Patient messaging & SMS
Fertiligent gives your clinic a single place to hold two-way conversations with patients — in the portal, over text (SMS), and from inbound email — with optional AI assistance that drafts replies for your team to review. This page covers how messaging works and how the AI fits into your day.
Conversations
Messages are organized into threads, so a conversation with a patient stays together over time. Within a thread your team can:
- send and receive messages, with file attachments;
- reuse templates for common replies, so answers stay consistent;
- see read status and who said what;
- send a bulk message to many patients at once (for example a clinic-wide notice).
Patients can reach your staff and admins; staff can message anyone. Everything lives in one inbox in the portal.
AI-assisted replies
When AI messaging is enabled, incoming patient messages can be analyzed and a suggested reply drafted for your team. The AI is built around a review queue and a simple risk assessment so a person always stays in control:
- Risk level. Each message is assessed as safe, needs review, or escalate. Anything sensitive is routed to a human rather than answered automatically.
- Review queue. Suggested replies land in a queue where staff can approve, edit and send, reject, re-run the analysis, or escalate to a colleague.
- Draft assist. Even outside the queue, staff can ask for a draft reply to a thread and edit it before sending.
- Pause per conversation. You can pause AI on any single thread — for example a delicate conversation you want to handle entirely by hand — and resume it later.
AI modes
How much the AI does is controlled per clinic by a mode:
| Mode | What happens |
|---|---|
| Off | The AI does no drafting; staff handle every message. |
| Review queue only | The AI drafts replies, but nothing is sent until a staff member approves it. |
| Safe auto-send | Low-risk, high-confidence replies can be sent automatically; anything else still goes to the queue or a human. |
Whichever mode you use, sensitive messages are escalated to a person, and every AI action is recorded so you can audit what happened.
Text messaging (SMS)
Patients can also reach your clinic by text, and the same assistant that answers your phone line handles the conversation. A few things are specific to SMS:
- Identity and consent come first. Before any personal health information is shared over text, the patient must both verify their identity (by date of birth) and give explicit consent to receive health information by text. A verified patient who hasn't consented gets a short message asking them to opt in — never their private details.
- Opting in and out. Patients can reply STOP to opt out at any time (which also withdraws their consent to receive health information by text) and START to opt back in. Replying HELP returns help text. These are handled automatically.
- Nothing gets lost. A text that doesn't answer an open question, and that the assistant isn't set up to hold a conversation about, still gets a courteous auto-reply pointing the patient to call or use the portal, rather than vanishing.
Asking a patient how they'd like to be reached
An outreach sequence can send a preference question: a confirmation that the clinic has received the patient's referral, followed by a short menu.
Reply 1 for text messages, 2 for email, 3 for a phone call, or 4 if you no longer wish to proceed. Reply STOP to opt out.
The patient can reply with the digit or in their own words — "text", "email" and "call" are all understood. A reply the assistant can't interpret gets a re-prompt offering the same options, never a different set. The stated preference is recorded against the prospect along with where it came from, so your team can see the patient chose it rather than a coordinator assuming it.
Your clinic authors the wording of this message. The meanings of the four options are fixed by the platform, so a reworded menu can't quietly change what "4" does.
How a patient withdraws
Withdrawal is deliberately harder to trigger by accident than an opt-out, because withdrawing means somebody has to tell the referring physician.
| What the patient sends | What happens |
|---|---|
| 4, while the preference question is open and it is the last step in the sequence | Recorded as a withdrawal. The prospect moves to Withdrawn, outreach closes, and any stated contact preference is cleared. |
| 4, while the question is open but further steps remain | Routed to a coordinator to handle, rather than closing the file automatically. |
| A withdrawal in their own words — "not interested", "stop contacting me" | Nothing is recorded. Outreach is put on hold so the patient stops receiving messages, and a coordinator is alerted to confirm. |
| 4, with no question open | Nothing is recorded. A lone digit only means "withdraw" in the context of the menu it answers. |
STOP is a carrier-level opt-out: it stops the texts. Option 4 is a care decision: the patient is telling the clinic they no longer wish to proceed with their referral. One does not imply the other, and they are recorded differently.
Your team can also send a text to a patient or prospect — for example a referral-received confirmation — from the portal, subject to the same consent rules. Text conversations are logged alongside calls, portal messages and email in the Conversations worklist, so your team reviews everything in one place — see Conversations.
Inbound replies are also written to the prospect's own timeline, so a coordinator looking at the record sees what the patient actually said rather than only that a reply arrived.
What the assistant can do over text
Over SMS the assistant runs the same AI as your phone line, with a tool set tuned for texting. Depending on what the patient needs — and, for anything personal, once their identity is verified and consent is on file — it can:
Answer and send information
- Answer questions about your clinic from your knowledge base — hours, location and directions, parking, services, pricing, and policies.
- Text a patient the public information they ask for, such as an address, how to prepare for a visit, or a public link. (Public info only — never private records or results.)
Book an intake call
- Find open appointment times and book a nurse intake call on the spot. See Intake nurse availability.
Help a verified patient with their own care
- Look up their upcoming appointments and the status of recent results.
- Check a referral's status, share the referred physician's current wait, and offer a shorter-wait alternative.
- Confirm an upcoming appointment, or request to cancel or reschedule one.
- Request to switch to the alternative physician it offered.
- Update a contact detail, or provide a missing referral detail (health card, email, or mobile number).
Always
- Capture a new inquiry as a prospect, with the patient's consent.
- Hand off to your team the moment something needs a person.
For anything that touches a patient's record or the calendar — a reschedule, a physician switch, a contact-detail change, a missing referral field — the assistant records a request or draft for your staff to review and apply. It never edits the record or moves the calendar on its own. The one exception is booking a nurse intake call, which is confirmed on the spot.
Availability
Messaging, AI-assisted replies, and SMS are each enabled per clinic. Because text messaging with real patients depends on identity verification, consent, and the required carrier agreements being in place, SMS is rolled out in a controlled way — ask your Fertiligent contact about enabling it for your clinic.
Related
- Voice phone assistant — the same assistant on the phone.
- Eva, the patient companion — chat on your website.
- Knowledge base — what the assistant draws its answers from.