AI receptionist or answering service: which is right for your practice?
How to decide between hiring a virtual receptionist, signing up with a national answering service, or putting an AI receptionist on the line. Dollar-for-dollar comparison, plus the questions to ask before you commit.
By Cadence team
Every dental practice owner runs into the same wall around year two: the front desk can't answer 100% of calls during business hours, and the calls coming in after-hours go straight to voicemail. The math: 40% of new-patient calls go unanswered in a typical solo practice (per Patterson Dental's 2024 ops survey), and 65% of those callers don't leave a voicemail — they just call the next dentist on Google.
You have three options. Here's how they compare.
Option 1: Hire another receptionist
Median front-desk wage in the US is $19/hour. Add benefits, FICA, training time, and a no-show buffer for the new hire's own schedule, and you're at $54,000/year fully loaded for one full-time employee covering 40 hours. That doesn't cover lunch breaks, sick days, or after-hours. To cover 24/7 you're hiring 4-5 people.
It works. It's also the most expensive line item on a small practice's P&L. And turnover is brutal — average front-desk tenure in dental is 14 months.
Option 2: National answering service
Companies like Specialty Answering Service or Always Answer charge $0.95-$1.40 per call answered, with a $200-300/mo minimum. Operators pick up, follow your script, and dispatch to your front desk via SMS or email. Coverage is 24/7.
Where they fall short:
- Operators don't book — they take messages. Your front desk has to call patients back the next morning, and 30-40% of those callbacks go unanswered.
- Operators don't know your schedule. They can't check if you're open at 8am Saturday or if Dr. Patel is on vacation.
- Operators don't speak Spanish, Portuguese, or French (without paying ~3× more for a multilingual tier).
- Wait times during peak hours stretch to 2-3 minutes — long enough that callers hang up.
Option 3: AI receptionist
An AI like Eva picks up in <2 seconds, books against your live calendar, switches languages mid-call, follows your practice's exact intake script, and never calls in sick. $249-$599/month flat for the equivalent of a 24/7 receptionist that handles 200-2000+ calls per month.
What it can't do well:
- Complex insurance pre-authorization questions still warm-transfer to a human (your escalation phone). Maybe 5-10% of calls.
- Off-script conversations — angry patients, long stories about a tooth that broke 3 years ago. The AI listens and takes notes; a human follows up.
The decision framework
If you're seeing <30 calls/day and you have a stable front desk, an AI receptionist is overkill — focus on scheduling and confirmations instead. If you're seeing 50+ calls/day, growing, or losing patients to unanswered calls, the math is straightforward:
- Hire a receptionist: $54k/yr for 40-hr coverage.
- Answering service: $250-500/mo for 24/7 message-taking.
- AI receptionist: $250-600/mo for 24/7 actual booking.
At our most-popular pricing tier ($599/mo with 2,000 included AI minutes), Cadence customers report a payback period of 3-5 weeks from the calls that would otherwise have gone unanswered. Worth a 30-day trial.