SMS & Patient Communication Guide

This guide explains how to properly use SMS and email communication within ChiroSpring.

It covers:

• How SMS is activated and where to find your practice’s assigned toll-free number
• How to update patient phone numbers and manage communication preferences
• How household messaging works for families sharing a number
• How patients opt in, opt out, and re-subscribe to SMS communications
• Where and how to send SMS messages (Scheduler Widget, Communicator Dashboard, Notification Center)
• How to use GrowthHub and GrowthHub Pro for recalls, reviews, marketing, and broadcast messaging
• SMS character limits and formatting best practices
• Common SMS errors and how to identify them
• How to monitor monthly SMS usage

This guide ensures staff can confidently communicate with patients, stay compliant, and avoid unnecessary SMS overages.

To send SMS messages, your practice must:

• Have CRM enabled
• Have a toll-free number assigned
• Have email configured

You will get an email when you SMS is activated , you can navigate to SETTINGS - COMMUNICATIONS - COMMUNICATION DATA to find your toll free number assigned to your account.

If you haven't already; the second step of onboarding is to: Fill out this form to help us configure your Text/Email Reminders 

Our team will start the process to get your text messages live as soon as you fill out the form. It then takes 2-8 weeks to complete the process as the number gets approved by the phone carriers. If you need to send out appointment reminders immediately, we recommend using email reminders first as they will be live immediately.

You will want to set up your WORK FLOW RULES NEXT —> CLICK HERE TO LEARN MORE

Reach out to the ChiroSpring Service team if setup help is needed: service@chirospring.com

To update patient SMS number:

• Go to Patient File - Billing Dashboard - Contact Information Card
  • Click the Pencil Icon to open and edit

• SMS Phone Field is what's used for sms communications
• You can manually OPT IN/OUT for SMS and/or Email Communications here as well
• Toggle ON/OFF Blackist Patient - Stops showing text messages from this patient

• You can also edit this field quickly from the Scheduler Widget by clicking the Gear Icon next to their name

• Go to GrowthHub → All Leads can click the pencil icon to open and edit

Ensuring accurate contact information reduces SMS errors.

We’ve made it easier for practices to manage text messages for families who share a phone number. Until now, those text messages were saved and displayed under each individual patient, which often led to duplicate messages and confusion. Our new Household SMS logic changes that.

You can now group related patients into a household and choose how text messages are handled:

Each member individually or Head of household

If the patient belongs to a household:

• SMS appears under that patient (Each member individually)
• Under the head of household, depending on the setting.
• Choose whether to view the conversation for the patient or the head of household.

*When messages come from a number linked to more than one household, you’ll see “Received from [phone number]” to help identify who sent it.

Note:  Existing households will stay set to Each member individually until changed. For New households, users can choose the preferred setting when creating or editing the household.

Learn more on Households —> CLICK HERE

Patients can opt out at any time

• You can manually opt a patient out of SMS and/or Email communications in their contact card.
  • Go to patient file, Billing Dashboard, Click the Edit (pencil icon) to open up Contact Card and toggle ON/OFF SMS or Email

• Patient can text STOP  at anytime to opt out of SMS
• By clicking the Unsubscribe link at the bottom of any email
• Opt Out SMS message is including automatically in the FIRST SMS sent to patient: Reply STOP to opt out.

Re-Subscribing

• If a patient opts out but later wants to receive messages again, they can text: UNSTOP
  • This reactivates SMS communication.
  • Patients always maintain control of their communication preferences.

Opting out applies to all SMS communications, including appointment reminders and marketing messages.

1. Scheduler Widget

Best for:

• Quickly texting a patient scheduled for today
• Immediate communication during practice hours

2. Communicator Dashboard (Previously CRM Dashboard)

Best for:

• Texting while reviewing a patient’s file
• Direct one-to-one communication

3. Notification Center

Best for:

• Viewing real-time incoming practice texts
• Responding to active conversations

GrowthHub and GrowthHub Pro allow you to send automated recalls, birthdays, reviews, marketing campaigns, and broadcast messages to multiple contacts at once as well as save templates for QUICK and STANDARD use anywhere

GrowthHub - Features Overview - Click Here

Understanding SMS segments helps you manage usage and avoid unnecessary multi-segment messages.

Standard SMS Limits

• 160 characters per segment (GSM-7 encoding)

  Plain text messages

• 70 characters per segment (UCS-2 encoding)

  Messages that include emojis, special characters, or Unicode

We do not recommend using emojis. They reduce your character limit from 160 to 70 per segment.

How Segments Work

If your message exceeds the character limit:

• ChiroSpring automatically splits it into multiple segments
• A User Data Header (UDH) is added
• The receiving device reassembles the segments into one message view

Even though the patient sees one message, each segment counts toward SMS usage.

SMS Length Best Practices

To keep messages within one segment:

• Aim for 90–120 characters
• Avoid emojis and special characters
• Account for replacement values (like patient names)
• Account for the required SMS footer

Required Footer

• Every SMS includes: Reply STOP to opt out.
  • This is 18 characters and counts toward your total.

Replacement Values

• Placeholder: Patient_Name     (12 characters)
• If the actual patient name is longer, the SMS will increase in character count

Always build messages with buffer room.

Recommended Tools

Use a character counter tool when crafting SMS messages to stay within the 160-character limit.

Invalid Service Type Error

This error means:

• The destination phone number is not SMS-enabled
• The issue is with the patient’s mobile carrier or device

ChiroSpring cannot resolve this issue.

The patient must contact their mobile provider to enable SMS capabilities.

Running Reminder Error Reports

To review SMS errors:

Reports → Appointment Reminders

This helps identify delivery issues.

Errors may occur:

• Internally between ChiroSpring and messaging partner
• Externally with mobile carriers or third parties

ChiroSpring 360 - 150 sms per month

ChiroSpring 360 Pro/Pro+ - 250 sms per month

GrowthHub - 2,000 sms per month

GrowthHub Pro - 5,000 sms per month

*sms overage is 2 cents per message

View monthly usage: SETTINGS - SUBSCRIPTION - OVERVIEW

GrowthHub Dashboard —> To learn more - CLICK HERE

Summary

• SMS activation requirements (CRM enabled, toll-free number assignment, email configuration)
• Carrier approval timelines (2–8 weeks) and onboarding steps for text/email reminders
• Workflow Rule configuration to automate communication delivery
• Patient opt-in/opt-out compliance standards, including STOP/UNSTOP functionality and required SMS footer
• Household SMS logic and how shared phone numbers are managed
• Message encoding rules (GSM-7 vs UCS-2) and how character segments impact billing
• Required SMS footer character impact and replacement value considerations
• Troubleshooting delivery errors such as “Invalid Service Type”
• SMS usage limits by subscription tier and overage costs ($0.02 per message)
• Where to monitor monthly SMS consumption

This guide supports compliant patient communication, minimizes support issues, and helps practices manage messaging costs effectively.