Long Codes add Security to Patient Communications

Major cell phone carriers have observed the abuse of short codes for spam, scams and theft. Carriers are implementing new measures to minimize this risk to their wireless users, including the broad adoption of unique, registered long codes. Learn how healthcare entities and their patients will benefit from the switch... 

May 27, 2021

As some of you may know, the Intrado HouseCalls platform was developed and made available in 1992. The telephone was king and the platform allowed healthcare agencies, for the first time, to automate voice mail messages to their patients. Fast forward 20 years and SMS text messaging is the most widely used one-to-one communication channel in our industry. SMS created new opportunities in patient communications including chat and closed-loop scheduling via text messaging.

According to a study performed by SMS Comparison, “95% of text messages are opened and responded to within three minutes of being delivered.” This data suggests that text messaging is a preferred form of rapid response communication for smartphone users. While many businesses have found useful ways to automate text messages, others have found ways to abuse text message automation - think scams and schemes that result in monetary and identity theft.

Curbing Short Code Spam, Scams and Theft

The major carriers including Verizon, AT&T, Sprint and T-Mobile have observed the abuse of short codes and are implementing new measures to minimize this risk to their wireless users. One of the new standards affecting Intrado healthcare platform users is the broad adoption of unique, registered long codes.


Short Code

Long Code


≈100 SMS/second

≈1 SMS/sec

Can it be blocked or filtered by cell carriers?



Inbound/Outbound Traffic Ratio




Separate code required


Voice Call Capable




A2P (application-to-person) bulk communications, e.g., marketing campaigns, alerts, confirmations, two-factor authentication

P2P (person-to-person) two-way communications, e.g., group messaging, peer-to-peer apps, agent-to-person apps


Historically, long code numbers were not as widely used since the sending throughput was not as high as short codes However, work is underway to improve long code transaction rates.

Short Codes versus Long Codes for Patient Communications

Since multiple users share the short code, it only takes one case of fraudulent use to affect numerous other users. This makes it difficult for carriers to weed out the good from the bad without adversely impacting customers. With little way to determine the user and the intent, companies resort to blacklisting the short code, thereby halting communication for all related code users.

For example, Intrado may have more than ten thousand healthcare customers using one shared short code for patient communications. Our customers are using the short-code numbers correctly. However, due diligence requires that cell phone carriers perform audits on all use of that short code to verify there isn’t any fraudulent use by another entity. If they find fraudulent use, all communication from that short code can be “blacklisted,” halting all future communication. This would be detrimental for our healthcare customers and their patients.

The method now preferred by carriers will be to restrict use of shared short codes. Instead they will require vendors, including Intrado, to set up customers with their own unique 10-digit long code number. Brand registration will help cell carriers verify use of the long code numbers and reduce the risk of the number being flagged as spam.

What are the Benefits of Switching to Long Codes?

In addition to meeting the new compliance standard, there are benefits to using a unique long code number for patient communications.

  • Multiple long code numbers can be assigned to your organization to differentiate locations or departments.
  • You can use the same number for both text messages and voice notifications.
  • It will be easy to set up and deliver custom messages to your patients for opt-in, opt-out or help replies.
  • Coming soon! Customers will automatically see your company name and/or logo on incoming call and text alerts and log:

What Does This Mean for Intrado Customers?

If you are a customer currently utilizing a shared short code via one of our healthcare notifications platforms, we will contact you about setting up your unique long code number. This new unique long code will be used for all future SMS text messages sent from your organization through the Intrado platform. There will be no work required from you other than notifying your patients to expect future notifications from the new number.


Ready to Learn More About Maximizing Your Patient Engagement Efforts?

Intrado's patient engagement platform helps healthcare teams fully leverage patient-preferred communications channels for automated, secure and timely broadcast, chat, appointment scheduling and care management needs.

Interested in learning more?

Request a demo today!

Request a Demo