Managing Inactive Clients and Resuming Care

This article explains how to manage clients who become inactive, how to resume care, and what to do if a client stops responding.

My Client Hasn’t Responded — What Now?

When a client stops responding and doesn't have any future visits scheduled, use this framework:

• Outreach cadence: If a client does not schedule a follow-up visit within 90 days after an initial appointment or within 30 days of the most recent visit, the provider is expected to make a minimum of one documented outreach attempt to inquire if the client would like to continue to receive services.
  • If there is no response from the patient within 10 days, a discharge note should be completed.
• Suggested script/copy (templates):
  • Provider portal message: “Hi [Client], I wanted to check in since we haven’t been able to connect. Please let me know if you’d like to continue sessions. If not, we can pause care for now.”
  • Email: Similar to provider portal message — short, supportive, and clear about next steps.
  • Voicemail: “Hi [Client], this is [Therapist] from Rula. I’m reaching out to see if you’d like to continue care. Please give me a call back or message me via your patient portal to confirm."
• Document outreach efforts: Record outreach attempts by adding a note(s) to the client's chart.
• Complete a Discharge Note: After multiple unsuccessful outreach attempts, complete a Discharge Note.
  • The Discharge Note template contains only a few fields and typically takes less than 2 minutes to complete.
  • If a client is unresponsive, you do not need to request to transfer the client to another therapist or try to reassign the client; simply complete the Discharge Note and discharge the client from your care.
• Impact on your caseload: Completing and submitting a Discharge Note concludes your therapeutic relationship with a client, moves the client from your “active” client roster to your “inactive” client roster, and removes them from your caseload (if applicable).
  • All future appointments with the client are canceled when you submit the Discharge Note.

How to Schedule/Resume Care For An Inactive Client

Understanding limitations:

• Providers cannot directly schedule appointments with a client marked as "Inactive" in the provider portal (i.e., they cannot schedule an inactive client themselves).
• Providers cannot manually move a client from the "Inactive" client list to the "Active" client list in the provider portal (i.e., you cannot manually "reactivate" a client via the provider portal). 

An Inactive client can only move to Active status if they schedule an appointment with their provider.

• Once an Inactive client has a future appointment scheduled with their provider, they will automatically move from the Inactive client list to the Active client list.
  • Inactive clients can easily schedule an appointment with their provider through their Rula patient portal. They can also contact the Rula Support team if they need help with scheduling.
• Suggested script/copy (templates):
  • If an Inactive client contacts you asking how to schedule a visit with you, you can send them a message using the following script.
    • “Hi [Client], I’d love to continue working with you. You can restart care by following these instructions: Resuming care with a previous provider. This will tell you how to schedule another visit with me via your Rula patient portal."
    • If you can't send the above link, you can also share these basic instructions for the patient:
      • Log in to the Rula patient portal
      • Navigate to the Care Team tab and select “Past providers”
      • Select their provider and click “Book Appointment”
      • Select an available date and time.
      • Fill out the mandatory note regarding why they'd like to resume treatment.
      • Click “Confirm Appointment”

Frequently Asked Questions

• Q: Do Inactive clients count toward my current caseload?
  • A: No. Only Active clients with future appointments scheduled are counted toward your current caseload. Therefore, if you complete a discharge note for a client that is already an "Inactive" client, you will not free up additional new client capacity.
• Q: Do clients need to consent to being discharged?
  • A: No, if you document outreach attempts and the patient is not responsive and does not have a future appointment scheduled, you can submit a Discharge Note without the patient's consent.
• Q: How many times should I reach out before discharging an unresponsive client?
  • A: If a patient does not schedule a follow-up visit within 90 days after an initial appointment or within 30 days of the most recent visit, the provider is expected to make a minimum of one documented outreach attempt to inquire if the patient would like to continue to receive services.
    • If there is no response from the patient within 10 days, a discharge note should be completed.
• Q: What happens if I discharge a client who still has future appointments scheduled?
  • A: All future appointments are automatically canceled, and the client will move to Inactive status.
• Q: A patient showed up on my portal client roster, but then moved to inactive. Why did this happen?
  • A: This happens when a new client schedules an initial appointment (either pending or confirmed) but then cancels the initial visit. Clients appear on the Active client roster as soon as they schedule an initial appointment, but if the initial appointment never occurs, they are moved to the Inactive client roster.
• Q: What should I tell an inactive client who asks how to restart care?
  • A: Tell them that you cannot schedule a visit for them, but that they can restart care with you by following these instructions to schedule a visit with you via their Rula patient portal: Resuming care with a previous provider.

Related Articles

Viewing your client roster in the Rula provider portal

Discharge a client from your caseload

Completing a discharge note in the Rula provider portal

Updated September 26, 2025 15:47