> ## Documentation Index
> Fetch the complete documentation index at: https://docs.routiq.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# Appointment Confirmations

> Two-way confirmation requests. Patients reply YES / NO / RESCHEDULE — Robyn parses and acts. Free up cancelled slots for waitlist patients automatically.

<Info>
  **Why this matters.** Confirmations are different from reminders.
  Reminders nudge patients who already plan to attend; confirmations
  give patients an explicit early opportunity to cancel — converting
  silent no-shows into reschedulable slots. Combined with [waiting
  list backfill](/outbound/waiting-lists), confirmations recover the
  lost revenue that no-show metrics are trying to measure.
</Info>

## How it works

A few days before each appointment, Robyn sends a confirmation message:

* **Reply YES** → appointment confirmed, marked as confirmed in your PMS
* **Reply NO** → appointment cancelled, slot offered to waitlist
* **Reply RESCHEDULE** → Robyn opens a reschedule conversation, suggests new slots
* **No reply** → second confirmation attempt; after that, the patient is queued for a phone call from Robyn or your team

## How Robyn handles confirmations

<CardGroup cols={2}>
  <Card title="Smart reply parsing" icon="brain">
    Doesn't just match "yes" — handles "yep", "all good", "see you then", "👍", "I'll be there", and dozens of other affirmatives.
  </Card>

  <Card title="Cancellation cascade" icon="rotate-right">
    Patient cancels → Robyn marks appointment cancelled in PMS → checks waitlist → offers slot to first eligible patient.
  </Card>

  <Card title="Reschedule conversation" icon="calendar-arrow-right">
    Patient asks to move → Robyn pulls live availability and books the new slot in the same SMS thread.
  </Card>

  <Card title="Cancellation-window respect" icon="shield">
    If the cancellation falls inside your [cancellation window](/features/appointment-scheduling), Robyn applies your configured rule — block, warn-of-fee, or auto-DNA.
  </Card>
</CardGroup>

## What your patient sees

> **Robyn (SMS, 2 days before):**
>
> *Hi Sarah, just confirming your appointment Friday 9 May at 2:00pm with Dr Lin at Bondi Physio.*
>
> *Reply YES to confirm, NO to cancel, or RESCHEDULE to change.*

> **Patient:** Reschedule
>
> **Robyn:** No problem. Dr Lin has these times available:
>
> *• Mon 12 May, 10am*
> *• Tue 13 May, 2pm*
> *• Wed 14 May, 4:30pm*
>
> *Reply with the one you'd like.*

> **Patient:** Tuesday 2pm please
>
> **Robyn:** Done — moved to Tuesday 13 May at 2pm. You'll get a new confirmation closer to the date. Have a great weekend.

## Setup

<Steps>
  <Step title="Create a confirmation instance">
    **Outbound** → **Create Automatic Instance** → **Appointment Confirmations**.
  </Step>

  <Step title="Configure when to send">
    Recommended: 2-3 days before appointment (early enough to fill the slot from waitlist, not so early the patient forgets again).

    For high-value appointments (e.g. surgery prep), consider a second confirmation 24 hours out.
  </Step>

  <Step title="Customise the wording">
    Default message includes appointment time, practitioner, location. Edit to add anything specific — prep instructions, bring-this-with-you, COVID-screening question.
  </Step>

  <Step title="Set the no-reply fallback">
    What happens if the patient doesn't reply within 24 hours:

    * **Send a second confirmation** (default)
    * **Email the team for a manual call**
    * **Robyn calls the patient** (uses voice channel)
    * **Do nothing** — proceed assuming attendance
  </Step>

  <Step title="Configure cancellation cascade">
    When a confirmation reply is "NO":

    * **Mark cancelled in PMS** ✅ default
    * **Offer slot to waitlist** ✅ default (requires [waiting list](/outbound/waiting-lists) instance active)
    * **Apply cancellation-window rule** if inside the window
    * **Notify the team** for manual follow-up
  </Step>

  <Step title="Activate">
    Toggle to **Active**. Confirmations start firing for new and existing future appointments.
  </Step>
</Steps>

## Common questions

<AccordionGroup>
  <Accordion title="What's the difference between a reminder and a confirmation?">
    A reminder nudges; a confirmation explicitly asks. Reminders reduce forgetfulness no-shows. Confirmations recover slots from patients who weren't going to attend anyway. Most clinics use both.
  </Accordion>

  <Accordion title="What if the patient replies with something Robyn doesn't recognise?">
    Robyn falls back to a clarifying question: "Just to confirm — would you like to keep the appointment, cancel, or reschedule?" If still ambiguous, escalates to your team.
  </Accordion>

  <Accordion title="Will reschedules count against my no-show stats?">
    No — Robyn marks them as reschedules in your PMS, not cancellations or DNAs. Your reporting stays clean.
  </Accordion>

  <Accordion title="What if a patient replies hours after the appointment time?">
    Late replies are flagged for the team. The appointment is already past, so no automated action is taken — manual review.
  </Accordion>

  <Accordion title="Can I run confirmations only on certain appointment types?">
    Yes — same filter system as reminders. Most clinics confirm initial consults and high-value appointments, skip routine maintenance.
  </Accordion>
</AccordionGroup>

## Next

<CardGroup cols={2}>
  <Card title="Waiting lists" icon="hourglass-half" href="/outbound/waiting-lists">
    Auto-backfill the slots opened by confirmation cancellations.
  </Card>

  <Card title="Appointment reminders" icon="bell" href="/outbound/appointment-reminders">
    Pair confirmations with reminders for the full no-show-reduction stack.
  </Card>
</CardGroup>