It knows who to call.It calls them.It proves it happened.
Most of the patients who need you are not on your phone right now — they are in your own records, quietly off track. Arbol reads what your practice already has, reaches those people by voice and text, books them, and closes every contact as a record you can audit. Answering the phone is the smallest thing it does.
- Live in 7 days
- Nothing to migrate
- Flat monthly fee, never per minute
- BAA before go-live
142patients off track this week
- R. WhitfieldHbA1c 9.4 · no review in 11 mo
- T. OkaforResult unread since 3 Apr
- M. DuarteNo-show 12 Mar · never rebooked
- L. Bianchi9 weeks pregnant · no first visit
“Hello Ms. Whitfield, this is Riverside Family Practice's assistant. Your diabetes review is overdue — I can offer Thursday at 9:20. This call is recorded.”
- Fact
- HbA1c 9.4% — source: lab result, 12 March
- Consent
- Captured on the call, revocable on voice and text
- Outcome
- Diabetes review booked, Thu 9:20
- Task
- Confirm labs beforehand — owner: front desk, due Wed
Half the demand calls you. The other half stops calling.
The payer changes at the border, so does the regulator, and so does the word for an appointment. The pattern doesn't: the people who reach you go to whoever picked up first, and the people who gave up don't appear in any report at all. Four countries, four public numbers, one conclusion.
These clocks run on real local time. At this moment most of these front desks are closed — and the calls are landing anyway.
The same instant, four working days
Teal = staffed 8–17 · marker = now
- US · New York—
- GB · London—
- CA · Toronto—
- AU · Sydney—
United States
New York
21:47
Local time
31days
average wait for a physician appointment
Across the fifteen largest metro areas — up from 26 days in 2022. The practice that picks up on the first try is the one that keeps the patient.
HIPAA and a signed BAA, the FCC's AI-voice ruling, all-party recording states.
Open United States →United Kingdom
London
02:47
Local time
16million
GP appointments missed in 2025
One in every 23 booked, out of 376 million. Confirming and refilling is the cheapest lever anyone has ever had on that number.
The 8 a.m. queue, DNAs, recall lists, NHS and private practice side by side.
Open United Kingdom →Canada
Toronto
21:47
Local time
5.9million
adults without a regular family doctor
Down from 6.5 million in 2022, and still a country where getting attached to a practice is the hard part. Every unanswered call restarts that search.
PIPEDA and provincial health privacy, after-hours demand, bilingual callers.
Open Canada →Australia
Sydney
11:47
Local time
26%
waited longer than they felt was acceptable for a GP
Rising to 33.6% in outer regional and remote areas, where one practice is often the only one for an hour in any direction — and its phone is the entire front door.
Medicare and bulk-billing economics, DNAs, Ahpra advertising rules, the APPs.
Open Australia →Ask in plain English. Get the list, with the evidence.
Every practice is sitting on the answer already — in the schedule, the results inbox, the no-show log. What nobody has is the hour to assemble it. Hoja is the operator inside Arbol: you ask, it returns names with the reason attached, and once you approve the rule it runs on its own, every week, inside your consent limits.
“Who missed their diabetes review this quarter?”
142 patients · evidence attached to every name
- Lab · 12 Mar
R. Whitfield, 62
HbA1c 9.4% · last review 11 months ago
- Results inbox
T. Okafor, 54
Result released 3 Apr, never discussed
- Schedule
M. Duarte, 47
No-show 12 Mar · never rebooked since
It reads what you already have
Schedule, results, no-show history, the notes your team keeps. No new data entry, and no separate database to feed.
Every name carries its reason
Nobody is on the list because a model felt like it. The record that surfaced the patient travels with the patient.
You approve the rule, not each call
Approve once and it runs on schedule — weekly, monthly, or the morning after a result lands — inside the contact budget you set.
Six calls. Two of them arrived while somebody was there.
One Tuesday at a two-provider practice. Keep scrolling — the hand below is the same twenty-four hours, and it moves with you.
24h
One Tuesday
Dark arc: the staffed shift, 8 to 17.
07:12
Nobody thereCall“Can someone see me before work? Left side, back tooth.”
