Dental Text-to-Pay - What's Changed in 2024

The Current State of SMS Communication For Practices

SMS Texting is a powerful communication channel for dentists - offering a low-cost way of reaching patients with a high degree of confidence and potential personalization. Whether sending appointment reminders, bills, or marketing content, text messages are the tool of choice for reaching patients outside of the office.

But while most modern software makes it easier than ever to provision a number and send SMS messages en masse, there are emerging limitations to the benefits of convenient text messaging.

When deploying such tools, there are important considerations regarding deliverability, compliance, and reputation that practices should be aware of.

These are new considerations (as of 2024) that many companies are not currently following, so be sure to check with your provider to ensure that your practice is in compliance.

These emerging constraints are the core reason why many dental SMS communication services (like text-to-pay or appointment reminders) currently being used by practices are now in jeopardy–at least in their current form.

What is changing about patient SMS communication

As a reaction to SMS abuse by companies, the FCC enacted the Telephone Consumer Protection Act (TCPA), which provides additional constraints to SMS services. Within dental, this act delineates the necessary requirements for patient consent for communication.

When a patient has willfully given their phone number to a practice, they are, in effect, consenting to be contacted about informational or transactional calls/texts as it relates to the service they received at the practice. But that does not mean that the consent is permanent.

Recent TCPA rulings strengthen consumer rights by enhancing opt-out provisions and clarifying consent requirements. The FCC's 2024 Report and Order requires that companies that send automated text messages must have clear opt-out phrases that adhere to patients’ communication preferences. 

On top of the TCPA, in December 2023 the US telecommunication industry announced that carriers will be enforcing 10 Digit Long Code (10DLC) registration for texting services that use US carriers. 

This announcement has since engendered a greater sense of urgency in SMS-based customer solutions, as 10DLC is designed to bring an end to the wild-west of SMS communication by enforcing carrier-wide standards for when and how SMS campaigns can be conducted.

The Current Options

Before diving into the new requirements, let's first take a look at the different phone number types available. While on the surface they might seem to be similar, they have major implications for your patient communication.

In addition to the familiar 10-digit long code, providers also offer the ability to use Toll Free or Shortcode numbers. All three number types have similar compliance requirements, however there are a few important distinctions to be aware of:

‍

• ‍^{Longcode - The phone number variant everyone is familiar with. These are your standard 10-digit phone number, just like your regular mobile number (e.g. (805) 123-4567).
  ‍}
• ‍^{Toll Free - Carry higher cost, can be more or less credible depending on the use case, similar but lower deliverability to long codes.
  ‍}
• ‍^{Shortcodes - Multi-month approval process with carriers, high degree of credibility versus long codes, guaranteed delivery by carriers.}

‍

Regardless of number type, US carriers now require businesses to meet strict requirements when sending texts to individuals at scale. The stakes are high for companies that offer SMS services – failure to meet these requirements can result in carriers refusing to deliver traffic on your behalf and per occurrence fees for SMS service providers in violation.

Importantly, notification campaigns are registered by EIN rather than phone number, meaning your reputation with the carrier will stay with you long after a non-compliant campaign / tool has been released.

Why This Is Important for Dental Practice Communication

So why does this matter for dental practices?

To start, if your practice is using an SMS service in violation of the current regulations, you might see a severe reduction in deliverability of your patient SMS communication.

It also opens your practice up to potential lawsuits, as patients now can sue practices for violations of these new communications standards.

For matters of due diligence for your organization, it is best to check with your SMS service provider to make sure that they are in compliance. For dental practices specifically, it is unfortunately the case that certain practice management systems are using SMS services that don’t meet the relevant (but stringent) requirements.

Let’s briefly review the most pertinent requirements so that your practice is informed.

• ‍<sup>Campaign Registration - A common step many SMS services skip is registering their phone number and campaign in the first place. This is a multi-stage process that requires campaign-specific details, sample notifications, and verification that other requirements are being met.
  
  Multiple iterations will be necessary before the carrier provides a final stamp of approval.  You can learn more about registration here on the Campaign Registry website.
  ‍</sup>
• ‍^{Keyword Handling - Even if the campaign is not for two-way communication, your number needs to handle specific keywords including STOP, START, HELP, and other opt-out parameters. Carriers will send test notifications to validate these keywords are working as expected.
  ‍}
• ‍^{Opt Out Handling - Your SMS campaign needs to have clear instructions in marketing materials & initial messages on how recipients can opt out. A proper opt-out system should include a tracked "opt-out" list, the ability to opt back in, and automatic enforcement of the opt-out list for all future messaging.
  ‍}
• ‍^{Pre-Verification - Your campaign's reputation will suffer and could eventually become throttled if you are persistently messaging unverified phone numbers. Consider implementing up-front number verification to avoid reputational damage from attempting to message landlines or out-of-service numbers.}

All this means that practices need to be wary about how their patients are opting into SMS communication, what kind of language is used, and how their SMS service provider is handling their text message campaigns. For billing communication in particular, these considerations are paramount, as campaigns can be blocked entirely from text-to-pay campaigns.

Regular Text-to-Pay vs. SMS Smart Automation

Here’s another reason why standard “text-to-pay” services are going out of style–they’re just standard.

Let’s say that your practice is using a reputable SMS campaign service that’s fully in compliance with TCPA and 10DLC. While you no longer have to worry about message throttling or angry patients that aren’t receiving notifications, your patient communication system is likely far from optimized.

Let’s take Text-to-Pay billing communication as an example again.

Does your practice…

• Regularly audit patient accounts to see which qualify for a payment request?
  ‍
• Manually batch and send SMS messages with links to pay?
  ‍
• Use the same language and tone for all billing text messages?
  ‍
• Send billing notifications sporadically?

If you answered “yes” to any of these questions, your practice can benefit from SMS Smart Automation.

With services that bring automation to the SMS communication process, your practice can set the rules for who receives texts, what those texts say, and how frequently they’re sent. Once established, billing communication can be sent without any staff input, freeing them for more meaningful tasks at your practice.

Text-to-Pay | Fully Automated and Optimized

While there are a handful of dental patient communication companies that can offer sanctioned SMS automation, Pearly remains best-in-class because of its smart balance targeting, language sequencing, and successful track record with some of the largest group practices and DSOs in the industry.

Pearly delivers millions of shortcode SMS billing notifications to customers every year, and along the way has uncovered and deployed best practices for delivering text notifications at scale.

With Pearly, patient billing notifications are delivered from a globally available shortcode that has been registered, approved, and tested by all major US Carriers. In compliance with both 10DLC and TCPA, Pearly offers opt-out measures to ensure that patients are given legally mandated control over whether they continue receiving messages.

Pearly gives patients a range of options that respect their privacy and contact preferences while ensuring that automated workflows remain efficient. This approach allows Pearly to deliver important information, such as billing notifications, in a way that aligns with both regulatory requirements and patient needs.

We take the complexity and regulatory burden out of SMS notification campaigns, so you can focus on what you do best, caring for your patients.

‍