Book the report of findings visit before the patient leaves the first exam, send a reminder the day before and the morning of, and call within hours if the patient misses it. GoHighLevel can run the sequence from the first exam appointment. The bottom line: the report of findings is where the doctor explains what was found and recommends a plan, and a patient who never comes back for it never starts the plan the exam was meant to produce.
Why this visit is the weak point
The first exam gives the doctor information and gives the patient very little. The patient leaves with questions about the X rays, the diagnosis, and the cost, and nothing is resolved until the next visit. A gap of two or three days is long enough for doubt, scheduling conflicts, and other options to take over. A clinic that treats the report of findings as a scheduled step, not an optional follow up, loses fewer new patients between the first and second visit.
Medicare patients need the cost explained first
According to the CMS Medicare Coverage Database, Medicare's chiropractic benefit is limited to manual manipulation of the spine to correct a subluxation, and exams, X rays, and therapy modalities performed by a chiropractor are not covered. Billing guides say the patient must be told, and given the Advance Beneficiary Notice where billing the patient depends on it, before a service Medicare does not cover. A Medicare patient who finds out at the report of findings that the exam and X rays were not covered is a patient who may not return. Our guide on what to tell Medicare patients before a visit covers the notice.
The sequence
| When | What goes out | Who acts |
|---|---|---|
| Before the patient leaves | The front desk books the report of findings and the patient gets a confirmation | Front desk |
| Same evening | A short thank you with the time of the next visit and a way to ask a question | Workflow |
| Day before | A reminder with the time | Workflow |
| Morning of | A reminder with the address and parking | Workflow |
| Visit missed | A call task within 2 hours and a text offering two times | Front desk, workflow |
| Missed twice | A task for the doctor to call | Doctor |
Build it in HighLevel
- Create a calendar for the Report of findings visit with the lengths and availability your doctors use.
- Start a workflow with the Appointment Status trigger for the first exam being marked Showed, and create a task for the front desk to book the report of findings, with a link to the calendar.
- When the report of findings is booked, add the tag ROF booked, and send the confirmation text.
- Add the day before and the morning of reminders using Wait steps, with an If/Else to skip them if the patient has confirmed or rescheduled.
- Use the Appointment Status trigger set to No show to create a call task due in 2 hours, and send the recovery text offering two times.
- If the tag ROF no show is already present, create a task for the doctor instead of a second text.
- Turn on Stop on Response so any question goes to a person.
Messages, written out
Evening: Thank you for coming in today, Chris. Your report of findings visit is Thursday at 10:30 at [Clinic]. If you have any questions before then, reply here or call [number]. Reply STOP to stop messages. Missed visit: Hi Chris, this is [Clinic]. We missed you for your visit today. We have openings tomorrow at 9:00 or Friday at 2:30. Reply with the one you prefer. None of the texts mentions the exam results or the X rays.
Worked example
A clinic that does 40 new patient exams a month and loses 25 percent before the report of findings loses 10 patients (40 times 0.25). If the booking step and the reminders cut that loss to 15 percent, the clinic loses 6 patients, which keeps 4 more patients in the plan each month (10 minus 6). The percentages are assumptions to replace with your own, and your doctors will know the real number.
What the text may not do
Do not summarize findings by text, do not name a diagnosis, and do not discuss cost in the message. The visit is where those conversations happen. Reminder texts need the patient's consent, a registered number, and a working STOP, and they should stay generic.
What the doctor should tell the front desk
The front desk can only book the right visit if the doctor leaves a short note: how long the report of findings should be, whether the patient is likely to need a longer visit, and whether the patient has a payer that needs a notice. A one line note in the record, entered before the patient reaches the desk, makes the booking accurate and avoids a second call.
Patients who want to think about it
Some patients will say they want to think about the plan. The report of findings is where that decision is made, so a patient who delays is deciding. Offer to book the visit anyway and say they can move it, and make rescheduling easy with a link in the confirmation. A patient with a visit on the calendar is more likely to come than one who was told to call.
How this was handled before
The front desk offered to schedule the next visit at checkout, and patients who were unsure said they would call. Many did not. A booked visit and a reminder sequence turn a promise to call into a time on the calendar.
What to measure
Track first exams, report of findings booked before leaving, show rate for the report of findings, patients lost between the two, and plans started. The share of exams that become plans is the number that tells you the gap is closing.
Questions people ask
What is a report of findings visit?
The visit where the doctor explains what the exam and imaging found and recommends a care plan.
When should the report of findings be booked?
Before the patient leaves the first exam, so it is on the calendar instead of left to the patient to schedule.
Does Medicare cover chiropractic exams and X rays?
According to CMS, Medicare's chiropractic benefit covers only spinal manipulation to correct a subluxation, and exams and X rays performed by a chiropractor are excluded.
To build the exam to report of findings sequence, start a GoHighLevel account here. The appointment workflows are in our capabilities demo.