If you have collected three quotes, some for answering services and some for AI receptionists, you have probably noticed they are hard to compare. One is a flat monthly fee. One is per minute. One has a setup fee that dwarfs the first year of subscription.
The prices are not really the problem. The pricing models are, because they determine whether your bill in month six looks anything like your bill in month one. Here is how to read them.
The four models you will see
Flat monthly. One price, unlimited or very high call volume. Predictable, and usually the most expensive at low volume because you are paying for headroom you may not use.
Per minute. You buy a bundle of minutes and pay an overage rate beyond it. This is the most common model for voice AI, because the underlying cost is genuinely per minute. Predictable only if you know your talk time, which most practices do not.
Per call. A fixed price per answered call regardless of length. Simple to forecast if your call volume is stable. Punishes you for spam and hangups unless the contract excludes them, which you should check.
Per booked appointment. Rare, and appealing on the surface because it looks like pay for performance. Read the definition of "booked" very carefully. If a cancelled appointment still counts, the incentive is not aligned with your schedule.
The line items that are easy to miss
The monthly number is rarely the whole number. Ask about each of these explicitly, in writing.
Setup or activation. Almost every dental deployment has one, and for a good reason. Somebody has to map your appointment types and lengths, encode your financial and eligibility rules, collect your procedure code sets, configure the transfer destinations, and test with live calls. That is real work and a vendor charging nothing for it is either doing it badly or recovering the cost somewhere else. What matters is that it is one time and disclosed up front.
Practice management system integration. A direct write-back integration into your PMS may be priced separately from the base service. Ask whether it is included, and ask specifically which system, because "dental integration" and "an integration with your dental software" are not the same claim.
Phone numbers and porting. Usually small, occasionally not. Also ask whether you are porting your main line or forwarding to a new number. Forwarding is lower risk and is what most practices should do, and it usually costs less.
Transfer minutes. When the AI hands a caller to a human, does that time bill? On a practice that transfers every implant and full-arch inquiry, this is not a rounding error.
Spam and wrong numbers. Dental offices get a remarkable volume of junk calls. If you are billed per call or per minute, ask how these are handled and whether there is any filtering.
After hours. Some vendors price nights and weekends differently. Since after-hours coverage is frequently the entire reason a practice buys, check this before you assume it is included.
Contract length and what happens at the end. Month to month versus annual, and whether your configuration and call recordings are exportable if you leave.
How to estimate your own volume before you get quoted
You can do this in about fifteen minutes and it makes every quote comparable.
Pull a call report from your phone system for a normal month. You are looking for three numbers:
- Total inbound calls.
- How many were answered, and how many rolled to voicemail or went unanswered.
- Average call duration.
Most VoIP systems will give you all three. If yours will not, your phone vendor can.
Now multiply total inbound calls by average duration to get monthly minutes. That is the number to hand every vendor. Ask each one to quote against it, including projected overage, and ask what happens in your busiest month rather than an average one.
While you have the report open, note the unanswered count separately. That number is the actual problem you are trying to solve, and it is also what you will measure against in ninety days.
Comparing against a front desk hire
This comparison gets made badly, so be careful with it in both directions.
The honest framing is not "AI replaces a front desk person." In most practices it does not, and vendors who pitch it that way are selling you a story your team will resent. The realistic framing is that your existing front desk stops being interrupted by the phone while a patient is standing in front of them, and calls that currently go unanswered stop going unanswered.
If you do want the cost comparison, use your real fully loaded number, not the wage. That means base pay, payroll taxes, benefits, paid time off, and a realistic allocation for turnover and training, since front desk turnover is not rare. Your accountant or your payroll report has these. Divide by twelve for a monthly figure, then compare.
Also count what a person covers that software does not, and the reverse. A person handles the walk-in, the difficult conversation, the moment that needs judgment. Software covers 2am, Sunday, and the fourth simultaneous call. They are not substitutes, which is why the useful question is coverage, not replacement.
Questions to put in writing before you sign
- What is the total first-year cost including setup, integration, and numbers, assuming my volume estimate?
- What is the overage rate and at what point does it trigger?
- Do transfers, spam calls, and hangups bill?
- Is the PMS integration included, and for which system by name?
- What is the contract term and the cancellation terms?
- If we leave, do we get our configuration, call recordings, and transcripts?
- What is included in support, and what is billable?
A vendor who answers all seven in writing without hedging is telling you something useful about how they will behave in month eight.
The number that actually decides this
Cost is the wrong denominator on its own. The right one is cost against calls you are currently losing.
If you are missing a meaningful number of calls a month, and some share of those are new patients, then the relevant comparison is not the subscription fee against zero. It is the subscription fee against the value of the patients currently reaching your voicemail and then calling the practice down the street.
We are not going to hand you an industry average for that, because your practice's new patient value is specific to your fee schedule, your case mix, and your market, and any number we invented would be worse than the one you already have in your own reports. Work it out with your numbers. There is a method for it in our piece on what a missed call costs a dental practice.
Then compare. If the math is close, the decision is genuinely hard. If the math is not close, you already know which way.
Telvana prices dental deployments against your actual call volume and your practice management system. If you want a real number rather than a range, bring your monthly minutes and we will quote against them.
