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Who covers SMS notification costs in appointment software, and should it be a separate line item on the quote?

YYavuz S***MemberCommunity member
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#1

We're a dental clinic in Kadıköy with four specialist doctors. A few months ago we shook hands with a software agency to build a patient tracking and appointment management system. During the proposal stage, we discussed that SMS notifications for appointment booking 24-hour confirmations and 2-hour reminders would be included in the software. The agency quoted 65.000 TL for development and initial setup, which we approved and kicked off.

The system has been live for two months. We handle an average of 1,200 appointments a month; between confirmations cancellations and reminders, we send over 3,000 text messages monthly. Yesterday, the agency billed us an extra 1.800 TL for SMS sender ID setup and credit consumption. We assumed this operational expense was covered by maintenance and system costs, but the agency claims it's a variable carrier expense.

In appointment projects like this, who is typically supposed to bear SMS notification expenses? How should this cost have been defined as a distinct line item in the proposal and contract phase so neither the clinic nor the agency runs into friction?

OOnur A***Member
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Most Helpful#2

Short answer: Since SMS notification costs are direct carrier usage fees, they always belong to the business receiving the service; they aren't bundled into development or maintenance fees. However, the agency should have clearly presented this as a variable cost in the quote and set up the messaging account directly under your name.

In software development, licensing/development and variable infrastructure usage are strictly separated. External API usage like SMS, email, or map services incurs charges based entirely on volume. The agency's biggest mistake here was failing to distinguish the technical capability of SMS integration from the ongoing credit consumption cost during the proposal stage.

The proper workflow is for the agency to only code the API connection. Registering the sender ID (originator) and purchasing bundles should be handled directly with an authorized bulk SMS provider under your clinic's official documents and tax certificate. That way, the agency steps out of the loop, invoices are issued directly to your business, and you manage credits on your own.

To keep costs under control, I suggest setting up tiered notifications in the software. If you send initial confirmations and appointment details for free via email or messaging apps, and only trigger an SMS for patients who haven't confirmed 2 hours before their visit, you'll cut your message volume in half.

MMerve T***ExpertCommunity member
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#3

Stop paying SMS invoices to the agency right away. Open a business account directly with a bulk SMS gateway using your own tax registration, hand over the API keys to your developer, and have them connect the system to that account. Buying bulk bundles without an agency markup will immediately bring costs down.

AAli T***MemberCommunity member
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#4

At our beauty salon, we send out 4,000 SMS messages a month. In the beginning, we were paying 60 kurus per message through an agency, which came out to 2,400 TL a month. We signed an annual contract directly with the carrier for a 50,000-message bundle, and our unit cost dropped to 24 kurus. We ended up saving over 15,000 TL a year.

EEmre A***MemberCommunity member
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#5

Does the quote you signed say 'SMS module included' or 'SMS delivery packages included'? If it only mentions module development, the agency might be technically right, but invoicing you without ever mentioning sending volumes doesn't sound like good faith.

MMeryem A***Expert
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Doki · Brand identity · 2026

#6

To avoid unexpected costs in a software proposal, three distinct line items must be clarified: 1) One-time fee for software development and integration, 2) Fixed monthly maintenance fee for server hosting, security patches, and tech support, 3) Third-party operator expenses tied directly to consumption, such as SMS, WhatsApp API, and maps.

MMert D***MemberCommunity member
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#7

we got the exact same surprise our first month so we had them tweak the system right away. confirmation goes out by email, sms only goes to no-shows... anyone sending 3,000 sms can easily drop the bill down to 1,000.

edit: I wrote something wrong above, sorry about that.

YYavuzExpert
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#8

Under current regulations, the SMS sender ID must be registered directly under your healthcare facility's legal title and tax identification number. Having the agency send SMS on your clinic's behalf via their own commercial account could create administrative liabilities during İYS (Commercial Electronic Message Management System) and data protection audits.

NNeslihan E***Member
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Doki · Corporate website · 2023

#9

Billing 1,800 TL for 3,000 SMS messages is quite steep compared to market rates. That works out to 60 kuruş per message, which is well above current corporate tiers. The agency is probably slapping a hefty markup or management fee on top of the actual usage costs.

KKaan B***Member
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#10

can't we just hook up the clinic's existing unlimited mobile plan to a device and send these automated alerts via software without using an intermediary carrier is that not technically feasible?

GGizem Y***Expert
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#11

Let me speak from the other side; I'm on the supplier side. If code ownership isn't in the contract, you have no bargaining power when leaving.

BBeyza K***Member
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#12

I completely agree. anyway when making a decision first look at what data you have on hand.

Implementing a change request process doesn't slow things down it speeds them up. like just leaving this note, it might be useful.

SSerkan A***Member
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#13

Saved.

KKadir A***MemberCommunity member
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#14

It's rare to find an explanation this clear.

MMerve K***Member
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Doki · Infrastructure migration · 2026

#15

I went through the same thing.

MMerve Ö***MemberCommunity member
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#16

Could you elaborate on that? Don't hesitate to ask; those who don't ask always pay more.

Just leaving this note, it might be useful.

AAli O***Member
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#17

Good call starting this thread.

MMustafa U***Member
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#18

There's one point I'm curious about. Taking notes for two weeks yields better results than a six-month estimate.

This is my opinion, I'm not claiming it's absolute truth.

KKadir K***VeteranCommunity member
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#19

We need to take it step by step. Every "we'll look at it later" in a meeting means unbilled work.

Proven by experience.

HHalil A***MemberCommunity member
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#20

The discussion got scattered, let me summarize. Mistakes made on the appointment SMS notification cost side are usually reversible but expensive.

Trying to do this alone is the most expensive way. If I were you, I'd go this route.

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