Your current solution handles core patient interactions effectively. Here's what's working, what real-world scenarios are missing, and the enhancements that unlock the next level.
These are actual situations patients encounter that the current agent cannot handle effectively. Each gap represents a missed opportunity for automation and better patient experience.
No complaint, upset, or frustration detection
Patient calls angry about a billing error or wait time. Agent has no empathy scripts, no de-escalation, no escalation path.
Upset patients hang up more frustrated, leave bad reviews, or churn
Basic 'running late' detection exists, but no policy enforcement
Patient calls saying they'll be 20 minutes late. Agent doesn't know: Can they still come? Must they reschedule? Is there a fee?
Staff manually handles every late call, inconsistent policy application
No awareness of cellphone vs landline
Agent offers to 'send a text confirmation' to a landline. Or fails to offer SMS to mobile users who would prefer it.
Missed SMS opportunities, awkward interactions, lower confirmation rates
Knows appointments exist, but no proximity-based intent prediction
Patient calls 45 minutes before appointment. Most likely: running late OR need directions. Agent asks 'How can I help?' instead of predicting.
Longer calls, missed opportunity for proactive service
No patient age or practice type differentiation
Parent calls about child's appointment. Agent says 'Your appointment' instead of 'Your child's appointment'. Misses guardian context.
Confusing communication, less professional experience for families
No explicit address handling found
Patient en route asks 'Where are you located?' or 'Where do I park?' Agent can't answer without transfer.
Simple questions require staff intervention
No knowledge of patient balances or payment status
Patient asks 'Do I owe anything?' or 'What's my copay?' Agent must transfer to billing staff.
25-30% of calls are billing-related, all require human handling
Single location assumption
Practice has 3 locations. Patient's appointment is at Main St but they usually go to Oak Ave. Agent can't clarify or redirect.
Patients show up at wrong location, confusion for multi-site practices