SMS providers and fallback
Connect your own SMS carriers, set which ones are used in each country, and see exactly what was sent.
SMS providers and fallback
MediSync sends SMS through providers (carriers such as Twilio, Vonage, or SMS Misr). You can use the ones MediSync provides, connect your own account, or mix both — and you can tell MediSync which providers to try, in which order, for each country you message.
SMS is a paid module. Turn it on in Settings → Modules first. You are billed per message segment, not per message — a long message is split into several segments by the carrier and costs more.
Do I need to do anything?
No. If you leave this alone, MediSync sends your appointment reminders through its own providers and bills you per segment. Everything below is optional.
You would set up your own provider if you want to:
- Use your own carrier contract — you may have negotiated cheaper rates.
- Send from your clinic's name instead of a shared number (a "sender ID").
- Use a local carrier, which is usually cheaper and more reliable for numbers in your own country.
Adding your own provider
Go to Settings → SMS → Providers and choose Add provider.
Pick your provider from the list and fill in the credentials it asks for. The form changes per provider — Twilio wants an Account SID and Auth Token, Vonage an API key and secret, and so on. You will find these in your provider's own dashboard.
Then press Test connection. This checks your credentials with the provider without sending anything. If it fails, the error from the provider is shown so you can see exactly what is wrong.
Finally, Send test message sends a real SMS to a number you choose, so you can confirm it arrives and looks right. Test messages are not billed to your usage allowance.
Your credentials are encrypted and are never shown again after you save them — not to
you, not to MediSync staff. You will only see the last four characters, like ••••9876.
If you lose them, get new ones from your provider and paste them in again.
Editing a provider without retyping the secret is safe: leaving the field blank keeps the saved value.
Fallback: what happens when a provider fails
A chain is the list of providers MediSync tries for one country, in order.
If the first provider fails — it is down, it rejects the message, or it simply does not answer — MediSync automatically tries the next one. Your patient still gets their reminder.
Set this up in Settings → SMS → Routing:
- Choose a country (or Any country, which is used when a country has no chain of its own).
- Add the providers you want, and use the ▲ ▼ arrows to put them in the order you want them tried.
- Optionally set a sender ID per provider for that country — many countries require a sender name to be registered with the carrier in advance.
A typical Egyptian clinic sets Egypt to SMS Misr, then Twilio: the local carrier is cheaper, and Twilio is there so nothing is ever lost if SMS Misr has a bad day.
When your providers all fail
By default, if every provider in your chain fails, MediSync falls back to its own providers so the message still gets through. You are billed for it as normal.
If you would rather a message simply fail than go out through a carrier you did not choose, turn off Fall back to MediSync providers in Settings → SMS.
When a provider is failing repeatedly
If a provider keeps failing, MediSync stops trying it for a while instead of making every message wait for it to time out. It is retried automatically once it has had time to recover. You will see it marked as Paused in the providers list, with the time it will be tried again.
Some failures pause a provider immediately, because retrying cannot help: a wrong API key will not start working, and an empty balance will not refill itself. Both show a clear reason in the list.
What is not retried
Some failures are the number's fault, not the provider's, so MediSync does not try another carrier — it would fail in exactly the same way and cost you money:
- The number is not a valid mobile number.
- The person has replied STOP and opted out. MediSync will not message them through another carrier; doing so would breach the rules you both agreed to.
These appear in the log as failed, with the reason.
The message log
Settings → SMS → Log shows every message, newest first: who it went to, whether it was delivered, which provider carried it, and what it cost.
Open a message to see its full history — including any providers that were tried and failed:
Twilio — rejected (500 server error) Vonage — accepted → delivered
This is the first place to look when someone says a patient did not get their reminder.
"Delivered" vs "Sent"
- Sent — the provider accepted the message.
- Delivered — the carrier confirmed it reached the phone.
Not every provider reports delivery back to us. Messages sent through AWS SNS stay at Sent forever — SNS does not tell us what happened afterwards. That is normal and does not mean the message failed.
If a carrier tells us a message it accepted was not delivered, MediSync automatically tries the next provider in your chain.
Message text is removed after 90 days
The text of each message is deleted after 90 days and shown as redacted, because it usually contains patient details. Everything else — when it was sent, whether it arrived, which provider, and what it cost — is kept, so your records and invoices stay complete.
Spend
Settings → SMS → Spend shows the last 30 days: how many messages were sent and delivered, how many segments they used, and what they cost.
The cost shown here is what the carriers charged, which can be slightly more than what you are billed — some providers charge for a message even when they reject it. Your invoice only ever counts messages that were actually sent.
Running out of allowance
Your plan includes a number of message segments per month. By default, if you go over, messages keep sending and the extra is added to your invoice — we would rather your patients get their reminders than have them silently stop.
If you would rather sending stop when you hit your limit, turn on Enforce hard cap in Settings → SMS.