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Do offices need written consent to initiate text messages with patients?

The short answer is NO. According to FCC rules governing SMS (text) and email marketing, any texts “facilitating, completing, or confirming a previously agreed upon transaction” are considered transactional messages, and not subject to regulation.

Marketing or promotional messages do not directly involve an existing transaction, and do require written permission by the recipient.

Here are some examples that apply to SMS use by a medical office:

Transactional Texts

  • Appointment reminders
  • Check-up reminders
  • Messages regarding account balance
  • Purchase order confirmations
  • Delivery status
  • Sign up details
  • Customer greetings (holiday, birthday, etc.)
  • Confirmation messages relating to purchases

Promotional Texts

  • Reminders to schedule the next appointment (not a follow-up)
  • Advertising new services
  • Health tips
  • Coupons, discounts or exclusive offers
  • Customer loyalty programs and rewards

Does HIPAA prohibit messaging without consent?

There are no rules prohibiting healthcare providers from texting appointment reminders, missed appointment notices, etc. to patients. HIPAA does not prohibit text communication, and in fact does not specifically mention text messaging at all.

Aside from the requirement for obtaining written consent, what are some of the regulatory differences regarding transactional messages and marketing messages?


Some more regulations

Transactional SMS (text) Regulations

  • Send any kind of information, e.g. bank transactions, alerts, notifications
  • May be sent any time of the day
  • May be sent to DND (Do Not Disturb) numbers

Promotional SMS (text) Regulations

  • Send any marketing/promotional content
  • Can be sent only between 9 am and 9 pm
  • Cannot be sent to DND numbers