A voicemail takes the message. Iris starts the request.
A good live front desk is the heart of a practice, and it cannot also be everywhere at once. Iris is a different kind of hire. She answers when the desk is with a patient or the listed hours have ended, takes a new patient or referral request in the practice's own words, answers payment questions from the practice's own statement, tells anyone describing a warning sign to call 911, and has a brief on Dr. Ament's desk by 7:00 AM. She says she is an AI, tells callers the call is recorded, and never diagnoses, never advises on a medication, never quotes a price, and never promises a time.
Iris's board, this visit
On duty- 0
- Requests opened
- 0
- Routed to staff
- 0
- Times and visits requested
- 0
- Texts and emails
- 0
- Brief items
- Play a scenario below and watch this fill up.
Six moments in a neurology practice's week.
Pick one. On the left, a live front desk plus voicemail doing what a good desk does. On the right, Iris. Watch what is still on your team's plate when each call ends.
Priya, a new caller (invented). She hit her head at a weekend game two weeks ago and has felt off since. She finally has a quiet minute after work. The listed hours ended at 5.
A live front desk plus voicemail
Assumed. The site names no phone vendor or answering service. Optional column: a medical answering service (Ruby, Smith.ai), by their published features
Iris
AI patient care coordinator, connected to the staff queue (the chart stays in AdvancedMD)
Patients, practices, and law firms in these scenarios are invented, with 555 phone numbers. The front desk column is an assumption, because the practice's website names no phone vendor, answering service, or voicemail policy. Dr. Ament, Nikki Biefel, and Seth Beal appear only as the people Iris routes to.
Pick a role. Call Iris. Watch the staff queue move.
Call Iris as Priya
Uses your microphone. Speak English or Spanish. Interrupt her any time.
Conversation
Start a call and the transcript appears here. Iris opens with a short greeting, then it's your turn.
What Iris did
Requests, referrals, texts, and staff notes land here the moment she makes them.
Iris works on a sample front desk here with invented people. Nothing touches Cherry Creek Neurology's real patients, schedule, or AdvancedMD account. Please do not share any real personal or health information. Try offering her a Social Security number, or asking whether you should stop a medication.
A coordinator writes the brief. Then waits for your call.
Everything that came in, the two decisions only you can make, and the follow-ups Iris is already running. The names and numbers are demo data and nothing clinical appears. Try the buttons.
Iris at Cherry Creek Neurology
to Dr. Ament · 7:00 AM
Wednesday, October 28 (demo data)
Good morning, Dr. Ament.
One urgent note, flagged first. Two things need you. Everything else is moving. Every name and number below is invented for the demo.
Needs you
Who should Iris send an urgent note to after 5 PM?
The website lists 8 AM to 5 PM by appointment only and publishes no after-hours line or emergency instruction. Last night Iris told a caller to call 911 for emergencies and queued the urgent note for the first person in this morning. How after-hours calls are routed is your decision, not hers.
Iris recommends naming one on-call person and one backup for urgent clinical notes, and a short recorded message for emergencies. Until you do, she makes no after-hours promise and urgent notes wait at the top of this brief.
Send the portal-forms nudge to the patients with visits next week?
Twenty patients are booked next week and eleven have not finished their portal forms. Eight of those eleven agreed to texts and reminder calls. Three did not, so Iris will not contact them. Outbound AI calls need prior express consent.
Iris recommends nudging the eight. It is logistics only: the Forms button, and arriving 30 to 40 minutes early if the forms are not done. Nothing clinical is said on any call.
Overnight
- Yesterday 4:52 PMA returning patient called about a possible medication reaction. No advice was given. He was connected to the front desk, and an urgent note was queued for your clinical team. Note RQ-2104, flagged at the top.
- Yesterday 12:20 PMAspen Grove Family Medicine called to refer a patient. Referral RF-3101 logged. The patient call is due within 2 business days. Iris told the office to fax details, not email.
- Yesterday 7:02 PMA new patient asked for a call about seeing you. Request RQ-2101 opened with who referred her and a morning preference. No callback time was promised.
- Yesterday 3:40 PMAn attorney's office asked about liens and records. Nothing about any patient was confirmed or shared. A written records request was routed to the front desk.
9
Calls and chats handled since yesterday
5
Staff requests opened
1
Referrals logged
8
Follow-ups Iris is running
On your calendar
- 8:00 AMFront desk calls the new patient (RQ-2101) and the referral patient (RF-3101)
- 9:00 AMRecords request from the attorney's office to read: written request required (RQ-2102)
- 10:30 AMVision therapy evaluation time to confirm for Rosa, in Spanish (RQ-2103)
Iris is handling
- Waiting on the front desk to confirm Rosa's vision therapy evaluation time
- Reminding eight patients to finish their portal forms, once you approve
- Watching for the faxed referral packet from Aspen Grove
- Checking in with the front desk on the urgent note by 10 AM
She remembers the person, not the chart.
Language, how someone likes to be reached, and whether the forms are done. Never a symptom, a medication, or a result. Across phone, text, and the website.
What Iris knows about Rosa
- Rosa D., prefers Spanish on calls
- Texts in the morning, before work
- Registered for the portal but has not finished the forms
- Vision therapy evaluation time requested, waiting on the front desk
- Never anything clinical: no symptoms, medications, or results
Nobody typed this into a profile, and none of it is clinical. Iris picked it up over a few weeks of calls, texts, and chats, and it is there the moment Rosa's number rings. Rosa is invented for this demo.
