Example: how a three-chair dental office would cover its phones

The situation in this example

Larkmoor Dental is a fictional three-chair general practice, built to show how the numbers work. It is owner-run, which is still how most dentists work: 72.5% of US dentists were private practice owners in 2023^[3]. The dentist works four and a half days, the hygienist runs the third chair, and two front-desk coordinators handle check-in, checkout, insurance and the phone. The phone report, invented for this example, shows about 150 inbound calls a week. That is roughly two calls for every patient visit, set against the 69.3 visits a week the average general dentist reported for 2025, hygiene appointments included^[1].

The coordinators are good on the phone when they are free. The trouble is the hours when they are not. At 8:05 one is checking in the first hygiene patient while the other sits on hold with an insurer. From noon to 1 the office closes for lunch and the line goes to voicemail. At 4:30 both are taking copays and printing treatment plans. In this example about 15% of calls go unanswered, roughly 22 a week, most of them in those three windows, plus evenings and Friday afternoons.

Hiring a third coordinator is the obvious fix and the hardest one. When the ADA Health Policy Institute asked dentists in late 2024 about their biggest challenge for 2025, about 62% named staffing shortages, the top answer^[4]. Receptionists in healthcare earned a median $19.00 an hour in May 2025^[5], and benefits made up 30% of private employers' compensation costs in June 2026^[6]. At that mix a $19.00 wage hour costs the practice about $27. The new hire would still take lunch at noon.

The calls that slip through are not random. New patients shop by phone, and the wait they hear once they get through has roughly doubled: general dentists reported an average 16-day wait for a new patient's first appointment in 2025, against 7.9 days in 2019^[1]. At the average general practice about two thirds of patients had private insurance in 2025^[1], so whether the office takes a given plan is the first question on many of those calls. Calling back from the voicemail list is a weak rescue: in a 2020 survey, eight in ten Americans said they generally do not answer cellphone calls from unknown numbers^[7].

How the calls would be handled

In the modelled setup the practice keeps its number and both coordinators. Its phone system forwards calls to an SI Employee in three situations: all through the lunch hour, after closing, and in office hours when every line is busy or a call rings four times unanswered. It can take several calls at once, so an 8 am pile-up does not end in a busy signal. Before the first forwarded call, the dentist and office manager sign off on five things:

• Approved answers: hours, parking, whether the practice is taking new patients, what a first visit includes, what to bring and the online scheduler address.
• The in-network plan list, word for word, with a line asking callers to confirm their own benefits with their insurer.
• Handoff rules: booking, moving or cancelling a visit, balances and anything about a specific patient stay with the coordinators. The caller hears when the desk is free and is not asked for details.
• One urgent number: a practice mobile the office manager carries in the day and the dentist takes home at closing. It has to be a separate phone: a transfer back to the main line, which is forwarding its calls on, would loop, so the system refuses it.
• Pain wording the dentist writes: no questions about symptoms, a transfer to the urgent mobile, and 911 for anyone describing trouble breathing or swallowing.

Pain calls are the ones the dentist worries about most. A toothache that never reaches a dentist can end up in an emergency room: tooth disorders accounted for about 1.94 million emergency department visits a year in 2020 to 2022^[8]. In this example nobody with a toothache hears voicemail. The call goes to the urgent mobile, whoever is carrying it, and the line never asks what hurts or how badly. If the mobile goes unanswered, the call comes back to the line, which apologizes and reads the fallback the dentist wrote.

Reschedules matter more than they look. A review of 105 studies of healthcare appointments put the average no-show rate at about 23%, and long lead time was one of the most commonly reported predictors^[9]. A patient who cannot get through to move a visit may simply not come. In the modelled setup those callers hear when a coordinator is free and get the online scheduler address, so the chair can be refilled before it sits empty.

What the numbers would look like

The calculator uses the missed-call model and counts first visits only. It leaves out recall visits, family members and treatment plans, which keeps the figure on the cautious side. Change any input to match your own phone report.

In this example about 97 calls a month would go unanswered, about 15 of them from new patients, and about seven first visits would not be booked. That is about $3,500 a month, or roughly $42,000 a year, in first-visit billings alone. It is the value passing through unanswered calls, not the value recovered. In this setup the desk still books every visit, so what comes back depends on how many answered callers use the online scheduler or ring back. If half of them did, the modelled figure would be about $1,750 a month before a single recall visit.

The coordinators would gain something harder to price. In this example most lunch-hour and evening calls are about hours, parking and plans, questions that never needed a person. The desk can finish checking out the 4:30 patient without a phone ringing behind it, and lunch becomes an actual lunch.

The first 30 days in this example

In this example the office manager keeps a running list of calls that did not fit: a parent asking about sealants for a child, a caller wanting a Saturday visit, someone asking whether the practice offers sedation. Each becomes an approved answer or a handoff rule. None of them moves the boundary; anything about a specific patient still goes to a person.

Measuring the month is simple. The practice compares four weeks of new-patient first visits booked, lunch-hour calls answered and voicemails left with the four weeks before. If voicemails do not fall, the forwarding is wrong rather than the answers, and the fix is usually a ring count or a missed time window. The same before-and-after method, for any kind of business, is in is an AI receptionist worth it?.

Lessons from the scenario

• Map when calls go unanswered before choosing any tool; at a dental desk the pattern is predictable.
• Write the plan list, handoff rules and pain wording before the first forwarded call.
• Pick an urgent number that is not the main line, and test what happens when nobody answers it.
• Keep patient-specific work with staff until a signed business associate agreement covers anything more.
• Judge the setup on new-patient visits booked, not on calls answered.

The scenario also shows what would not change. The practice keeps its number, its coordinators and its schedule, and the SI Employee covers the gaps around them. A caller who asks for a person hears when the desk is free; a caller in pain is put through.

For more on general-information calls, handoff wording and the HIPAA boundary at medical and dental offices, see the Ava Medical Intake FAQ. The same method applied to a legal practice is in the family law intake example.