Concierge & DPC

AI receptionist answers billing, membership, and insurance questions for concierge practice members

Members call with billing questions, membership inquiries, or prior auth requests outside of business hours. An AI receptionist answers common questions, escalates complex cases, and logs all interactions—so your billing staff handle fewer routine calls.

Answer questions about membership fees, annual dues, billing cycles, and renewal dates
Explain coverage tiers, add-on services, and what's included in each membership level
Handle prior authorization callbacks: capture request status, insurance carrier response, and clinical need
Explain lab or medication costs before the visit; direct members to patient financial counselor if needed
Capture billing address, insurance, and payment method updates during member calls
Route complex disputes, claim denials, or coverage exceptions to your billing manager or revenue cycle team

How it pays back

Reduce Billing Department Phone Load

Your billing staff spend less time answering 'What's my membership fee?' or 'When is my renewal?' and more time resolving actual claim issues and maximizing reimbursement.

Answer Members 24/7 Without Extra Staff

Members don't want to call during business hours. An AI receptionist answers common billing questions any time—evening, weekend, or holiday—so members get answers immediately and your team focuses on work that requires human judgment.

Capture Insurance and Payment Updates

When members call to confirm membership or ask about billing, the AI captures updated insurance card info, payment method, or address changes on the call. That information is logged and returned to your staff to sync into your practice management system—no sticky notes, no callbacks.

Flag Prior Authorization Holds

Before a member's appointment, if a procedure needs prior auth, the AI proactively calls to explain the status, provide a timeline, and route urgent holds to clinical staff or your insurance specialist.

Insurance updates captured on call

New insurance cards, payment methods, and billing address changes logged for your staff to sync

Prior auth status tracked

Callback responses and insurance status captured and flagged for clinical or billing team

Complex cases escalated

Disputes, denials, and out-of-coverage exceptions routed to your revenue cycle or billing manager

Frequently asked questions

How does the AI explain membership plans and coverage without being a billing expert?

You configure the AI with your membership tiers, fees, renewal dates, and what's included in each tier. The AI reads this information accurately and clearly. If a member has a question that falls outside the configured details—like 'Does this cover my child's visit?'—the AI escalates to your billing staff or care coordinator.

Can it collect updated insurance information?

Yes. During a call, if a member provides a new insurance card, the AI captures the carrier name, member ID, and effective date. That information is logged and returned to your staff, who enter it into your practice management system. Your staff then sync those updates to your EMR or practice management system.

What if a member disputes a charge or says they were overcharged?

The AI documents the dispute and escalates immediately to your billing manager or revenue cycle team. Your staff review the charge, investigate, and contact the member directly if needed. The AI logs all escalations so nothing falls through the cracks.

How does it handle prior authorization questions?

You configure the AI to track common prior auth procedures (imaging, surgery, specialist referral). When a member calls asking about status, the AI checks your system and provides an update: 'Approved,' 'Pending,' or 'Insurance needs additional information.' If urgent, it routes to your clinical or insurance team for follow-up.

Does it integrate with practice management systems like SimplePractice?

MedReception integrates with named practice management platforms including AdvancedMD, Elation, and others. Billing and membership updates are logged in your AI interaction records and handed to your staff for entry into your practice management system.