The 3 Automations Chiropractic Offices Build First
Most chiropractic practices that start automating want to solve three things: patients who book and don't show up, patients who responded well to care and then disappeared, and happy patients who leave without being asked for a review. Each of these is a rule-based, repetitive workflow — exactly the kind of thing automation handles better than any staff member can at scale.
1. Appointment Reminder Sequence
A 12–18% no-show rate is not unusual for a chiropractic practice. At $65 average visit value and 120 appointments per month, a 12% no-show rate wipes out $936 per month in scheduled revenue — money that was already on the books. The patients intended to come. They just didn't get the right prompt at the right time.
Manual reminder calls are slow and inconsistent. A front desk coordinator handling check-ins, phones, and checkout at the same time cannot reliably place 14 reminder calls a day without gaps. Automation runs the entire sequence without touching staff time — and the volume stays unlimited regardless of how full the schedule gets.
The 3-touch reminder sequence: A confirmation SMS the moment the appointment is booked. A 48-hour reminder with a one-tap confirm or cancel option. A same-day text 2 hours before the visit. Cancellations that come in early enough are automatically flagged so the front desk can offer the slot to a patient on the waitlist — turning a cancellation into a same-day booking rather than lost production.
How chiropractic appointment reminder automation works:
Step 1 Appointment booked in ChiroTouch or Genesis Chiropractic Software → Step 2 Confirmation SMS sent immediately with date, time, and location → Step 3 48-hour reminder sent with one-tap confirm or cancel option → Step 4 Same-day reminder sent 2 hours before the appointment → Step 5 Cancellation received → front desk notified automatically → waitlist patient offered the slot
2. Patient Reactivation Campaign
Most chiropractic practices have a reactivation opportunity sitting in plain view: 200–400 patients who have not visited in 90 or more days. These are not strangers. They came in, got care, and drifted — a busy schedule, a resolved symptom, a lapse in insurance, or no prompt to return. A structured outreach sequence brings a meaningful share of them back with no additional ad spend and no new patient acquisition cost.
The key design rule is that the sequence stops the moment a patient responds or books. Nobody gets a sixth message if they already booked after the first. The outreach is spaced far enough apart — over six weeks — that it reads as a genuine care touchpoint, not spam. Done right, reactivation campaigns average 8–12% conversion from the lapsed list. On a list of 300 patients, that is 24–36 rebooked visits from a single campaign run.
The math on reactivation: 300 lapsed patients at a 10% reactivation rate is 30 rebooked visits. At $65 average visit value, that is $1,950 recovered from one campaign. Most practices run this continuously — new patients who hit the 90-day threshold enter the sequence automatically, so the list never goes stale and the revenue recovery compounds over time.
Step 1 Patient identified as 90+ days since last visit in ChiroTouch or Genesis → Step 2 Wave 1: SMS or email sent at day 1 of sequence with personalized message and direct booking link → Step 3 Wave 2: Follow-up message sent at week 3 if no response or booking → Step 4 Wave 3: Final outreach at week 6 → Step 5 Patient responds or books → sequence stops automatically → Step 6 Non-responders tagged for manual review or archived after wave 3
3. Post-Visit Review Request
Google reviews are the most visible trust signal for a chiropractic practice. A prospective patient searching "chiropractor near me" will click the practice with the most reviews and the highest rating before anything else — website quality, location, ad spend. A practice at 4.8 stars and 180 reviews beats a competitor at 4.1 stars and 22 reviews almost every time.
The problem is not that patients are unwilling to leave reviews. Most happy patients say they will — then forget by the time they get home. The ask at checkout is easy to nod at and easy to let slip. Automated review requests sent 2 hours after the visit, while the experience is still fresh, produce far higher follow-through than any in-person ask. Well-run review request automation generates 20–40 new Google reviews per month for active practices — with no action from the front desk.
The routing logic: Not every patient who receives a review request should be sent directly to Google. The automation first sends a satisfaction check. Patients who respond positively get a direct link to the Google review page — frictionless, one tap. Patients who express any dissatisfaction are routed to a private feedback form instead, giving the practice an opportunity to address the concern before it becomes a public one-star review.
