A Smart List in GoHighLevel can list them: contacts whose last visit date is more than 18 months ago, with no future appointment, who have not opted out and are not marked as transferred or deceased. The bottom line: the list is the easy part, and accuracy is the harder one, because a list built from stale data will text patients who moved, changed doctors, or have died.
What belongs on the list
| Include | Exclude |
|---|---|
| Last visit date older than 18 months | Patients with a future appointment |
| Active patient status in the practice system | Patients marked transferred, deceased, or dismissed |
| A valid mobile number and consent on file | Patients tagged Opted out |
| Visit types that warrant a wellness visit | Patients under a specialist's care for the same issue, where the specialist owns recall |
A third party guide describes Smart Lists as saved filters on contact fields, tags, dates, and pipeline data that update as the data changes. The filter is only as good as the Last visit date field, so decide how it gets there, by import from the practice system or by an integration, and check a sample against the chart before sending anything.
The rules on outreach
HHS says communications that describe a covered entity's own health related services are not marketing under HIPAA, and its FAQ says disease management, preventive care, and wellness communications are generally not marketing, unless a third party pays the practice to send them. So a reminder from the practice about the practice's own wellness visit is allowed without an authorization. The FCC's healthcare exemption lists wellness checkups among exempt healthcare treatment messages from HIPAA covered entities, subject to the conditions summarized in our reminder guide, and Medicare's annual wellness visit is a covered service once every 12 months for eligible beneficiaries. The Community Preventive Services Task Force found that reminder and recall raised vaccination rates by a median of 11 percentage points.
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
- Import the Last visit date, Active status, and Future appointment fields from the practice system, and confirm the update schedule.
- Create the Smart List with the filters in the table.
- Review the count, and check 20 names against the chart by hand.
- Send the list to the office manager for approval before any outreach.
- Build a workflow that adds approved contacts to a tag, Wellness outreach, and sends one text and one email with a booking link, generic wording, and a STOP line.
- Add a call task for staff 7 days later for patients who have not booked.
- Stop the workflow when the patient books or replies.
Worked example
For example, a practice with 6,000 patients and 12 percent unseen for 18 months has 720 names (6,000 times 0.12). After removing 15 percent who transferred or opted out, 612 remain (720 times 0.85). If 8 percent book, that is about 49 visits (612 times 0.08).
Mistakes to avoid
- Using stale data. Check the sample against the chart.
- Texting patients who transferred or died. Exclude those statuses.
- Including promotions. That leaves the exemption and may become marketing.
- Sending more than one or two messages. Follow the frequency limits.
How this was handled before
A report from the practice system listed patients by last visit date, and a staff member mailed or called a sample when time allowed. A saved filter keeps the list current, and the privacy rules on marketing and texting now shape what the practice may send.
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 quarter.
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 your privacy officer and compliance lead approve the list rules and the message before any outreach. This is general information, not legal advice.
Questions people ask
Is a wellness visit reminder marketing under HIPAA?
HHS says communications about the practice's own health related services are not marketing, unless a third party pays.
Can the FCC exemption cover wellness checkups?
The exemption lists wellness checkups among covered treatment messages, subject to its conditions.
How does a Smart List update?
A third party guide says it is a saved filter that updates as contact data changes.
Ready to try it yourself? Start a GoHighLevel account here.
You can also see this in action in our GoHighLevel capabilities demo.