Triaged against your booking rules, offered the 8:15 opening, took the insurance details, texted the intake form.
Booked
12:40
Desk staffedFour lines at onceFour callers, four conversations, none of them on hold.
Answered in parallel. No hold music, no queue, no callback list waiting on the afternoon shift.
No hold
15:05
Desk staffedCall“Something came up, I can't make Thursday.”
Slot released at 15:05, offered to the waitlist in the order you set, taken at 15:11 by a patient who had waited three weeks.
Backfilled
18:40
Nobody thereCall“Do you take my plan? What do I need for a first visit?”
Answered from your knowledge base, booked the new-patient slot, collected what the front desk would have asked for tomorrow.
New patient
21:22
Nobody thereText“Need to move Thursday to any morning next week.”
Same agent, same memory, different channel. Rescheduled, confirmed both ways, calendar updated.
Rescheduled
02:15
Nobody thereCall“He's having chest pain and it isn't going away.”
No clinical advice, ever. Your after-hours protocol runs verbatim: emergency instructions read, on-call paged, full transcript attached.
Escalated
Four of the six landed with the practice shut — and the one at 02:15 never touched a clinical question.
- Handled
- 6
- Inside the shift
- 2
That was our Tuesday. We'd rather show you yours.
Send last month's call report and we'll read the same day out of your own line — answered, abandoned, after-hours, no-shows.
This is the work that simply doesn't happen
Not work done slowly — work skipped. Every practice knows the overdue reviews should be called and the released slot should be refilled. Nobody has the hours, so the list quietly becomes the backlog nobody mentions in the meeting.
What the list would cost a person
30h
A week of somebody's undivided attention, for a two-provider practice. That is why it doesn't get done — and why the answer was never “work faster”. It is coverage, not efficiency.
- Answering and triaging the phone180 min / day
- Calling everyone whose review is overdue60 min / day
- Closing results nobody has discussed35 min / day
- Rebooking no-shows and refilling cancellations40 min / day
- Confirming tomorrow's appointments, one by one40 min / day
Illustrative for a two-provider practice, not a measured average — the shape is what matters, and the demo runs it against your own numbers. None of this removes a single minute of clinical time: it removes the interruptions around it.
Put a number on the half that tried to reach you
Somebody calls at 6:40 p.m. Somebody hits a busy line at lunch. Somebody calls on a bank holiday. They don't leave a voicemail — they call the practice down the road, and that never shows up in your phone report, only in the visit you never billed. This is the cheapest half of the hole to measure; the patients who stopped calling are the expensive one.
Your practice · monthly
- Calls that never reached you
- 678
- Visits that never got booked
- 224
Revenue that never happens · yearly
$497,280
Your own assumptions × 22 business days — the size of the hole, not a promise of recovery. An unanswered call is not always a lost booking: that is what the last slider is for, and it is worth pulling down before believing the number.
Every call ends as a record you can hand over
Every AI vendor demos the voice. The question that actually decides the purchase is what exists the morning after — and whether you can hand it to a regulator, a complaint or an auditor without a search party. One conversation closes as one record. This is all of it.
Conversation record
Voice · Tue 21:47 · 2m 14s
- Recording
- 2 min 14 s · stored, searchable
- Transcript
- Every turn, both sides, timestamped
- Summary
- “New patient, crown came off, booked 8:15 tomorrow.”
- Outcome
- Booked · written into the schedule at 21:49
- Facts
- Reason · coverage · first visit — each with its source
- Consent
- Captured 21:47, revocable on voice and text at once
- Follow-up
- Verify coverage · owner: front desk · due 8:00
Exportable in full, whenever you ask — including the day you leave.
How governance works →Nothing is a black box
Every conversation ends as a record a manager can open: what was said, what was decided, what the agent wrote down and where it came from.
Facts carry their source
A detail collected on a call is stored with the turn it came from, so nobody has to take the summary on faith.
Consent travels with the patient
Captured once, honoured everywhere. A “stop” on a text stops the calls too — and the trail proves it.
And the follow-up has an owner
What the call couldn't finish becomes a task with a name and a date on it, not a note somebody hopes to read. That is the difference between an assistant and an answering machine.
