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Twilio (Texting Phone Number) - Integrations

Set up your Twilio texting line and complete A2P registration to ensure uninterrupted patient messaging in ChiroHD.

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📝 Overview

Welcome to the Twilio integration process! This guide will walk you through everything you need to know to successfully set up Twilio for your business, ensuring compliance with regulations and smooth messaging operations.


🔗 Why Twilio Integration is Important

Twilio is our texting provider, enabling you to send messages through ChiroHD. However, phone carriers such as Verizon, AT&T, and T-Mobile have filtering mechanisms that may block unregistered business numbers. To prevent this, businesses must complete an A2P (Application-to-Person) registration. This registration informs carriers that your number is legitimate and should not be marked as spam.

Failure to complete the A2P registration will result in the inability to send texts.


🛠 Step 1: Setting Up Your Twilio Number

  1. Log into Your ChiroHD Account.

  2. Navigate to: Settings > Initial Setup > Integrations > Twilio.

  3. If billing setup is required, contact your Onboarding Specialist to link your Stripe account.

  4. Once billing is initiated, return to the Twilio integration screen.

  5. Click Find Number and Area Code to search for a business texting number.

    • If your preferred area code isn't available, try again later as availability changes.

    • Note: ChiroHD does not control phone number availability; Twilio provides these numbers.

  6. Select and purchase your desired number.


📝 Step 2: Completing the A2P Registration

  1. After purchasing the Twilio number, click A2P Registration.

  2. Fill out business details exactly as registered with the IRS, including:

    • Business Name

    • Tax ID Number

    • Address

  3. Mismatched information will result in denial and delay the process.

  4. Submit the registration and wait for Twilio’s approval. (This may take weeks.)


💲 Step 3: Understanding Twilio Fees

  • A2P Registration Fee: $45 (one-time)

  • Monthly Twilio Fee: $10 per texting line

  • Per Text Message: $0.125

These fees are billed by Twilio and appear on your ChiroHD invoice without any markup.


🔧 Step 4: Managing Your Twilio Account

Once your A2P registration is approved:

  • Your Twilio number will be locked in. Do not release it without contacting ChiroHD support.

  • Incoming calls to this number will play an automated message.

  • Customize your auto-reply in Settings > Twilio Integration.

    Suggested message:
    “This number is for text messages only. Please call our office at [your main office number].”


📊 Step 5: Viewing Your Invoice and Texting Usage

  1. Log into ChiroHD.

  2. Click your name in the top-right corner > Subscription.

  3. Under View/Pay Invoice, click View Invoice Payment Details.

Your invoice will show:

  • Number of texts sent

  • Per-message rate

  • Total texting cost

  • Monthly Twilio fee ($10)

  • A2P registration fee ($45, one-time)


⚠️ Important Reminders

  • A2P registration is required by government regulation.

  • Ensure IRS-registered business information is entered accurately.

  • If A2P is denied, you must resubmit to gain texting access.

  • Once completed, you can begin sending texts through ChiroHD.

If you already have an existing Twilio number, it cannot be used with ChiroHD. To ensure proper functionality for patient communication and text reminders, you must complete the process outlined above to obtain and configure a dedicated Twilio number through ChiroHD.


✅ Key Takeaways

  • Twilio is the texting provider for ChiroHD; setup is required before use.

  • A2P registration is mandatory to avoid message blocking by carriers.

  • Costs include a one-time $45 A2P fee, a $10 monthly fee, and $0.125 per message.

  • Custom auto-replies can be configured for incoming calls to your Twilio number.

  • Setup must be done with accurate IRS business information.

  • All texting charges will be reflected on your ChiroHD invoice.


📌 Conclusion

Properly integrating Twilio and completing your A2P registration is essential for reliable patient communication through ChiroHD. Following these steps ensures your text messages are delivered without interruption or carrier filtering. Be proactive with registration and invoice monitoring to stay compliant and maintain seamless operations.

Need help? Contact your ChiroHD Onboarding Specialist for one-on-one support.

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