Insurance and fee questions come in constantly, and they're easy to answer wrong.
Where it breaks down:
The same questions come in all day: do you take my plan, what does a cleaning cost?
Staff repeat the same answers between patients.
Answers differ depending on who picks up.
Patients get mixed messages about what they'll pay.
Coverage questions are really questions for the insurer.
Staff spend time explaining what they can't promise.
We drew the line first: what the agent may say, and what it must never say.
- Accepted plans and posted fees are facts the practice already knows and can approve.
- What a plan will pay for a specific patient is the insurer's call, not the practice's and not an agent's.
- A treatment cost depends on a treatment plan that only your clinical team can produce.
The agent had to:
- Answer only from information you've approved.
- Never promise coverage or quote a treatment cost.
- Hand off cleanly when the question goes past that line.
A RevAIvo Voice agent scoped to the plan and fee information you provide.
Approved answers only
Responds from your accepted-plan list and posted fees. If it hasn't been approved, the agent doesn't answer it.
No coverage promises
Never says what a plan will pay and never makes a coverage determination. It says so plainly and offers a callback from your team.
No treatment quotes
Treatment costs depend on a treatment plan, so those go to your team.
Context carried over
The plan and the question are captured before the handoff, so the patient doesn't repeat them.
It brings in your team when…
Scoped narrow on purpose. Where you've set a number it can connect the caller; otherwise it logs a callback request for your team.
- The caller asks what their plan will pay.
- The caller asks the cost of a specific treatment.
- The question is clinical, or about a diagnosis.
- The caller asks for a person.
What the call sounds like
Hi, do you accept Harbor Dental PPO?
Let me check our accepted-plan list. Yes, Harbor Dental PPO is on it.
Great. Will it cover my crown, and how much will I pay?
I can't say what your plan will pay or quote a treatment cost, because that depends on your plan and your treatment plan. Our team can walk you through it, so I'll log a request for them to call you, with your plan noted.
Okay, thanks.
You're welcome. When we hang up, I'll email you our list of accepted plans, and our team will call you about your coverage question.
Sent after the call
Thanks for calling Maple Street Dental. Here is our list of accepted plans: maplestreetdental.example.org/plans. We've passed your question about coverage and treatment costs to our team, and they'll follow up with you.
Message wording is illustrative and deliberately minimal: no health details. It goes out when the call ends, based on how the call went.
What changes for your team
An illustrative scenario:
Say your team handles 300 insurance and fee calls a month, and the agent takes 40% of them end to end, at an assumed 5 minutes a call. These figures are assumptions for illustration, not customer results.
In a pilot we measure this with you, on your own calls in RevAIvo Pulse: calls connected, how each call ended, and how many needed a callback.
The simple questions answered the same way every time, and anything about coverage or cost passed to your team.
Insurance and fee calls handled within a line you draw.