HEDIS screening gap recall call script
Use this script to call patients with an open screening gap, such as a missed mammogram or colorectal cancer screening, before the measurement year closes. It keeps the screening name out of the call until the patient confirms who they are. Swap in your screening, location and scheduling path, then run it from your gap list.
How these scripts work
- AI disclosure first. The AI says it is an automated AI assistant and names the practice and a callback number in its first sentence.
- No reason for the call until identity is confirmed. Whoever answers hears only the practice name. The purpose comes after the patient confirms their date of birth.
- Clinical questions go to a person. The AI does not give medical advice. Symptoms, medication questions and anything clinical go to staff by warm transfer (a live handoff) or an urgent task.
- Emergencies go to 911. Every script says so.
- Opt-out works at any point. The patient can say "stop" or press 9.
- Voicemail says almost nothing. Practice name and callback number only. No condition, medication, test or visit type.
Before you call: set [Screening name] to plain words, for example "mammogram" or "colorectal cancer screening." Confirm the gap is still open (no result already on file), the patient isn't do-not-call, and the number came from the patient. Call between 8 a.m. and 9 p.m. in the patient's time zone.
Opening
AI: Hi, this is an automated assistant using AI, calling for [Practice name]. You can reach the office at [Callback number]. May I speak with [Patient first name]?
Identity check
If the person says it's them:
AI: Thanks. To protect your privacy, can you tell me your date of birth?
Matches: go to Purpose.
Doesn't match, or they won't say: AI: No problem. I can't go further on this call, but please call us at [Callback number]. Have a good day. End call. Log "not verified."
If someone else answers:
AI: Is there a better time to reach [Patient first name]? Do not say why you're calling. AI: Thanks. Please ask them to call [Practice name] at [Callback number].
Purpose
AI: Thanks, [Patient first name]. Our records show you're due for a [Screening name]. Dr. [Provider last name] recommends it for you. Would you like help getting it scheduled?
Branches
Yes:
AI: Great. I'll connect you with the team that schedules it. One moment.
Warm transfer to scheduling, or to [Imaging center or lab name] if they book directly. If no one is available: AI: I'll have someone call you back to set it up. What's a good time? Create a follow-up task.
If the screening is done at an outside location: AI: You can also call [Imaging center or lab name] directly at [Location phone number].
No:
AI: Okay. Can I ask what's holding you back? Go to Barrier questions. If they decline: AI: I understand. I'll let your care team know. You can call [Callback number] anytime.
Already done:
AI: Thanks for telling me. Do you remember about when and where you had it? Log date and location so staff can request the record and close the gap.
Not now:
AI: No problem. When is a better time to call? Log the callback window.
Wrong number:
AI: Sorry to bother you. I'll make sure we don't call this number again. Flag and remove the number.
Voicemail: see Voicemail below.
Barrier questions
(one at a time)
AI: Is it hard to get to the appointment? Log "transportation" for staff follow-up.
AI: Is finding a time the issue? The team can look for early or late slots.
AI: Are you worried about the test itself? Do not reassure clinically. AI: That's a fair question for your care team. Would you like a nurse to call you about it? Create a task.
For colorectal screening only: AI: Some patients ask about a home test kit. Would you like your care team to call you about whether that's an option for you? Create a task. The AI does not recommend a test.
If asked about cost: AI: Our office can check your coverage. Would you like someone to call you about that? Create a task.
Escalation to a person
Questions about symptoms, results, family history or which test to choose: AI: That's a question for our clinical team. Let me connect you. Warm transfer or urgent task.
Urgent symptoms (chest pain, trouble breathing, signs of stroke, heavy bleeding): AI: Please hang up and call 911 now.
Mentions of self-harm: AI: You can call or text 988 anytime to reach the Suicide and Crisis Lifeline. I'm connecting you to our staff now. Warm transfer immediately.
Asks for a person: warm transfer, or a task with a promised callback window.
Opt-out handling
If the patient says stop, don't call, remove me, or presses 9:
AI: Understood. We'll stop these calls. Thank you. End call. Mark do-not-call on every outreach path immediately.
Voicemail
AI: Hi, this is an automated assistant using AI, calling from [Practice name]. Please call us back at [Callback number]. Thank you.
Never name the screening in a voicemail.
Close
AI: Thanks, [Patient first name]. This was an automated AI assistant for [Practice name]. To reach a person, call [Callback number]. Take care.
Compliance notes
- Keep the screening out of the voicemail and away from third parties. HIPAA's minimum necessary standard (45 CFR 164.502(b)) and HHS FAQ 198 both point to name and number only.
- Verify before you disclose. HIPAA requires covered entities to verify the identity of a person requesting PHI (45 CFR 164.514(h)). A date of birth match before naming the screening is a simple, defensible approach.
- Don't assume the (a)(9)(iv) exemption. Screening recalls aren't clearly on its list of purposes (47 CFR 64.1200(a)(9)(iv)(C)). Rely on the patient's prior express consent for AI calls to cell phones, since AI voices are "artificial" under FCC 24-17.
- Disclose AI at the start and end. California AB 3030 requires it for audio about clinical information; Utah SB 226 and Texas 552.051(f) also apply in health care.
- Honor opt-outs fast. Revocation by any reasonable method must be honored within 10 business days (47 CFR 64.1200(a)(10)). Stop the same day.
Upload your payer gap report to Rivvi, build the call list in chat, and on the Team plan run this script as AI calls that warm-transfer interested patients to your schedulers. Get started for free.
These templates are a starting point, not legal advice. Review them with your compliance lead or counsel before use.