A good way is a reviewed list, one friendly message with a booking link, a call task for patients who do not respond, and a stop after two attempts. GoHighLevel's Smart Lists keep the list current. The bottom line: two years without a visit is the point at which even the longest evidence based recall interval has passed, so the message should invite the patient back for an exam, not scold them for being late.
What two years means clinically
NICE guidance recommends individual recall intervals of 3 to 24 months for adults, with 24 months the longest, for patients who have repeatedly shown they maintain oral health. A Cochrane review and a four year UK trial found no difference in oral health between 6 month, 24 month, and risk based recall for the lowest risk adults. So a patient last seen two years ago is overdue even by the most generous standard, and the clinical message is to schedule a comprehensive exam, which may include new X rays. That is for the dentist to decide, so the message should say come back for a check up, not what the exam will include.
Building a list that is accurate
| Include | Exclude |
|---|---|
| Last visit more than 24 months ago | Patients marked transferred, moved, deceased, or dismissed |
| Active patient status in the practice system | Patients with a future appointment |
| A mobile number with a documented texting preference, or an email | Patients tagged Opted out |
| Visit types that merit recall | Patients in active treatment elsewhere with a specialist |
A third party guide describes Smart Lists as saved filters on contact fields, tags, and dates. The data behind the filter comes from the practice system, so check a sample of 20 names against the chart before any message goes out.
The rules
HHS says communications about a covered entity's own health related services are not marketing under HIPAA, unless a third party pays for them. The FCC's healthcare exemption lists wellness checkups, subject to conditions including no marketing content, 160 characters, frequency limits, and immediate honoring of opt outs. A message that offers a new patient discount to returning patients falls outside the exemption, so keep the offer, if any, to a separate decision with counsel.
Build it in GoHighLevel
- Import Last visit date and Active status from the practice system.
- Create the Smart List with the filters in the table, and review the count.
- Have the office manager approve the list and a dentist approve the message.
- Build a workflow that adds approved contacts to a tag and sends one text and one email: we have missed you, book a check up here, reply STOP to stop messages.
- Add a call task 7 days later for patients who have not booked, and a second message at 14 days.
- Stop after two messages and one call, and tag the patient Reactivation attempted so they are not contacted again for 12 months.
Reactivation channels, compared
| Channel | Strength | Weakness |
|---|---|---|
| Postcard | Reaches patients without current mobile numbers | Slow, and costs postage |
| Cheap, and holds a longer message | Often unread, and not encrypted | |
| Text | Read quickly, with a booking link | Needs consent and registration, and short |
| Phone call | Human, and can answer questions | Costs staff time |
Practices that once mailed a yearly postcard now combine channels: an email and a text first, and a call for those who do not respond. The mix matters less than the data behind it. A message to a patient who moved, changed dentists, or died damages trust, so the list review is the step to protect.
Worked example
For example, a practice with 6,000 patients and 10 percent unseen for two years has 600 names (6,000 times 0.1). After removing 20 percent who moved, transferred, or opted out, 480 remain (600 times 0.8). If 8 percent book, that is about 38 patients (480 times 0.08).
Mistakes to avoid
- Texting people who moved or died. Check the data.
- Scolding. Invite them back.
- Adding a discount. That leaves the exemption.
- Never stopping. Two messages and a call is enough.
How this was handled before
Practices printed an inactive patient report once a year and mailed a postcard. Many names were out of date. A saved filter stays current, and a short sequence replaces the one time mailing.
What to measure after launch
Track names on the list, names removed after review, visits booked, and opt outs. Check the list against the chart each time before sending.
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. Have the privacy officer and the dentist approve the list rules and the message. This is general information, not legal advice.
Questions people ask
Is two years too long between visits?
NICE's longest recommended adult interval is 24 months, for low risk patients. Longer is overdue by any standard.
Is a reactivation message marketing under HIPAA?
HHS says communications about the practice's own services are not marketing unless a third party pays.
How many messages should the practice send?
Two messages and one call is a reasonable limit.
Ready to try it yourself? Start a GoHighLevel account here.
You can also see this in action in our GoHighLevel capabilities demo.