charge.

How Omcall handles it

Omcall is Omneri's contact center for Colombian IPS (see the platform; context in call center for IPS). For no-shows, it does the following:

Reminders. By default at 72 and 24 hours, configurable, through a WhatsApp message template with Confirm, Reschedule and Cancel buttons. The last reminder is not sent if the appointment is already confirmed. Canceling releases the appointment and triggers slot refilling; rescheduling goes to a person or to the Scheduler.
Confirmer. With this AI agent turned on, the reminder goes out on WhatsApp and, for people who do not have it, an AI voice call can be configured. More in AI agents for call centers.
Slot refilling. It filters the waitlist by service, site, days, hours and deadline, and sorts it by priority population and days waiting. It offers the slot in rounds (by default 3 people, 30 minutes and up to 3 rounds), holds it in the schedule when the clinical software allows it, assigns it to the first acceptance and notifies anyone who replies late. Offers go out between 07:00 and 20:00.
Metrics. No-shows by service and site, with a separate column for appointments without an attendance record; confirmation by reminder; recovered slots; timeliness by specialty and site. They can be exported to CSV and Excel.
Dates. The request date and the first assignment do not change when rescheduling, a criterion your legal advisor must validate.
Hours. Reminders are treated as informational and go out from 07:00 to 21:00. Whether they should be governed by Ley 2300 de 2023 (Law 2300 of 2023) is an open question, and the treatment can be changed in the settings.

Omcall does not promise a reduction figure: it gives you the data to measure your own. To see it with your schedule, book a demo.

Applicable regulations

Law 1438 of 2011, article 55. It prohibits fines for missed scheduled appointments.
Resolution 1552 of 2013. Three-business-day deadline, recording of dates, monthly measurement and analysis in the PAMEC.
Law 1581 of 2012. Health data is sensitive: the reminder carries the minimum. How Omcall handles data is described in its privacy policy.
Law 2300 of 2023. Whether it applies to reminders is still to be resolved with your legal advisor.

The legal parameters that come with Omcall are configurable drafts; this guide does not replace legal review.

Frequently asked questions

It depends on the network, the service and the year, and there is no single figure. An article in DYNA, the Universidad Nacional's journal, compiles figures of 13% in Bogotá in 2016, 8.7% in Bogotá's public network in 2017 and 12.3% reported by an EPS in early 2018. As an international reference, a review of 105 studies published in Health Policy found an average of 23%, with 27.8% in South America. The most useful step is to measure your own IPS's rate by service and site.
Probably yes, although the strongest evidence is about text messages in general. The 2013 Cochrane review, with eight trials and 6,615 participants, found attendance of 67.8% without a reminder and 78.6% with a text message, with an effect similar to that of phone calls. WhatsApp works as a text message and adds buttons to confirm or cancel, but that review did not evaluate it separately. That is why it is worth measuring the confirmation rate and the no-show rate before and after you turn it on.
No, for most patients in the system. Article 55 of Law 1438 of 2011 prohibits charging any kind of fine for scheduled medical appointments to contributing members and beneficiaries of the contributory and subsidized regimes and to the población vinculada. The response to no-shows has to be operational: reminders, simple cancellation, a waitlist and measurement. If you see private-pay patients or patients under other regimes, check with your legal advisor which rules apply in those cases.
No regulation sets it, and the most common practice is to combine two reminders. One at 72 hours leaves time to cancel and to offer the slot to the waitlist; another at 24 hours reminds the patient when the appointment is close. The Cochrane review on mobile phone reminders asks studies to report the timing of the message relative to the appointment, precisely because that evidence is missing. That is why the timing should be configurable and you should measure the confirmation rate for each reminder.
Offer it to the waitlist, starting with the people who can use it. The slot is filtered by service, site and acceptable time, held while candidates respond and assigned to the first one who accepts; the others are told it has already been taken. The DYNA article on no-shows in the Colombian system proposes precisely this: notifying waiting patients when an appointment is canceled. If the slot opens up with very little notice, nobody may be able to make it in time, and that is also worth measuring.
Divide the number of no-shows by the sum of attended appointments and no-shows in the period. Appointments canceled with notice do not count as no-shows, and those with no attendance record should be kept separate, because they hide the real figure. Then it helps to segment by specialty, site, day and lead time. A study in Bogotá with 23,384 records found more no-shows for Saturday appointments and for those booked more than 10 days ahead, so those cuts often show where to act first.
Omcall is billed as a license per agent per month plus AI and channel usage, such as voice minutes and messages. The price depends on how many people handle contacts, how many sites and channels you connect and which AI agents you turn on, so it is sized in the demo with your real operation, and that produces a specific figure, not a range. Each WhatsApp reminder adds Meta's charge per delivered template. IPS that join as design partners get a 30-day pilot at no cost. You can book the demo.