Open Chair Recovery & a Working ASAP List
Every hole in the schedule gets offered to the right patient automatically, in priority order, one at a time, from a list that is actually usable.
- Tier
- Growth
- Build order
- 3rd of 7 for dental practices
- Shape of it
- 8 steps
- At launch
- Runs supervised, with you approving what goes out
The problem this solves
A cancellation at 4pm for tomorrow is recoverable for about two hours, and recovering it means somebody calling down the ASAP list. That person is at the front desk with patients checking out.
The list itself is usually the bigger problem. Most ASAP lists are a column of names with no note of what procedure the patient needs, which provider they see, what times they can genuinely do, or whether they still want to be on it. So working it means five calls to find one patient who fits, and nobody has time for five calls.
And when a slot is offered to everyone at once, the practice creates eight disappointed patients and one who now knows the schedule is not real.
How it works, step by step
Every wait, threshold and branch below is a value we set with you during the build, against your stages and your language. None of it is a default we impose.
- What starts it
Step 1Trigger
A slot empties: a cancellation, a failed appointment, a reschedule, or a procedure that finished early.
Step 2
The system builds the offer list from patients who actually fit that slot: the right procedure, the right length, the right provider, and a patient who said they wanted an earlier date.
Step 3
Priority order is agreed in advance. Patients in pain first, then accepted treatment waiting to be scheduled, then overdue recare, then everyone else.
Step 4
The offer goes to one patient at a time with a real hold. Long enough to be answered, short enough to still fill the slot.
Step 5
The moment somebody takes it, the offer stops and every pending message about that slot is cancelled.
Step 6
The ASAP list maintains itself. Joining it captures the procedure, the provider, the days and times that genuinely work, and an expiry, so a patient who has since been treated drops off instead of being called about a slot they no longer need.
Step 7
Anything still unfilled after the sequence goes to the front desk as a short list with the patient's details already on it, rather than as a task to go and build a list.
Step 8
Every unfilled slot is recorded with its value, so open chair time becomes a number rather than a feeling.
How it gets built
Built inside what you already run
- Dentrix
- Eaglesoft
- Open Dental
- Curve
- or whatever your office already runs on
Nothing to log into and nothing to license. If a system needs a record your platform does not hold, we add the field to your platform rather than starting a second one beside it.
This is the actual build order, in the phases its own steps fall into. It runs in supervised mode first, with you approving what goes out, until you are happy with the tone.
- 1
Agree
Define slot eligibility with the practice manager and the hygienist: procedure, length, provider, and any equipment or room constraint.
The thresholds, the wording and the names are yours. We write them down with you and get the consequential ones signed off.
- 2
Agree
Agree the priority order in writing.
- 3
Build
Rebuild the ASAP list with the fields that make it workable, and accept that the existing list mostly has to be re-collected rather than migrated.
Built inside the software you already run, against your stages and your language.
- 4
Agree
Set the hold window per offer.
- 5
Build
Build the stop condition first and test it before anything else goes live. The failure that damages a practice here is two patients arriving for one slot.
- 6
Build
Add the expiry and the self-maintenance rules.
- 7
Prove
Run the first two weeks with the front desk approving each offer, then let it run.
It runs with a person approving what goes out until you are happy with the tone. Nothing sends unreviewed on day one.
What changes after it goes live
How it runs today
A cancellation at 4pm for tomorrow is recoverable for about two hours, and recovering it means somebody calling down the ASAP list. That person is at the front desk with patients checking out.
After this one is live
A cancellation stops being a lost hour. The front desk stops being the only person capable of filling a hole. And the ASAP list becomes an asset instead of a piece of paper that everyone knows is out of date.
How to measure whether it worked
Your arithmeticRun with your numbers, not ours
Count the slots that emptied and stayed empty last quarter, and value them at the practice's own hourly production for that column. Separate hygiene from restorative, because they are very different numbers and the hygiene one is usually larger than the owner expects.
We agree the baseline before anything is built, and we do not take credit for things that were going to happen anyway. There is no figure on this page claiming what we have produced for somebody else, because there is no verified figure to publish.
What we will not do
This is from the same delivery document as everything above it. It is on the page because a supplier who has not thought about it will not tell you, and you would find out later.
Every system here touches protected health information and sends automated messages to patients in the United States. Two separate regimes apply and satisfying one does not satisfy the other. HIPAA governs the information and the vendors. The TCPA governs the calls and texts.
HIPAA
A dental practice transmitting claims or eligibility electronically is a covered entity, and its patient information is PHI.
