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📱 SMS Automation

Set it up once. Every patient gets followed up — forever.

Spokk's post-visit SMS sequence runs automatically after every appointment: feedback request, gentle reminder, review nudge, referral ask. Smart skip logic means patients only get messages relevant to their actions. No over-messaging, no manual work.

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90%
SMS open rate within minutes of delivery — vs ~20% for healthcare email
source ↗
29%
reduction in missed appointments with automated SMS reminders — clinical trial data
source ↗
$200
estimated revenue lost per missed appointment slot in primary care
source ↗
40–70%
patient feedback response rate via SMS — vs 5–10% for email surveys
source ↗

The four-step post-visit sequence — and why each step is timed the way it is

The timing isn't arbitrary. Each step is placed at the moment where it's most likely to get a response and least likely to feel intrusive.

1
2 hours after check-inFeedback request
"How was your appointment today, [Name]? Quick 30-second feedback means a lot to us 👇"
The experience is still fresh. They're home and relaxed. This is the highest-converting moment for honest feedback — and the timing removes the authority dynamic that makes patients say 'fine' at checkout.
2
24 hours after check-inGentle reminder
"Just a gentle nudge — your feedback helps us keep improving. Takes under a minute 😊"
Some patients mean to respond and forget. A single follow-up at 24h captures a meaningful additional percentage without feeling aggressive.
⚡ Skip logic: Automatically skipped if the patient already submitted feedback.
3
3 days after check-inReview nudge
"Glad your visit went well, [Name]! Would you mind leaving us a quick Google review? Takes 90 seconds."
Patients who submitted positive feedback but haven't yet written a Google review get this prompt. The AI-drafted review is ready — they just need a nudge to post it.
⚡ Skip logic: Skipped if the patient rated below your threshold, or if they've already clicked the review link.
4
20 days after check-inReferral ask
"Know someone looking for a doctor? Share your link — you both get a reward 🎁"
20 days is enough time for the appointment to be a clear, positive memory — and for the patient to have mentioned you to someone naturally. The referral ask formalises what was going to happen anyway.
⚡ Skip logic: Skipped if the patient has opted out of communications.

The real cost of patient no-shows — and why SMS changes the equation

Between 15 and 30% of medical appointments end in a no-show. Most practice owners know this number abstractly. Fewer have calculated what it actually costs them.

No-show cost calculator — example primary care practice

Appointments per dayTypical primary care volume
30
No-show rateConservative estimate
20%
Missed slots per day30 × 20%
6
Revenue per appointmentAverage primary care billing
$150
Daily lost revenue6 × $150
$900
Annual lost revenue (250 working days)$900 × 250
$225,000

A 29% reduction in no-shows — the figure from clinical trials on SMS appointment reminders — would recover roughly $65,000 per year for that practice. For most clinics, that number alone pays for any patient engagement software several times over.

Spokk isn't a dedicated appointment reminder system — it's a feedback and growth platform. But the post-visit engagement loop it creates has a real effect on patient connection and show rates. Patients who feel followed up with, heard, and valued are more likely to show up when they're supposed to.

Why SMS — and not email, paper forms, or asking at checkout

Every channel for patient follow-up has been tried at some point. Here's the honest breakdown.

SMS
Feels personal. Arrives when they're home and relaxed. No app needed. Mobile-optimised form takes 60 seconds. Highest engagement of any channel by a significant margin.
Open rate
~90%
Response
High
Email
Healthcare email is heavily filtered into promotions. Patients have dozens of unread medical emails. Long-form surveys lose people. Even with good delivery rates, response rates are poor.
Open rate
~20%
Response
Low
Checkout ask
Power dynamic. The doctor or receptionist is standing there. Patients say 'fine' regardless. You're collecting social politeness, not feedback.
Open rate
N/A
Response
Biased
Paper forms
Blank page anxiety. Gets lost in the bag. Impossible to aggregate. Biased toward either very happy or very unhappy responses.
Open rate
Low
Response
Very low

SMS works in healthcare for a structural reason: it reaches people when they're receptive, in a format that requires minimal effort, without the social dynamic that makes clinic-based feedback collection unreliable. Everything else has a built-in friction or bias that SMS doesn't have.

SMS messaging and HIPAA — what you need to know

The first question many medical practices ask about SMS automation is: “Is this HIPAA-compliant?” The short answer is that Spokk's SMS messages are designed to stay outside PHI scope. Here's the longer answer.

✅
What Spokk SMS messages contain
Patient name, your practice name, and a personalised link. No diagnoses, no medications, no appointment details, no clinical information. The message is a follow-up communication — not a clinical communication.
⚠️
What Spokk SMS messages do not contain
Protected Health Information (PHI) — which under HIPAA includes diagnoses, treatment details, medications, clinical notes, lab results, or any health-specific information tied to an identifiable patient. Spokk is a feedback and engagement platform, not a clinical messaging system.
📋
Your HIPAA obligations
HIPAA compliance depends on your specific workflows, what data you handle, and how. Spokk's feedback data (names, phone numbers, satisfaction ratings, comments) should be reviewed with your compliance advisor in the context of your practice's overall HIPAA posture. We recommend consulting a healthcare compliance professional for a full assessment.

Note: This is not legal or compliance advice. Requirements vary based on your practice type, jurisdiction, and specific data workflows. Always consult a qualified healthcare compliance advisor for guidance specific to your practice.

The default sequence works out of the box — and you can customise everything

Most clinics go live with the default settings. But every practice is different.

⏱

Adjust timing

Move the feedback request from 2h to 4h for afternoon appointments. Delay the review nudge to 5 days if your patients tend to take longer. Every step's delay is independently adjustable.