The three layers, running together
A programme nobody has to remember for nine months
A single call is a feature. This is what the system is actually for: a pregnancy that stays on schedule from the lab result to the postpartum visit, with every step found, contacted and evidenced — and not one calendar reminder in a nurse's head.
Weeks 6–9
Found from the lab result
A positive pregnancy result lands in the feed. She is contacted the same day — not when somebody next opens the chart.
Week 9
First visit booked
Booked into a real prenatal slot, with the paperwork and preparation texted ahead of it.
Weeks 12–36
Kept on schedule
Every visit confirmed, every missed one rebooked, in her channel and her language, with a contact budget she never feels.
Week 6 after birth
The visit everyone forgets
The postpartum check is booked and verified as attended. The programme closes on evidence, not on a reminder.
The same machinery runs chronic reviews, cancer screening recalls and post-discharge follow-up. The programme changes; the three layers don't.
The second sentence is where a foreign agent gives itself away
Not the accent — the paperwork. Ask a Londoner for their copay or a Sydneysider for their network and the call is over, whatever the voice sounded like. Same product, four different second sentences.
“Are you bulk-billed with us?”
“Is Dr. Reyes in-network on your plan, or would this be self-pay?”
“What's your copay for this visit?”
“Can I take your NHS number? Is this one for the GP or the nurse?”
“Which insurance carrier are you with?”
“Do you have your health card handy? I'll just need the number.”
“Have you met your deductible this year?”
“Would you like a bulk-billed slot, or is the gap fee alright?”
- Says it is the practice's AI assistant in the first sentence, with your name on it.
- Discloses recording before it asks for a single detail.
- Never gives clinical advice — not a dose, not a diagnosis, not an opinion on a symptom.
- Hands over to a human with the transcript and everything already collected.
“It waits its turn, lets you interrupt, spells names back, and switches to Spanish when the caller does.”
Hear how the voice behaves →Six things that stop depending on somebody remembering
Not assisted, not queued for later — executed, on your number and inside the schedule you already keep, whether the patient called you or you had to go find them.
Answers every call, in seconds
Peak hours, lunch, after close, weekends and holidays — in parallel, so nobody waits on hold and nothing lands in a voicemail box somebody has to work tomorrow.
The voice →Books in the schedule you keep
Real availability, the right provider, the right location, your booking rules. Nothing to migrate and no IT project in the middle.
Confirms, then refills
Reminders by voice and text before the visit. When somebody cancels, the released slot goes to your waitlist immediately — before the hour goes cold.
Outbound →Phone, text and WhatsApp, one memory
Somebody who called yesterday and texts today is not asked for their details again. One thread per patient, whatever the medium.
Channels →Works the recall list
Overdue annuals, lapsed patients, results follow-up. You approve the list and the script; consent is checked before every single dial.
The proactive system →Leaves evidence of every contact
Recording, transcript, summary and outcome — searchable from hour one and exportable in full whenever you ask for it.
Governance →A week is 168 hours. Here is how much of it each option covers.
Solid means somebody — or something — can finish the job on the spot: book it, move it, refill it. Hatched means the phone was picked up and a message was taken.
Nine hours a day, five days — and only while nobody is at lunch, on the other line or off sick.
More hands inside the same nine hours. The evening, the weekend and the overdue-review list are exactly where they were, and now there is a salary against them.
Somebody picks up at 2 a.m. and writes it down. Nothing is booked on the call, the bill grows with every minute, and the callback list lands on your desk in the morning.
Available all week and unable to finish anything. Press 1, press 2, leave a message — a menu is not an answer.
Every hour of the week, in parallel, finishing the job: booked, moved, refilled, escalated — and calling the list nobody had time for.
The rules moved twice while vendors were shipping demos
An AI that phones patients is regulated twice over: once as healthcare, once as telecoms. Both bodies of rules changed recently, in ways most voice products still ignore. Here is the sequence, dated — and what we do about each line.
Standing
45 CFR §164.502(e)
HIPAA and the BAA
Any vendor handling protected health information is a business associate, and the agreement has to exist before the handling does.
We sign the BAA before a single call is handled — a precondition, not an upsell.