- A signed Business Associate Agreement with every vendor that creates, receives, maintains or transmits PHI, before that vendor touches any of it. This includes the messaging platform, the SMS gateway, the hosting provider, the CRM, any analytics tool and any AI service in the path. The narrow conduit exception covers transmission-only services with no routine access; it does not cover an ordinary patient-engagement or automation platform.
- Minimum necessary. Send the fields the system needs, not the chart. A reminder needs a date, a provider and a contact number. It does not need a diagnosis.
- What goes in an unencrypted message. HIPAA does not ban PHI in SMS or email, and HHS explicitly permits appointment reminders without authorization. What does not belong in one: diagnoses, clinical findings, procedure names that reveal sensitive treatment, radiographs or images, medication details, insurance or balance information, and anything about a second patient.
- Offer and honour confidential communication requests. A patient can ask to be contacted a different way, and that request has to reach every system.
- Treatment, payment and operations do not need an authorization. Recall, appointment reminders, pre- and post-operative instructions, and a request to schedule treatment already recommended are ordinarily treatment-related. Promotion is different. "Book this month and save" is marketing whatever list it went to, and calling a sequence a recall does not make it one if the purpose is to sell.
- Financial remuneration changes the analysis. If a third party pays the practice or a vendor for a communication, HIPAA's marketing rules can apply to something that would otherwise be operations.
- Audit logs, role-based access, retention limits, a documented risk analysis and an incident response procedure, all of them boring and all of them the first thing asked for if anything goes wrong.
TCPA
HIPAA permission is not TCPA consent.
The FCC's healthcare treatment exemption can reduce the consent standard for messages from a covered entity, but it is narrow and it comes with hard conditions that shape every sequence in this playbook:
- Only to the wireless number the patient gave the practice.
- The provider's name and contact information in the message.
- Concise: generally no more than 160 characters for a text.
- No cost to the patient.
- One message per day, and no more than three per week, counting calls and texts together.
- An easy opt-out, honoured immediately.
That frequency limit is a design constraint, not a footnote. It is substantially stricter than what a normal marketing automation would send, and it means every sequence in this document has to be sparse and every message has to earn its place. A five-touch week is not an aggressive cadence here. It is non-compliant.
The exemption does not cover advertising, promotional offers, solicitation of new services, billing or debt collection, or anything unrelated to the patient's care. Those need consent on the ordinary standard, captured and documented per channel and per purpose. A phone number in the chart is not blanket permission for promotional automation.
The line that is never crossed
No automated system answers a clinical question. Ever. Not whether it will hurt, not whether a symptom is normal, not what medication to take, not whether treatment is needed. Every one of those routes to a clinician, and the patient is told a person is being reached. Every classifier in this playbook errs toward escalation, and every one of them is tested against deliberately ambiguous messages before it goes live.
Nothing in this document is legal, clinical or regulatory advice. State privacy and telemarketing law, dental board advertising rules, payer contracts and the exact sending technology can each add requirements, and this area has moved more than once recently. Every template stating a clinical or commercial term requires review by the practice's own counsel before it goes live.
Nothing here is legal advice. Rules in this area have moved more than once recently, and every template that states a commercial term or a guarantee goes to your own counsel before it goes live.
Seven systems fordental practices.
We build one at a time and prove it moved before starting the next. The tiers are the dependency order, not a price list.
Tier 1Foundational
Nothing arrives late or unowned. These come first because everything above them assumes they are true.
Tier 2Growth
The recoverable money. These work the pools the foundational systems have made visible for the first time.
- 3Open Chair Recovery & a Working ASAP Listyou are hereTurns System 2's cancellations into recovered chair time.
- 4Unscheduled Treatment RecoveryUsually the single largest recoverable pool in the practice.
Tier 3Flagship
One connected system end to end, plus what the owner reads on a Monday. Only once the pieces are proven individually.
The tiers are the dependency order for dental practices, not a price list. Most firms do not start at the first one, because the order is a default and the call is where it gets changed.
A note on sequencing this trade
Do not build all seven at once.
Each stage is proven against its agreed measure before the next begins.
One sequencing note specific to dentistry. System 4's existing backlog should be worked by hand in week one, before any of it is automated. It is the fastest money in the engagement, it proves the value of the whole programme before a single sequence goes live, and working it manually is what tells you what the five branches should actually say.
Back to the dental practices overview for the stage map and where these fit.
Is this the oneyou need first?
Often it is not. On the call we look at what is actually costing you most right now, which is frequently a different system from the one that brought you to this page. If there is nothing worth building yet, we will say so.