Use this SOP to schedule appointments within required access standards, send timely reminders, and consistently follow up on canceled and missed appointments.

⏱ Appointment Access Standards

  • Urgent care: within 48 hours

  • First prenatal visit: within 10 business days

  • Non-urgent (routine) care: within 10 business days

📚 Resources Needed

  • The scheduling system and the patient’s medical record or electronic health record (EHR)

  • Current patient telephone number, email address, SMS consent or preference, and push-notification settings

  • Current provider schedules and appointment-type availability

  • Approved email, telephone, SMS, and push-notification templates

  • Clinic and telehealth access instructions for helping patients attend their visits

✅ Before You Start

  • Use an organized, actively maintained scheduling process for routine care, urgent care, prenatal care, pediatric periodic health assessments and immunizations, adult initial health assessments, specialty care, and emergency-care access.

  • Schedule each appointment according to the patient’s stated clinical needs and the applicable health-plan timeliness standard.

  • Notify patients of scheduled routine and preventive screening appointments.

  • Protect patient privacy. Use only approved communication systems and include only the minimum information needed in reminders.

  • Verify the patient’s preferred and permitted communication channels and correct contact information whenever possible.

  • Document every outreach attempt and its result in the patient’s medical record, including attempts related to missed or canceled appointments.

🔔 Besa Reminder Schedule

Annual Outreach

  • Every patient receives an annual email inviting them to schedule an appointment.

Appointment Reminders

  • One week before the appointment

  • Two days before the appointment

  • Two hours before the appointment

  • At the time of the visit

Use email, telephone, SMS, and push notification depending on when the appointment was booked, the patient’s permitted communication settings, and channel availability.

Booking-Window Rule

Send only reminders that are still timely. If an appointment is booked inside a reminder window, do not send an outdated reminder; begin with the next applicable contact and continue through the remaining intervals.

📘 Instructions

Step 1 Identify The Patient’s Appointment Need

  • Ask what type of appointment the patient needs and when the concern began, without independently diagnosing or clinically triaging the patient.

  • For urgent or potentially emergent concerns, follow the clinic’s medical-advice and emergency-routing procedures so licensed personnel determine the appropriate level of care.

  • For specialty care, follow the applicable referral and authorization process and arrange access within the health plan’s required timeframe.

Step 2 Schedule Within The Required Timeframe

  • Urgent care: offer access within 48 hours.

  • First prenatal visit: offer access within 10 business days.

  • Non-urgent routine care: offer access within 10 business days.

  • Schedule pediatric periodic health assessments and immunizations, adult initial health assessments, preventive screening, specialty care, and other care according to the patient’s stated clinical need and applicable plan requirements.

  • Confirm the appointment date, time, visit type, provider or department, physical-clinic location or telehealth access method, and any approved preparation instructions.

Step 3 Confirm Contact Information And Reminder Eligibility

  • Confirm the patient’s telephone number and email address.

  • Confirm whether SMS and push notifications are available and permitted.

  • Record the patient’s communication preference and any accessibility or language assistance needed.

  • Enter the appointment accurately so the reminder process can use the correct timing and channels.

Step 4 Send Annual Scheduling Outreach

  • Send every patient an annual email inviting the patient to schedule an appointment.

  • Document the annual outreach in the approved system or patient record, including the date and delivery result when available.

  • If the patient responds, schedule the appointment according to the patient’s stated clinical need and the standards in Step 2.

Step 5 Send Appointment Reminders

  • Contact the patient one week before, two days before, two hours before, and at the time of the visit when those intervals occur after the appointment is booked.

  • Use email, telephone, SMS, and push notification depending on the booking timing, the patient’s permitted communication settings, and the channel’s availability.

  • For routine and preventive screening appointments, ensure the patient receives a reminder through at least one approved, available channel.

  • Include the appointment date and time, physical-clinic or telehealth instructions, and an approved way to contact the clinic for questions, cancellation, or rescheduling.

  • Record staff-generated reminder attempts and outcomes in the medical record. Retain automated delivery or activity records according to clinic workflow.

Step 6 Process A Patient Cancellation

  • Confirm which appointment the patient is canceling and record the cancellation promptly so the schedule is accurate.

  • Ask the patient whether they would like to reschedule.

  • If the patient agrees, reschedule according to the patient’s stated clinical need and applicable access standard; confirm the new appointment details and reminders.

  • If the patient declines, document that rescheduling was offered and declined. Route any clinical follow-up need according to clinic policy.

  • Document the cancellation, reason if voluntarily provided, contact method, date and time, staff member, rescheduling offer, and outcome in the medical record.

Step 7 Follow Up On A No-Show

  • Call the patient after the missed appointment.

  • Ask whether the patient needs assistance getting to the physical clinic or joining the telehealth visit.

  • Provide approved non-clinical assistance or route the patient to the appropriate team member for transportation, accessibility, technical, language, or check-in support.

  • Ask whether the patient would like to reschedule. If yes, schedule according to the stated clinical need and applicable access standard.

  • Document the no-show, the call or call attempt, the assistance offered or requested, the rescheduling offer, and the outcome in the medical record.

Step 8 Verify Follow-Up And Close The Task

  • Confirm that missed and canceled appointments have a documented follow-up result or an active follow-up task.

  • Document every telephone, SMS, email, push-notification, or automated outreach attempt used for follow-up when that information is available to staff.

  • Escalate repeated unsuccessful outreach or a clinically important missed appointment to the appropriate licensed clinician or supervisor under clinic policy.

  • Do not close the workflow until the record clearly shows the appointment outcome, outreach attempts, assistance offered, and rescheduling result.

🛠 Troubleshooting

The Appointment Was Booked Less Than One Week Before The Visit

Do not send a past-due one-week reminder. Begin with the next applicable reminder interval and continue with the remaining contacts.

The Patient Cannot Be Reached

Use the patient’s other permitted channels when available. Document each attempt and delivery result, then follow the clinic’s escalation process for clinically important or repeated missed appointments.

The Patient Needs Transportation Or Accessibility Help

Identify the type of non-clinical assistance requested and connect the patient with the appropriate clinic or health-plan resource. Do not promise transportation or another service until availability is confirmed.

The Patient Cannot Join Telehealth

Confirm the approved telehealth link or instructions, provide basic connection assistance, and route unresolved technical problems to the appropriate support team. Offer rescheduling when the visit cannot proceed.

No Appointment Is Available Within The Required Standard

Notify the scheduling lead or supervisor immediately and follow the health plan’s access-escalation process. Do not simply place the patient on a later schedule without documenting and escalating the access issue.

✅ Completion Check

  • The appointment was scheduled according to the patient’s stated clinical need and applicable access standard.

  • The patient was notified of the scheduled routine or preventive appointment.

  • The annual scheduling email and all applicable reminder contacts were sent through permitted channels.

  • The reminder schedule was adjusted correctly when the appointment was booked inside a reminder window.

  • A canceled patient was asked whether they wanted to reschedule, and the outcome was documented.

  • A no-show patient was called, offered help with the physical clinic or telehealth visit, asked about rescheduling, and the outcome was documented.

  • All contact and outreach attempts for missed or canceled appointments were documented in the patient’s medical record.

  • Any access delay, clinical concern, or unsuccessful required follow-up was escalated appropriately.

References

Source: CalOptima Provider FSR/MRR Binder, page 159 • Revised Apr 20, 2026