This page is for the CEO, administrator or marketing director of an orthopedic group who pays for new-patient demand and wants to know how much of it reaches a surgeon. It covers each step from first call or form to kept consult, and what to measure and ask for at each.
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When I reviewed the pages that rank for this topic, most were sold by someone. Across three searches I opened 24 of the 27 results. Seventeen were vendors selling phone answering, AI receptionists or intake software. Three were hospital or clinic intake forms, three were marketing firms and one was a chiropractic association article. Only three of the 24 linked to PubMed, MGMA or CMS. The missed-call statistics repeated most often, such as a 23% average miss rate, were credited to vendor reports with no link I could follow, so none of them appear here.
Why intake belongs on the marketing report
Marketing reports usually stop at the lead. Everything after that is treated as operations, so nobody owns the gap between “the phone rang” and “the patient sat in front of a surgeon”.
One orthopedic practice I audited had appointment buttons on its website that led to a page with no form. No monthly report showed it. It surfaced only when a single click was traced all the way to an appointment, and there was nothing to trace it to. Every step below can fail that quietly while the lead count looks fine.
The seven leak points at a glance
| Leak point | What to measure | What to ask for |
|---|---|---|
| Answer rate and hold time | Share of new-patient calls a person answers, and time in queue | Weekly answer rate and abandoned calls by hour |
| Voicemail and callback speed | Missed calls, and time to the first callback | Yesterday’s missed calls, callback time and outcome |
| Insurance and payer screening | Inquiries lost because the plan is not accepted | Payer-outs by campaign |
| Scheduling lead time | Business days to the first offered new-patient slot | Lead time per surgeon and location |
| No-shows | Booked new-patient visits not attended | No-show rate by source and confirmation status |
| Web form response time | Minutes from submit to first contact attempt | A monthly test submission and response-time log |
| Referral-fax intake | Days from referral received to patient contacted and scheduled | Open referrals older than five business days |
1. Answer rate and hold time
Definition. Answer rate is new-patient calls answered by a person, divided by new-patient calls received. Hold time is how long a caller waits in the queue before that happens.
How to measure it. Give new patients their own IVR option or tracking number first, or billing and refill calls will drown the number.
The best evidence I found comes from outside orthopedics. A study of 1,037,363 call records at a large academic health system found that time in queue was the strongest predictor of a caller hanging up, ahead of staffing levels and time of day. Across a series of workflow changes, abandonment fell from 8.7% to 2.8%, and risk was highest on Mondays and between 11 a.m. and 4 p.m. (JMIR Medical Informatics, 2026). I have not found a peer-reviewed answer-rate benchmark for orthopedic practices, so I will not give you one.
What a CEO should ask for. A weekly line: new-patient calls received, answered live, abandoned, and the three worst hours.
2. Voicemail and callback speed
Definition. New-patient calls that end in voicemail or a hang-up, and the time to the first callback attempt.
How to measure it. Match each missed inbound call to the next outbound call to the same number.
There is no peer-reviewed number here that I could verify. The vendor figures on voicemail hang-ups had no sources I could open.
What a CEO should ask for. A daily list of yesterday’s missed new-patient calls, when each was returned and what happened.
3. Insurance and payer screening
Definition. The point in the call where the caller’s plan is checked, and the caller is either booked, redirected or lost.
How to measure it. Add an outcome code for “plan not accepted” to every inquiry, and report it by campaign. A campaign that fills the phones with plans you do not take will look busy and produce nothing.
Researchers have secret-shopped orthopedic offices on exactly this step. In a JAAOS study, mystery callers made 1,002 calls to 501 orthopaedic surgeons in 47 states, and 37% of the included surgeons did not accept Medicaid (PubMed). A 2026 spine study called 304 spine surgeon offices in 45 states three times each, once per insurance type. Among eligible practices, 52% accepted Medicaid, 95% accepted Medicare and 99% accepted Blue Cross Blue Shield (The Spine Journal). In sports medicine, 34% of the included surgeons did not accept Medicaid (Orthopaedic Journal of Sports Medicine, 2025).
What a CEO should ask for. Payer-outs per month, by source.
4. Scheduling lead time
Definition. Business days from first contact to the first new-patient appointment offered.
How to measure it. Call your own new-patient line and ask for the next available appointment, as the researchers did, then compare with the scheduling system.
The same studies give reference points, not targets. In the JAAOS study, Medicaid callers waited a mean of 24.9 business days against 19.6 for Blue Cross Blue Shield callers. In the spine study the means were 26.6 business days for Medicaid, 23.1 for Medicare and 22.1 for Blue Cross Blue Shield, and academic affiliation was associated with a 124% longer wait. In sports medicine, the medians were 13 days for Medicaid and 12 for Blue Cross Blue Shield.
