> ## Documentation Index
> Fetch the complete documentation index at: https://docs.bilby.health/llms.txt
> Use this file to discover all available pages before exploring further.

# Patient replies and the SMS limit

> How replies reach the right patient, YES to confirm, cancel words, STOP and START, and the monthly SMS limit.

## Patient replies

> [!NOTE]
>
> Not every practice has this yet. Bilby turns it on for each practice. If you can't see it, contact Bilby support.

With SMS on, your practice has its own mobile number and patients can reply to your texts. Replies appear in **Messages** on the patient they belong to. Replies cost nothing.

If Bilby can't tell which patient a reply is from, for example when several patients share a mobile, everyone gets an Unmatched SMS reply notification. Check the number and follow up by phone if you need to.

### YES confirms the appointment

When **Reply YES to confirm** is on in [Settings › Reminders](https://docs.bilby.health/messages/reminders.md#reply-to-confirm), a patient can reply YES to their reminder. Bilby confirms the appointment, texts the patient back and lets your team know. A YES to any other text is just filed as a reply.

### Cancel words never cancel

A reply of NO or CANCEL never cancels an appointment, because a person should always decide. Bilby flags it as a cancellation request and notifies your team. Contact the patient, then cancel or move the appointment on the [calendar](https://docs.bilby.health/calendar/overview) yourself.

### STOP and START

A patient who replies STOP gets no more texts from your practice. Everyone at your practice with that mobile is opted out together, such as a family sharing a phone, and your team is notified. Replying START turns texts back on.

Staff can change this on the patient's record with **Allow SMS messages**. Only turn it back on when the patient asks you to.

## The SMS limit

> [!NOTE]
>
> Not every practice has this yet. Bilby turns it on for each practice. If you can't see it, contact Bilby support.

Your practice has a monthly limit on texts, and a long text counts as more than one. Admins are warned as you get close. At the limit, Bilby stops sending texts until next month, and reminders that would go by SMS are skipped. Emails still go.

To keep sending, subscribe on the Billing page if you're on a trial, or contact Bilby support to raise the limit.


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