Glossary
A2P 10DLC for Healthcare Practices
A2P 10DLC is the US carrier registration system for application-to-person (A2P) SMS sent from 10-digit long codes (10DLC). Required for any business texting patients from a regular phone number.
Until 2021, businesses could send texts from regular phone numbers without registration. Now US carriers (T-Mobile, AT&T, Verizon) require every business sender to register its brand and use cases through The Campaign Registry, or messages get filtered/blocked and per-message surcharges apply.
Why it exists
Spam and scam SMS exploded. Carriers needed a way to identify legitimate business traffic and price/throttle it differently from junk. A2P 10DLC is the answer — register your brand, declare your use cases, pay a small monthly fee per campaign.
What practices need to do
(1) Register the brand with The Campaign Registry, (2) register one or more campaigns (appointment reminders, marketing, etc.) with sample messages, (3) wait for vetting and approval (days to weeks), (4) then send.
Common rejections
Vague sample messages, lack of opt-in disclosure, mismatched website-vs-DBA, missing privacy policy, no SMS terms page, opt-out language not in samples. Healthcare-specific: be careful not to imply you are sending PHI over SMS in your sample messages.
Who handles it
If you use a modern texting vendor (PatientCopilot, Twilio, Telnyx via a vendor), they typically file the registration on your behalf. DIY through The Campaign Registry is possible but tedious. Either way, the practice owns the brand registration.
Related reading
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