Step 1 Visit marked complete in ChiroTouch or Genesis → Step 2 2-hour delay (patient has had time to get home and settle) → Step 3 Satisfaction check SMS sent: "How was your visit with us today?" → Step 4 Happy patients routed directly to Google review link → Step 5 Unhappy patients routed to private feedback form → practice receives alert to follow up
Tools Chiropractic Offices Use for Automation
Chiropractic automation builds on top of the practice management software the office already uses. There is no new system to learn, no new platform to log in to, and no migration of patient records. The automation layer connects the existing tools — reading appointment and visit data to trigger the right message at the right moment.
The automation engine — n8n or Make, depending on the practice's existing setup — monitors appointment and visit records, evaluates conditions (is this patient 90 days lapsed? did this visit just get marked complete?), and fires the appropriate action. Everything runs on your own accounts and infrastructure. No new vendor relationships, no recurring platform fees to Aplos AI.
What the Numbers Look Like
Here is what the three core chiropractic automations look like on paper for a practice running 120 appointments per month at a $65 average visit value.
No-show recovery: A 12% no-show rate on 120 monthly appointments is 14.4 missed visits — call it 14 — costing $910 per month in scheduled revenue that never materializes. Automated reminders consistently reduce no-show rates by 30–50%. Recovering even 6 of those 14 visits per month puts $390 back on the schedule every month, from a one-time build investment.
Reactivation revenue: A lapsed patient list of 300 at an 8% reactivation rate is 24 rebooked visits. At $65 per visit, that is $1,560 recovered from a single campaign cycle — and the campaign runs continuously, pulling in new patients at the 90-day threshold automatically. Over 12 months, the compounding effect of continuous reactivation at even modest conversion rates significantly outpaces the one-time build cost.
Review volume: A practice running 120 visits per month that implements automated review requests typically generates 20–40 new Google reviews per month, assuming a 17–33% response rate among happy patients. At 30 new reviews per month, a practice goes from 40 reviews to 400 reviews in under a year — changing its competitive position on local search without any additional marketing spend.
| Automation | Estimated Hours | Flat-Rate Range |
|---|---|---|
| Appointment Reminder Sequence | 20–30 hrs | $3,000–$4,500 |
| Patient Reactivation Campaign | 30–45 hrs | $4,500–$6,750 |
| Post-Visit Review Request | 20–25 hrs | $3,000–$3,750 |
Every build at Aplos AI is scoped in hours before we start, at a flat rate of $150/hr. No hourly billing surprises mid-project. No ongoing monthly retainer. You pay once for the build and own it outright.
HIPAA Considerations for Chiropractic Automation
HIPAA compliance matters in healthcare-adjacent automation. It's worth being precise about what these automations actually do — because the answer is narrower than most chiropractors assume.
What these automations handle: Scheduling and communication workflows only. Appointment reminders, reactivation outreach, and review requests contain no protected health information. A reminder SMS says "Your appointment is tomorrow at 2:00 PM" — not "Your lumbar disc herniation treatment is tomorrow at 2:00 PM." No diagnosis, no treatment notes, no clinical data, no billing codes are included in any automated message. The automation reads appointment timestamps and visit-complete flags, not clinical records.
Before any build begins, we review the specific data handling approach with each client to confirm the workflow meets HIPAA requirements. The automation engine runs on your infrastructure, so patient scheduling data stays within your own systems rather than passing through a third-party platform. Your patient data does not flow through tools you did not explicitly approve.
If your practice uses a Business Associate Agreement with Twilio for SMS (which is available and standard for healthcare SMS use cases), that is reviewed as part of the pre-build scoping conversation as well.
Deep Dive: Chiropractic Practice Automation Services
This article covers the three automations chiropractic offices build first. Our full chiropractic automation services page goes deeper on scope, what a complete stack looks like for solo practices versus multi-location groups, integration notes for ChiroTouch and Genesis, and how the delivery process works from signed scope to live automation.
Read the full chiropractic automation services page →
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