Will-call returns: how to dispatch them without missed rides

A will-call is a return leg booked without a pickup time. The rider, a caregiver or the facility calls when the rider is ready, and only then does the leg become a real pickup on someone's run. Until that call, the leg exists, the rider and addresses are known, but it is on nobody's schedule.

That is the whole difficulty. A normal leg is planned the night before with every other leg on the run. A will-call arrives in the middle of a working day, when every van already has a plan, and it needs a van with the right space and a driver who can get there soon.

• The call goes to one dispatcher's phone or a sticky note, and the shift changes.
• Nobody knows which van is closest right now, so the first free driver is sent from across town.
• The runs are packed so tightly there is no room for a return anywhere in the afternoon.
• The rider is told "soon" and calls back three times, each call taking a dispatcher off the board.
• The van arrives and the rider is not ready after all, and the driver leaves with no record of waiting.

The stakes are higher than one late ride. In California, DHCS requires managed care plans to monitor their transportation providers, and Health Plan of San Joaquin's policy, for example, lists no-show rates and arrival within 15 minutes of the scheduled appointment among the things it checks every quarter. A pattern of riders left waiting is the kind of thing that costs a provider its trips.

You cannot know when a will-call will come, but you know it will come. Three habits make room for it.

1. Book the return as a will-call when the outbound is booked, with the facility, its phone number and any arrival notes. A will-call created when the rider calls is a will-call nobody planned for.
2. Look at where the day's will-calls will be. If six riders are at the same dialysis center in the afternoon, keep a van with wheelchair space working near there instead of sending it to the far edge of the county.
3. Leave some slack. A run planned to the minute from 8 to 5 has nowhere to put a return. A gap in the afternoon on one or two runs is cheaper than a rider stranded for two hours.

Your broker or plan may also set how fast a return must be picked up once it is called. Find that number in the contract and treat it as the deadline every will-call is measured against.

1. Activate the will-call the moment you hear from the rider or the facility, and record the time. That time is when the clock starts, for you and for the payer.
2. Shop it against every run that can take it: the right space type, room on board, within the driver's hours, close enough to make it in time. Nearest is usually best, but not if it makes three other riders late.
3. Tell the rider. A text with the van and a rough time cuts the call-backs, and a link to where the van is cuts them further.
4. Tell the driver, with the pickup in the run's order, not as a phone call while they are driving.
5. Watch it until it is picked up. If the assigned van is falling behind, move it early, while another van can still make it.

Some returns are known to the driver first. A driver who drops a rider for a short appointment can often see when the rider is done. Let drivers put a return in the queue themselves, so it does not wait for someone to phone the office.

Under DHCS All Plan Letter 22-008, NEMT from an acute care hospital to a skilled nursing facility or a similar inpatient setting, right after an inpatient stay, must be provided within three hours of the request. If it is not, the hospital may arrange another provider and the plan must cover it. Treat a discharge the way you treat an activated will-call, with a firm deadline, and tell the hospital early if you cannot make it.

Sometimes the call comes early and the rider is still in the chair when the van arrives. Record it: when the van arrived, how long the driver waited, who said the rider was not ready. Then decide with the facility whether the van waits or the will-call goes back in the queue. Without a record, this looks like a late pickup on your numbers, and sometimes like a no-show. Our post on no-shows and dry runs covers what to record when a pickup does not happen.

Will-calls do not have a scheduled pickup time, so on-time reports often leave them out or count them wrong. Track them on their own: time from activation to pickup, and how many waited longer than your contract allows. It is the one number that tells you whether your afternoons have enough room. Pickup windows and on-time performance covers the rest of the day.

In MileCall, a return without a time waits in the dispatch queue as a will-call. Ready now activates it, or you set a time. The rider gets a text in their language, and the runs that can take it are ranked, nearest first, with what each would change. The driver can call a return in too: "Rider ready for return" on the drop-off screen puts it in the queue. A pickup about to miss its window turns amber on the board, with the runs that can still make it. See MileCall dispatch and rider texts.

1. All Plan Letter 22-008: Non-Emergency Medical and Non-Medical Transportation Services and Related Travel Expenses (DHCS)
2. Provider Update 22-972: Action required for NEMT requests (APL 22-008 summary and PCS form) (CalViva Health and Health Net, Medi-Cal plans)
3. Policy UM55: Emergency Transportation, Non-Emergency Medical Transportation and Related Expenses (Health Plan of San Joaquin, a Medi-Cal plan)

This post explains how things work in general; it is not legal, medical or billing advice. Rules change and differ by payer, so check your payer’s current manual and your contract before you rely on any detail here.