8 Feb 2024
FCC declaratory ruling
An AI voice became an “artificial” voice
The FCC ruled that AI-generated voices fall under the TCPA's artificial-voice rules: prior express consent, identification, and a working opt-out.
It identifies itself in the opening line and every outbound dial checks consent first.
11 Apr 2025
FCC rules, in force
Consent became revocable any reasonable way
“Stop.” A reply to a text. A word said mid-call. However it arrives, it counts — and it has to be honoured across channels.
One revocation lands on voice and messaging at once, with the trail to prove when.
Varies by state
State wiretap statutes
Recording disclosure follows the caller
All-party-consent states require every participant to be told, and the rule follows the person on the other end of the line, not your address.
The agent discloses recording wherever the jurisdiction requires it.
Half an hour, and you keep the numbers either way
No slide deck, no discovery questionnaire, no access to your systems. You send whatever your phone system exports, and we spend the time on your own line.
Book the 30 minutesPrefer to write first? support@getarbol.com reaches a person, not a queue.
The call, minute by minute
30:00 total
- 0:00
Your own line, read out loud
Answered, abandoned, after-hours, no-shows, how far out the book runs. Most practices have never seen these four numbers on the same page.
- 10:00
The agent takes a live call in your specialty
Not a recording. You call it, interrupt it, ask it something awkward, and hear where it stops and hands over.
- 20:00
The list it would work, and what it costs
Which patients in your own records it would surface first, the contact rules you'd want on it, and a flat monthly number sized to your volume.
You leave with your own figures written down and a flat monthly quote sized to your volume. If the arithmetic doesn't pay for itself, we say so on the call — that is a cheaper outcome for both of us than finding out in month three.
Straight answers
Prefer email? Write to support@getarbol.com — a person answers.
Will patients actually accept this?
The alternative it replaces is not your receptionist — it is a recording saying the office is closed, or a hold queue. It says what it is in the opening line, speaks plainly, and hands over to a human the moment somebody asks or the call needs judgement. Reaching somebody in nine seconds at 9 p.m. is the part patients react to.
What if the numbers don't work for our practice?
Then we say so on the call. The thirty minutes runs on your own call report, so the business case is arithmetic you can check line by line, not a forecast we own. And whatever you decide later, every recording, transcript and record stays exportable in full.
Do we have to replace our practice management or phone system?
No. Arbol answers the number you already publish and books in the schedule you already keep. Nothing is migrated, nothing is ripped out, and your data is exportable in full if you ever leave.
Does the patient know they're talking to an AI?
Yes, in the opening line, using your practice's name. It also discloses recording where that applies. Transparency is not a setting an implementation can switch off.
What does it actually sound like?
Like a calm front-desk person who never has four other things happening at once. It waits its turn, handles interruptions, and speaks English or Spanish depending on the caller. The fastest way to judge it is to let it call you — that is what the demo is.
What happens with clinical or urgent calls?
The agent never gives clinical advice. If somebody describes a red flag or the call needs judgement, it runs the escalation path you defined and hands over everything it has already collected.
What if it doesn't know the answer?
It says so and hands off, instead of inventing something. Those moments show up in your dashboard as gaps to close, and closing one takes minutes: you add the answer once and it is used from then on.
Why isn't there a price list?
Because a generic plan misprices most practices in both directions. It is a flat monthly fee sized to your call volume, channels and locations — not per minute — and you get the number in writing after the first call.
Seven days from your call report to your first booked patient
No IT project, no data migration, nobody on your team retrained. The whole week, drawn to scale — five of those days are ours, and you spend them approving things.
Day 1
We audit the phone
Thirty minutes: call volume, hold and abandon rates, no-show rate, how far out the book runs. Nothing gets installed — you leave with the business case in your own numbers.
Days 2–6
We train it on your practice
Services, providers, locations, hours, insurance and booking rules. You approve the tone, the flows and the escalation paths before it takes a single call.
Day 7
Live on your number
Voice and messaging connected, every conversation recorded, transcribed and searchable — on a flat monthly fee sized to your volume.
BAA signed before go-live · nothing to migrate · flat monthly fee.