What a CEO should ask for. Lead time per surgeon per location every week, plus a count of callers who declined the date they were offered.
5. No-shows
Definition. Booked new-patient visits the patient did not attend.
How to measure it. From appointment status in the PM system, split by marketing source and by whether the appointment was confirmed.
A study of every scheduled appointment in 2016 at one orthopedic multispecialty institution found an overall no-show rate of 11.5% (PubMed). At one academic arthroplasty clinic the rate was 6.9%, and appointment confirmation was strongly protective, with an adjusted odds ratio of 0.24 (Arthroplasty Today, 2026). At two academic centers, surgical patients who used the patient portal had a mean no-show rate of 6.8% against 9.3% for those who did not (PubMed). These are single systems, so treat them as context. I could not verify an orthopedic study tying lead time to no-shows, so test that on your own data.
What a CEO should ask for. New-patient no-show rate by source and by confirmation status.
6. Web form response time
Definition. Minutes from a form submission to the first human attempt to reach that person. Also: does the form submit at all?
How to measure it. Compare the form timestamp with the first call or text in your CRM log, and submit a test form from a phone once a month.
I could not find a peer-reviewed or primary healthcare source for speed-to-lead, so there is no benchmark on this page. The audited practice above is why the monthly test matters more. A form that does not exist has a response time of never.
What a CEO should ask for. The monthly test result, pass or fail, and median response time for real form leads.
7. Referral-fax intake
Definition. The time from a referral arriving, by fax, e-referral or portal, to the patient being contacted and then scheduled. And the referrals that never get scheduled at all.
How to measure it. A referral log with four dates: received, first contact attempt, scheduled, seen. The middle two dates are the ones to watch.
I could not verify a peer-reviewed study on referral-fax handling in orthopedic practices, so this one has no benchmark. I wrote separately about why orthopedic physician referrals decline.
What a CEO should ask for. Open referrals older than five business days, by referring practice. Five is my working threshold, not a published standard.
Putting intake on one page
These seven rows sit between inquiry and consult in the monthly marketing KPI dashboard I recommend. Once they are measured, cost per kept consult replaces cost per lead, which is the logic behind orthopedic patient acquisition cost. Follow-up that software should handle is covered on my orthopedic practice automation page.
A 30-day intake audit
- Days 1 to 7, baseline. Export 30 days of new-patient phone data. Call the line yourself 10 times across hours and payers, as the mystery-caller studies did. Test every appointment button, phone link and form on phone and desktop.
- Days 8 to 15, trace. Take the last 50 new-patient inquiries and record the outcome of each: kept consult, no-show, payer-out, declined date, never contacted, or unknown.
- Days 16 to 22, referrals. Build the four-date log for every referral received in the last 30 days.
- Days 23 to 30, decide. Rank the seven leak points by patients lost and pick one to fix first. One. Write down the baseline number for it.
Stop point. Decide it before day 1. For example: if by day 30 your team cannot give an outcome for at least 40 of those 50 inquiries from systems you already own, stop there. Tracking is the first project, and no new marketing spend gets added until it exists.
Two facts, side by side
In a 2026 national study of spine surgeon offices, 52% of the eligible practices accepted Medicaid, against 99% that accepted Blue Cross Blue Shield.
In one orthopedic practice I audited, the appointment buttons on the website led to a page with no form, and no monthly report showed it until a click was traced to an appointment.
If you want a second opinion on where your intake loses patients, book a 30-minute call. I will look at your site and your market before we talk.
Frequently asked questions
What is new-patient intake in an orthopedic practice? For marketing purposes, it is everything between a patient’s first call, form or referral and their kept consult: answering, payer screening, scheduling, reminders and referral handling.
What is a good call answer rate for an orthopedic practice? I have not found a peer-reviewed benchmark for orthopedic practices. Measure your own new-patient line for a month and track the trend by hour and day.
How long do new patients wait for an orthopedic appointment? In national mystery-caller studies of orthopaedic and spine surgeons, mean waits ran from 19.6 to 26.6 business days depending on insurance, with Medicaid callers waiting longest. In sports medicine the medians were 12 to 13 days.
What is a typical no-show rate in orthopedic clinics? Single-system studies have reported 11.5% across all appointments at one orthopedic institution and 6.9% at one arthroplasty clinic. Neither is limited to new patients, and neither is a national benchmark.
