I keep seeing "AI receptionist" thrown around without anyone explaining what's actually happening under the hood. Here's a technical breakdown of how the call flow works for dental practices.
The 6-Step Pipeline
1. Call Routing (0-2s)
Standard SIP forwarding. Three modes: primary (AI first), overflow (human first, AI fallback after 3-4 rings), after-hours only. No hardware needed at the practice.
2. ASR — Speech Recognition (Real-Time)
Converting speech to text at 95-97% accuracy. The tricky parts:
- Regional accents (Irish English has significant variation between Dublin, Cork, rural)
- Domain-specific vocabulary ("periapical abscess", "composite veneer", "occlusal splint")
- Noisy environments (caller in car, on street)
- Interruptions and corrections
3. Intent + Entity Extraction (50-200ms)
LLM processes the transcript and determines:
- Intent: book, cancel, reschedule, ask question, report emergency
- Entities: dates, dentist preferences, treatment type, patient name
- Sentiment: calm, anxious, in pain
Example input: "I was in last week for a filling and it's still quite sore"
→ Intent: post-treatment concern (triage trigger)
→ Entities: patient context (recent filling), symptom (pain)
→ Action: run emergency triage protocol
4. PMS Query (200-500ms)
This is where it gets interesting. The AI connects to practice management systems (Dentally, SOE, Exact, Carestream) via API and:
- Queries real-time appointment availability
- Respects booking rules (appointment types, durations, provider assignments)
- Checks patient records (returning patient? usual provider?)
- Applies business logic (new patients get 45-min slots, emergencies get same-day)
The appointment is booked and in the diary before the call ends. No "someone will call you back."
5. Response Generation (100-300ms)
LLM generates contextual response → TTS with natural prosody. Modern TTS includes pauses, intonation, even filler words ("let me check that for you").
6. Conversational Loop
Steps 2-5 repeat. Full context maintained throughout. Handles topic switches, corrections, multi-part requests.
Total per-exchange latency: 400ms-1s.
What's Automatable vs. What Needs Humans
~75% of dental practice calls follow predictable patterns: booking, confirming, rescheduling, directions, insurance queries, treatment FAQs. All automatable.
The remaining 25% (emergencies, complex treatment discussions, complaints, billing disputes) get warm-transferred with a conversation summary. Patient never repeats themselves.
The Security Stack
For health data:
- AES-256 at rest, TLS 1.3 in transit
- EU data centres only (GDPR)
- Configurable retention (default 90 days, auto-delete)
- No model training on patient data
- DPA and DPIA support
Interesting Stat
92% of callers don't realise they're talking to AI. Average AI call: 2:15 vs human: 3:40 — AI is faster because it has instant PMS access.
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