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Does it write to your system, or just read from it?

This is the single most revealing question, and a lot of products fail it. Reading availability is easy. Writing a confirmed appointment back into Dentrix or Epic — respecting operatory constraints, provider rules, and appointment-type duration — is the hard part.

If the assistant only takes a request and emails your front desk to complete it, you have not automated anything. You have moved the work and added a step. Ask to watch an appointment appear in a live test system during the demo.

What happens on the calls it cannot handle?

No assistant handles everything, and any vendor claiming otherwise is selling you a future disappointment. What matters is the failure mode. Does it transfer to a human with context, or dump the caller into a queue? Does your staff hear a summary before they pick up, or start from scratch?

Ask specifically about emergency handling. The answer should involve an immediate live transfer on emergency language, with no triage attempt and no hold.

Ask for the BAA before you ask for the price

Any vendor touching PHI must sign a Business Associate Agreement. If that takes more than one email to obtain, treat it as a signal about how seriously they take compliance generally.

Be equally sceptical of the phrase "HIPAA certified". There is no certifying body for HIPAA, so the phrase is at best sloppy and at worst deliberately misleading. Ask instead: where is data stored, how long is it retained, who internally can access it, and is our data used to train shared models? The last one should be a firm no.

Listen to real recordings, not the demo reel

Every vendor has a polished sample. Ask for unedited recordings from a practice of your size and speciality, including calls that went badly. A vendor confident in their product will share the messy ones, because the recovery is the impressive part.

While you listen, time the pickup. Anything over three seconds feels like dead air to a patient, and the pause before each response matters more to perceived quality than the voice itself.

Understand the pricing shape, not just the number

Per-minute pricing aligns the vendor’s incentives against yours — they earn more when calls run long. Per-seat pricing punishes you for giving your team visibility. A fixed monthly fee tied to call volume is the cleanest structure, and ask directly what happens when you exceed it.

Insist on a real pilot

Start in overflow-only mode on a single location. Set a clear success measure before you begin — answer rate, bookings per week, staff hours recovered — and review the actual call transcripts weekly for the first month. A vendor who resists a scoped pilot is telling you something.