A 4:30 slot in Buckhead is a broken promise for a patient coming from Gwinnett
An appointment time the patient cannot realistically reach is a cancellation you scheduled yourself.
Front desks offer whatever is open. The patient says yes because they want the appointment, then works out the drive later, and the reschedule call comes two days before.
Offer times against the trip rather than the calendar. If a caller is coming from Gwinnett County to an office inside the Perimeter, an early morning or a mid morning slot survives; the top of rush hour usually does not.
So the script has to establish where the caller is traveling from, and the team has to know the pattern well enough to steer. That is a training change, not a software change.
Look at your no shows by time of day and by the caller's home area, and see whether a few slot and origin combinations are doing most of the damage. If they are, stop offering them. A schedule fixed that way costs nothing in new spend.