SARAH
Healthcare / Medical Clinic Network — USA
Client Profile
Industry
Healthcare / Medical Clinic Network (USA)
Size
Regional clinic network with 12 locations across Texas, 85
physicians, 25,000 active patients
Business Model
Insurance billing (70%), private pay (30%), primary
care and specialty services
Challenge
8,200+ monthly patient calls, 45-minute average hold time,
32% call abandonment
Business Problem
→ Patient phone volume averaged 8,200+ monthly across 12 clinics with
45-minute average hold time
→ 32% call abandonment rate – patients giving up and going to
competitors or ER
Exotica IT Solutions
www.exoticaitsolutions.com
→ 85% of calls were routine: appointment scheduling, prescription
refills, lab results, directions, hours
→ Front office staff overwhelmed, leading to errors in scheduling and
message taking
→ After-hours and weekend calls went to voicemail, creating Monday
morning backlog
→ Patient satisfaction declining – HCAHPS scores dropped from 4.1 to 3.3
stars
→ Staff burnout high with 40% annual turnover in reception roles
→ No appointment reminder system – 18% no-show rate costing $420K
annually
Objective
Reduce hold time from 45 minutes to under 2 minutes
Decrease call abandonment from 32% to under 5%
Deflect 75%+ of routine calls through AI voice assistant
Provide 24/7 patient support including after-hours and weekends
Reduce no-show rate from 18% to under 8%
Improve patient satisfaction from 3.3 to 4.5+ stars
Reduce front office staffing costs by 40%
Automation Details
Intelligent Call Routing
AI answers calls, identifies patient intent,
handles or routes to appropriate department
Appointment Scheduling
Checks physician availability across 12
clinics, offers next 5 available slots, books appointment in Epic
Prescription Refills
Captures medication name, pharmacy, insurance,
routes to physician for approval, sends to pharmacy
Lab Result
Securely delivers normal results via phone or SMS, flags
abnormal results for physician cal
Patient Verification
Verifies identity using name, DOB, last 4 SSN
before accessing PHI
Smart Reminders
48-hour and 2-hour appointment reminders via
patient’s preferred channel (call, SMS, email)
No-Show Prevention
If patient cancels, immediately offers slot to
waitlist patients
Common Questions
Provides clinic hours, locations, directions,
insurance accepted, service offerings
After-Hours Support
Handles routine requests 24/7, triages urgent
issues to on-call provider
Call Analytics
Tracks call volume, hold times, resolution rates, patient
satisfaction, identifies process improvements
Solution Overview
→ Deployed HIPAA-compliant AI voice assistant handling inbound patient
calls
→ Natural language processing trained on medical terminology and clinic
protocols
→ Integrated with EHR system (Epic) for real-time scheduling,
prescriptions, lab results
→ Automated appointment scheduling with physician availability checking
→ Prescription refill requests routed directly to pharmacy with physician
approval workflow
→ Lab result notifications delivered securely via voice or SMS
→ Automated appointment reminders via phone, SMS, email
→ Seamless transfer to human staff for complex medical questions with
full call context
Technology Stack
LLM
GPT-4 with medical knowledge base and HIPAA compliance
guardrail
Voice
AssemblyAI for medical-grade speech recognition, Azure Neural
TTS for natural voice
Telephony
Twilio Voice API with call routing and recording
EHR Integration
Epic FHIR API for appointments, prescriptions, lab
results, patient demographics
Security
End-to-end encryption, HIPAA-compliant storage, audit
logging
NLP
Intent classification (appointment, refill, results, directions), entity
extraction (dates, medications)
Database
MongoDB for conversation logs, Redis for session
managemen
Infrastructure
Azure (HIPAA-compliant regions), load balancing,
disaster recovery
Notifications
Twilio SMS, SendGrid email for reminders and results
Compliance
PHI handling protocols, patient consent management,
data retention policies
Outcome & Impact
→ Hold Time: Reduced from 45 minutes to 1.8 minutes (96%
improvement)
→ Call Abandonment: Decreased from 32% to 3.2% (90% improvement)
→ Call Deflection: 82% of routine calls handled entirely by AI (6,724 of
8,200 monthly)
→ No-Show Rate: Reduced from 18% to 6.5% through automated
reminders, saving $350K annually
→ Patient Access: 24/7 support enabled – after-hours calls up 245%,
improving patient convenience
→ Patient Satisfaction: HCAHPS scores improved from 3.3 to 4.7 stars
→ Staff Impact: Front office staff reduced by 35% through natural
attrition, saving $280K annually
→ Staff Satisfaction: Reception staff burnout decreased, turnover from
40% to 12%
→ Appointment Volume: 22% increase in scheduled appointments due
to improved access
Exotica IT Solutions
www.exoticaitsolutions.com
→ Revenue Impact: $1.2M additional annual revenue from reduced no-
shows and increased appointment volume
Why This Matters for Similar Clients
Medical Clinics
Practices with 5+ physicians can deflect 75-85% of
routine calls, dramatically improving patient access
Dental Practices
Automate appointment scheduling, insurance
verification, post-treatment follow-up
Specialty Practices
Handle referral intake, pre-visit paperwork, test
prep instructions
Urgent Care Centers
Provide wait time estimates, symptoms
assessment, location directions
Hospital Systems
Scale patient access across 20+ departments with
consistent experience
ROI
Healthcare organizations typically see 10-16 month payback with
300-500% ROI over 3 years from improved patient access, reduced no-
shows, and lower staffing costs
Reduction in Patient Hold
Time
Call Deflection via AI
Additional Annual Revenue