Member Receptionist

This is the AI that answers your phone. Day or night, when someone calls your agency, the receptionist picks up, greets them (by first name if they're already in your book), and helps with whatever they need. If it can't handle something, it transfers the call, books a time with your team, or logs an inquiry so someone follows up.

It doesn't have a script, because it doesn't know what people will ask. Benefits, billing, enrollment status, coverage, or something totally random: it listens, figures out what they need, and takes the right next step.

For setting up the voice, name, and call routing, see Configure Your Receptionist.

In the template picker, this one's called ACA Member Receptionist.

In the lines below, anything in brackets fills in for each caller: [First name], [AI name] (whatever you've named your receptionist), [Agency], and [Carrier].

At a glance

There's no automation and no outbound cadence with this template (its Pulse is empty). The only outbound calls it makes are appointment callbacks and inquiry callbacks (more on those below).

What callers hear

The receptionist comes with six AI employees. Which one picks up depends on whether the caller is already a member in your book, and whether it's during your business hours.

How it handles calls

All four of the employees above work the same way once the greeting's done. The after-hours ones just know the office is closed, so most of the time they're booking a time for your team to call back or logging an inquiry so someone follows up in the morning.

If the caller just says hi, it says hi back ("hey, how's it going?") and lets them explain. If they jump right into why they're calling, it skips the small talk and helps. If what they need is vague, it asks one clarifying question.

• Benefit, coverage, or plan questions. It can look up the caller's plan info. If it doesn't have the answer, it says so instead of guessing, and offers to get them to someone who can pull it up.
• Something your team needs to handle. It can transfer the call, book a time with your team, or log an inquiry.
• Medical questions. It points them to their doctor: "that's actually something you'd wanna talk to your doctor about."
• They want a supervisor. That's a transfer, right away: "yeah absolutely, let me get someone for you. one sec."
• They want off the call list. Done, on the spot: "you got it, I'll take care of that right now."
• "Are you a real person?" It's direct about it: "yeah, I'm an AI assistant, but I've got your info pulled up right here - so what can I help you with?"

The receptionist never ends the call on its own. After it helps, it checks in ("anything else I can help you with?"), and when they're done it closes with "okay, well you've got our number if anything else comes up. hope you have a great rest of your day."

A few other habits worth knowing:

• It won't fake plan details. It never guesses or fills in a value that isn't in the caller's actual plan info.
• It keeps turns short. One thing at a time, one question at a time, and no reading off a menu of options.
• It doesn't read your number unless they want it. They just called it, after all. If they need it (say, to pass along to a friend), it asks first.

Heads up: the new-caller employees use that same "I've got your info pulled up right here" line if someone asks whether it's an AI, even though new callers aren't in your book yet. If that bugs you, tweak it in Employees.

Callbacks

Two more AI employees handle the follow-through.

Appointment callbacks

When an appointment comes up, what happens depends on your appointment configuration. If the AI makes the callback, it opens with:

Hi [First name], this is [AI name] from [Agency] calling for your scheduled appointment with our team. Is now still a good time?

It doesn't know (or guess) why the appointment was booked. It mentions the recorded line, checks that now still works, and transfers them to your member care team: "ok great, let me get you over to them right now, just hang on one sec." If now's not good, it books another time, confirms it so it feels locked in, and gives them your number in case they need you before then. If someone else picks up and [First name] isn't around, it rebooks.

Heads up: this script's instructions still describe callers as "mostly seniors," a leftover from the Medicare version. Members don't hear those lines, but you might want to clean them up in Employees.

Inquiry callbacks

When your team answers an inquiry, the AI can call the member back with the answer. It opens with:

Hi [First name], this is [AI name], your personal assistant from [Agency] again. I had a chance to run your question by the team, and I have your answer! Is now a good time?

It reminds them what they asked ("does that ring a bell?"), waits for them to remember, then delivers your team's answer in plain language, a piece at a time if there's a lot to it. It doesn't improvise beyond the answer it was given. If they have new questions, it gives them your number so the team can help. When they're done, it signs off with "alright sounds good, I'll talk to you later then. take care. bye bye." If they don't pick up, it leaves this voicemail:

Hi [First name], this is [AI name], your personal assistant from [Agency] again. I had a chance to run your question by the team, and I have your answer! Please give me a call back whenever you get the chance. Thanks. Bye bye.

Before you turn it on

• Configure the receptionist (name, voice, and routing). See Configure Your Receptionist.
• Set up your escalations in Employees > Escalations. Point Transfer Call at a transfer destination and Book Appointment at an appointment configuration. Inquiries don't need anything, they go to your Inbox and the Inquiries page, and the member's assigned agent gets notified. See Handle Inquiries.
• Set your business hours, since that decides whether callers get the daytime or after-hours greeting. See Business Hours and Holidays.
• Import your book so members get greeted by name and the AI has their plan info. See Import Your Book of Business.
• Test it by calling in. See Test Your Campaign.

Changing any of this

• Greetings and what the AI says: the Employees tab. See Edit Your AI with Employees.
• When it transfers, books, or logs an inquiry: Employees > Escalations. See Escalations.