✍️

Edit message copy

Rewrite any message in your practice's voice. More formal for specialist practices, warmer for family medicine. Variables like {{name}} and {{link}} insert automatically.

🔀

Enable or disable steps

Turn off the referral step if you're not running a referral program. Disable the review nudge if you prefer to handle it separately. Mix and match what fits your workflow.

📅

Feedback cooldown

Set minimum days between automation triggers per patient. Prevents over-messaging patients with frequent visits — chronic condition management, physiotherapy, ongoing care plans.

➕

Add custom steps

Build your own steps with the flow editor. Post-procedure care tips, 6-month re-engagement messages, specific follow-ups for complex appointments — all configurable without technical setup.

📍

Per-location configuration

Multi-location practices can run different sequences per location, or share one configuration across all sites. Each location tracks separately in your dashboard.

Common questions about SMS automation for medical clinics

What SMS messages does Spokk send automatically for medical clinics?+
The default sequence sends: (1) a feedback request 2 hours after check-in; (2) a feedback reminder 24 hours later if they haven't responded; (3) a Google review nudge 3 days after if feedback was submitted but the review link wasn't clicked; and (4) a referral request 20 days after. Every step is customisable — timing, message copy, and which steps are active.
How does Spokk know when to skip a message?+
Smart skip logic is built into every step. The feedback reminder skips if the patient already submitted feedback. The review nudge skips if the review link was already clicked. The referral step checks opt-out status. No patient gets a message for an action they've already taken.
How is the automation triggered for medical patients?+
The automation triggers on patient check-in via QR code scan at reception. The patient scans, confirms their visit, and the sequence starts automatically. You can also trigger it manually from the dashboard, or via API if you want to connect to your practice management system.
Can I customise the SMS messages?+
Yes. Every message template is fully editable — wording, delay timing, and which steps are active. Templates support dynamic variables: {{name}} for the patient's name, {{company}} for your practice name, {{link}} for the relevant URL. You can adjust formality, localise the language, or add specific care instructions.
What if a patient doesn't want to receive automated messages?+
Patients can opt out by replying STOP to any message. Opted-out contacts are flagged immediately and never messaged again — all subsequent automation steps are automatically skipped for that contact.
Is the SMS number a dedicated number for my practice?+
For US and Canadian clinics, Spokk provisions a dedicated toll-free SMS number on paid plans. During the 14-day free trial, messages come from a shared Spokk number. International practices can use their own Twilio credentials (BYOT).
Can I add extra steps beyond the default sequence?+
Yes. The Spokk flow builder lets you add custom SMS steps at any interval. For example: post-procedure care instructions at 4 hours, a check-in for chronic condition patients at 1 week, or a re-engagement message for patients who haven't visited in 6 months.
How does SMS automation connect to the loyalty and referral programs?+
They share the same automation backbone. The loyalty milestone SMS triggers automatically when a patient hits a reward threshold. The referral SMS in the standard sequence uses each patient's unique referral link. All messages are tracked and tied to the same patient contact record.
What is the feedback cooldown and how does it work?+
The feedback cooldown prevents the automation from triggering too soon after a recent run. You configure the number of days — for example, if set to 30 days, a patient who recently received the sequence won't be triggered again for 30 days. This prevents over-messaging patients with frequent appointments.
Is Spokk SMS messaging HIPAA-compliant?+
Spokk's SMS messages do not contain Protected Health Information (PHI). Messages include patient name, practice name, and a personalised link — no diagnoses, medications, or clinical details. This keeps the messaging outside PHI scope. For any HIPAA obligations specific to your practice, consult your compliance advisor.
Can I see a log of what messages were sent to each patient?+
Yes. Your Spokk dashboard shows full automation activity per contact — which steps were sent, when, what was skipped and why, and whether the patient clicked any links.

More resources for medical clinics

Spokk for Medical Clinics

The full overview — every feature Spokk brings to your practice.

Google Reviews

How the review nudge step turns positive feedback into 5-star reviews.

Patient Feedback Collection

What to ask, how to act on responses, and the two form types.

Patient Referral Program

How the referral step generates trackable new patient referrals.

Patient Loyalty Program

QR check-in, visit milestones, and automatic SMS rewards.

Physician Performance Tracking

Per-provider satisfaction scores from real patient feedback.

Starter

For solo operators & small teams

$49/month

Billed $588/year

250 customers / month

Unlimited SMS included

  • 250 customers / month
  • 1 manager + 1 staff member
  • Unlimited locations
  • Dedicated toll-free SMS number (US & Canada)
  • Full automation sequence
  • AI review response drafts
  • Loyalty & referral programs
  • Feedback forms & QR codes
  • HubSpot integration & API access
  • Buy additional customer top-ups

Growth

For growing businesses & teams

$82/month

Billed $984/year

500 customers / month

Unlimited SMS included

  • 500 customers / month
  • 2 managers + 2 staff members
  • Unlimited locations
  • Dedicated toll-free SMS number (US & Canada)
  • Full automation sequence
  • AI review response drafts
  • Loyalty & referral programs
  • Feedback forms & QR codes
  • HubSpot integration & API access
  • Buy additional customer top-ups

Pro

For high-volume businesses

$166/month

Billed $1992/year

1,500 customers / month

Unlimited SMS included

  • 1,500 customers / month
  • 3 managers + 5 staff members
  • Unlimited locations
  • Dedicated toll-free SMS number (US & Canada)
  • Full automation sequence
  • AI review response drafts
  • Loyalty & referral programs
  • Feedback forms & QR codes
  • HubSpot integration & API access
  • Buy additional customer top-ups

All plans include a 14-day free trial. No charge until your trial ends. Questions?