Pediatric well-child visit recall: a front desk system

Why pediatric recall is different

In most adult practices, recall is simple: last visit plus a fixed interval. Pediatrics doesn't work that way. The well-visit schedule your clinicians follow is tied to the child's age, with several visits in infancy, more spacing in the toddler years and yearly visits for older children and teens. A baby who was seen two months ago may already be due again. A ten-year-old seen eight months ago is not.

Two other things are particular to pediatrics. The person you need to reach is a parent or guardian, often juggling several children's schedules at once. And one family may have children due at different times, which is an opportunity: one message can book siblings together.

For the wider picture of where pediatric practices lose revenue, see revenue recovery for pediatric practices. This guide is only about the well-visit recall routine.

Building the due list from your data

You need four fields per active patient: date of birth, date of last well visit, date of next booked well visit (if any) and a household or guarantor identifier so siblings can be grouped. Most practice management systems can export these.

Then translate your clinicians' visit schedule into a simple table: for each age milestone, the age at which that visit is due. Your clinical team owns this table; the front desk only uses it. With the table in hand, run this each week:

1. For each child, work out which milestone visit is next based on date of birth and the last well visit completed.
2. Calculate the date that visit becomes due.
3. Sort children into three lists: due in the next 60 days with nothing booked, due now with nothing booked and overdue by more than 60 days.
4. Group each list by household so siblings due within a few months of each other are contacted together.
5. Remove anyone who has transferred care, and anyone who has asked not to be contacted.

Who to contact first

Not every name on the list is equally urgent or equally likely to book. A sensible order:

• Infants and toddlers due now. Visits come close together at this age, so a missed one quickly turns into two. Your clinical team may want these families contacted first.
• Due in the next 60 days. These are the easiest bookings in the practice. The family is engaged, the visit is expected and you have time to offer convenient slots.
• Households with more than one child due. One booking conversation fills two or three visits.
• Older children overdue by months. Still worth reaching, but at a steadier pace, a set number each week, so they don't crowd out the families above.

Messages parents actually answer

Parents read texts in short bursts: in a pickup line, at lunch, after bedtime. Messages that ask them to call during office hours compete with everything else in their day. Messages that offer real times and take one tap to answer don't.

Keep each message minimum necessary. Never include the child's name, age or the type of visit; practice name, times and choices are enough:

"[Practice Name]: it's time to book a visit. Reply 1 for Tue 3:30 p.m., 2 for Thu 4:15 p.m., 3 for other times. Reply STOP to opt out."

For a household with siblings due:

"[Practice Name]: two visits are due in your household. Reply 1 to book them back to back Sat 9:00 a.m., 2 for other times. Reply STOP to opt out."

Timing matters. Late afternoon and early evening tend to suit working parents, but your own reply data will tell you more than any rule. Watch which send times get answers and adjust.

Illustrative math: the value of a current recall list

These numbers are illustrative; use your own. Say a practice has 3,000 active children and about 250 become due for a well visit in a typical month. Suppose 60 percent book on their own or at their last visit, leaving 100 a month with nothing scheduled.

If a steady recall routine books half of those, that is 50 extra well visits a month. At an illustrative $160 per well visit, that's $8,000 a month in visits that were already expected to happen. Many of those visits also lead to follow-ups the clinician orders, which this math leaves out.

The bigger point: because children keep aging into new visits, an unworked due list doesn't stay the same size. It grows every week.

Close the loop at checkout

The cheapest recall message is the one you never have to send. Before a family leaves a well visit, the front desk should look up when the next one is due and book it, even if it's a year out. A visit booked twelve months ahead can be moved later; a visit never booked has to be found again.

Then measure two numbers monthly: the share of well visits that leave with the next one booked, and the size of your overdue list. If the first goes up and the second goes down, your recall system is working.