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No-show rate dropped from 18% to 7.4% in 60 days.
18% → 7.4%
No-show rate
~$400/day
Revenue recovered
70%
Front desk calls reduced
The front desk at this 3-location group was spending 2–3 hours a day calling to confirm appointments. Half those calls went to voicemail. No-shows were running at 18%, costing the practice an estimated $400 a day in lost chair time at their busiest location. The reminder system was a combination of manual calls and a sticky note on someone's monitor.
We built a two-way SMS confirmation system using n8n and Twilio, connected directly to Dentrix. Patients receive a reminder 24 hours out, a second reminder 4 hours before, and a reply prompt for both. 'Yes' confirms and updates the schedule. 'No' cancels and triggers a waitlist notification. No reply after the second SMS creates a follow-up call task for staff — but only after the automation loop runs. Day-of no-shows trigger a rebooking text the following morning.
No-show rate dropped from 18% to 7.4% within 60 days. At 30 patients per day and roughly $350 average procedure value, that's around $350–500 recovered per day in chair time that would otherwise sit empty. Front desk call volume dropped by about 70% — that time went back to actual patient interaction.
Appointment created or modified in Dentrix triggers the n8n workflow automatically.
24-hour reminder SMS sent via Twilio with appointment time, location, and a reply prompt.
Patient replies Y or N. Confirmed appointments update status in Dentrix. Cancellations trigger waitlist notification.
No reply by 8 hours before triggers a second SMS.
Still no reply: front desk gets a task card with the patient's name and phone number.
4-hour reminder sent to all confirmed appointments with parking and directions link.
Day-of no-shows trigger a rebooking text the next morning.
Three no-shows in 12 months flags the patient for staff review before their next booking.
Timeline: 3 weeks
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