Yes. A missed call text in GoHighLevel can stay HIPAA safe if it names the practice, says someone will call back, and carries nothing about the caller's health, care, or payment. The bottom line: HIPAA turns on what the message says, so the safest text is one that would be harmless on anyone's lock screen, and the settings around it, the add on, consent, and opt out handling, do the rest.
What HIPAA allows
HHS's Omnibus Rule commentary, as quoted by the Holland and Hart health law blog, confirms that covered entities may send individuals unencrypted messages if they have advised the individual of the risk and the individual still prefers that channel, and that the practice is then not responsible for unauthorized access in transit. HIPAA also lets patients request confidential communications by alternative means under 45 CFR 164.522(b), which practices commonly apply to texting. A missed call text goes to a caller who may not be a patient yet, so there is no documented preference to rely on. That is why the content should be generic, with no health detail to protect.
What the message says
| Say | Do not say |
|---|---|
| The practice name and that you missed the call | The specialty, a condition, or a procedure |
| Someone will call back during office hours, with the hours | A test result, refill, or balance |
| If this is an emergency, call 911 | Any medical advice |
| Reply STOP to stop messages | The caller's name, unless matched to a record and approved by your privacy officer |
Ask your privacy officer whether the practice name alone hints at a sensitive specialty. If it does, register and use a neutral display name.
The TCPA layer
The FCC's 2015 healthcare exemption lets HIPAA covered entities and their business associates send certain treatment messages, such as appointment and exam reminders, without prior express consent, but only under conditions. Law firm summaries list them: the message goes only to the number the patient provided, states the provider's name and contact information, has no marketing, billing, or debt collection content, complies with HIPAA, is concise (160 characters or less for a text), is limited to one message a day and three a week per provider, offers an easy opt out, and every opt out is honored immediately. The FCC also said the calls must be free to the end user, not charged against the patient's plan, which many practices cannot guarantee. Because of that, many practices also collect consent and treat reminders as informational messages.
Build it in GoHighLevel
GoHighLevel's help portal says accounts are not HIPAA compliant by default, and that HIPAA Compliance is a paid upgrade, $297 a month as an account wide add on, that must be enabled for the agency and then configured for the sub accounts that need it. Third party guides add that the add on provides a business associate agreement, encryption, audit logging, and multi factor authentication, that the practice also needs its own agreement with the agency, and that GoHighLevel itself recommends avoiding protected health information in SMS and email even with the add on. Whether the AI features are covered by the agreement is a question to put to HighLevel in writing before any patient data reaches them.
- Decide with your compliance lead whether to buy the HIPAA add on and sign the agreements before any patient texts are sent.
- Complete A2P brand and campaign registration, using the practice's neutral name if needed.
- Go to Settings, then Phone System, then Voice, and open Voicemail and Missed Call Text Back for the main number.
- Turn on Missed Call Text Back and write the message from the table.
- Turn on Call Connect so a call that reaches voicemail is not counted as answered.
- Build a workflow with the Call Details trigger for missed inbound calls that creates a callback task, as in our law firm voicemail guide, and adds a tag with no health detail.
- Turn on Stop on Response and route replies to staff.
Worked example
For example, if a practice misses 60 calls a month and 20 of those callers reply to the text or are reached by a callback within the hour, that is 20 patients or prospective patients kept in the system (60 times 0.33). We did not find a verified, peer reviewed figure for the share of missed calls at medical practices, and vendor surveys quote large numbers we could not confirm, so measure your own.
Mistakes to avoid
- Naming the specialty or condition. A lock screen can show it.
- Using a marketing message. That leaves the TCPA healthcare exemption.
- Ignoring opt outs. They must be honored immediately under the exemption.
- Assuming the add on makes everything safe. Content and process are still yours.
How this was handled before
Practices let calls roll to voicemail and returned them in order the next morning. Texting was discouraged for years because of privacy concerns, until HHS commentary confirmed that patients can choose unencrypted channels after a warning. A generic missed call text fits inside that framework.
What to measure after launch
Track missed calls, replies to the text, callbacks within an hour, and opt outs. Audit a sample of texts monthly for any wording that hints at a specialty or a condition.
Check before you switch it on
US text messages sent from a standard 10 digit number need A2P 10DLC registration. The HighLevel support portal says registration is required for texts to US recipients from 10 digit long code numbers and that toll free numbers do not require it. HighLevel's opt in guidelines also say a person cannot be forced to agree to text messages in order to submit a form, so keep the consent box optional. One compliance guide separates informational texts, which need documented consent, from marketing texts, which need prior express written consent. Ask your attorney which category your reminders fall into. This is general information, not legal advice. Have your privacy officer and counsel review the text, the consent language, and the agreements. This is general information, not legal advice.
Questions people ask
Can a practice text a patient without encryption?
HHS commentary says covered entities may send unencrypted messages if they warned the individual of the risk and the individual prefers it.
Does GoHighLevel need the HIPAA add on?
GoHighLevel's help portal says accounts are not HIPAA compliant by default and the add on is $297 a month.
What must a healthcare text include under the FCC exemption?
Law firm summaries list the provider's name and contact information, no marketing or billing content, 160 characters, frequency limits, and an easy opt out.
Ready to try it yourself? Start a GoHighLevel account here.
You can also see this in action in our GoHighLevel capabilities demo.