Five weeks, one thread
- Sep 14Phone
Called in Spanish. Iris answered in Spanish and noted it so the desk never has to ask again.
- Sep 14Text
Said morning texts are best, before work. Iris noted it.
- Sep 22Web chat
Asked how the patient portal works. Iris explained that staff enter basic information first, then the Forms button is available.
- Oct 12Phone
Asked about vision therapy. Request RQ-2090 opened for the front desk to confirm an evaluation time.
- Monday, 9:15 AMPhone
Called again in Spanish. Recognized from her number, greeted by name in her language, and her portal status was already in front of Iris.
Credit where it is due. And where the documentation stops.
A live front desk is warm, quick, and trusted, and an answering service adds hours. Ruby lists plans from $250 a month for 50 minutes to $1,725 a month for 500 minutes. Smith.ai lists plans from $300 a month for 30 calls (extra calls $11.50 each) to $2,100 a month for 300 calls. The question is who does the work after the call ends, and what happens when the desk is busy.
Assumption: the practice's website names no phone vendor, answering service, or voicemail policy. The first column is written to what a live front desk plus voicemail does. The second column is an optional medical answering service and is shown only for comparison.
| The job | A live front desk plus voicemail (assumed) | Optional: a medical answering service | Iris |
|---|---|---|---|
| Answers the phone | Live during the listed 8 to 5 hours when someone is free. Calls during a visit, lunch, or a second call go to voicemail | Yes, live agents around the clock (Ruby, Smith.ai) | Yes, every call, with the recording and AI disclosure first. After-hours routing is set by the owner |
| Takes a message with name and number | Yes, by hand or on a voicemail someone replays | Yes | Yes, with a reason category and who referred, and nothing clinical |
| Spots a 911-level warning sign | Depends on who is at the desk and training. A voicemail cannot | Scripted screening is documented. Medical triage judgment: Not documented | Says call 911 once, clearly, then queues a staff note. Never interprets a symptom |
| Logs a referral from another office | Takes the details by hand. A message left after hours may be missing the fax number | Takes the details as a message or lead. Practice-specific referral rules: Not documented | Logs provider, practice, callback, fax, reason category. Tells the office to fax, never email, patient details |
| Requests a time (staff confirm) | Yes, in the scheduling system when it is open and a person is free | Booking into some calendars is documented (Smith.ai charges $1.50 per call). Access to AdvancedMD: Not documented | Logs a request, never promises a time. Live booking into AdvancedMD needs AdvancedMD's partner certification |
| Speaks Spanish | Depends on who is at the desk. Not documented for this practice | Yes (Ruby bilingual, Smith.ai English and Spanish) | Yes, in the caller's language |
| Recognizes a returning patient | By memory and the chart, while the phone rings | Not documented | By the number on file, then logistics only: language, text preference, whether forms are done |
| Shares nothing with a third party | Depends on training and the moment. Caller pressure is real | Not documented | Never confirms or denies that someone is a patient. Records go to a written request |
| Refuses Social Security, insurance, and card numbers | By habit | Not documented | Always. The engine refuses and logs them |
| Calls patients first (outbound) | By hand, between everything else. Twenty reminder calls is an afternoon | Ruby lists outbound call assistance and Smith.ai offers outbound on some plans. Working a due-list from your records: Not documented | Reminder and portal-forms nudge to patients who opted in, with a script and a log. Outbound AI calls need prior express consent |
| Sends the owner a morning brief | A stack of messages and voicemails | Transcripts and call notes. A daily brief is Not documented | Every day, with two decisions you can answer |
| Monthly cost | About $5,180 a month for one full-time medical secretary (assumption below). One person covers about 40 of 168 weekly hours | Ruby $250 to $1,725 a month. Smith.ai $300 to $2,100 a month plus per-call and booking fees | Not shown on this page |
Sources checked October 27, 2026: Ruby's and Smith.ai's own pricing and product pages, and BLS wage data. Ruby lists plans from $250 a month for 50 minutes to $1,725 a month for 500 minutes. Smith.ai lists plans from $300 a month for 30 calls (extra calls $11.50 each) to $2,100 a month for 300 calls. BLS Occupational Employment and Wage Statistics, May 2025, Denver-Aurora-Centennial metro: Medical Secretaries and Administrative Assistants, median $22.98 an hour (about $47,798 a year, about $3,983 a month in wages). The fully loaded figure of about $5,180 a month uses a 1.30 multiplier for payroll tax, benefits, paid time off, and equipment. The 1.30 multiplier is our assumption, not a BLS figure. “Not documented” means the vendor pages we read do not list it, not that the product cannot do it. Prices and wages were checked on October 27, 2026 and change; re-check before relying on them. Neither Ruby's nor Smith.ai's pricing page states a business associate agreement. AdvancedMD's patient portal, which this practice appears to use for forms, is a documented fact; AdvancedMD's phone or AI features for this practice are Not documented. Iris's column describes the demo on this page, built with invented people. It is not HIPAA compliant as built; real use needs a signed business associate agreement across the voice, speech, and model chain. This page is not legal advice. Sources: Ruby pricing, Smith.ai pricing, BLS OEWS.
You keep your number. Calls forward to her. The to-do list shrinks.
01
Sign the paper first
Real patient calls need a signed business associate agreement across the voice, speech, and model chain before Iris hears a real name. This demo uses invented people only and is not HIPAA compliant as built. Then we connect Iris to the way you want after-hours calls handled. You choose who she tries first for an urgent note.
02
Forward
Keep your main number and your phones. Calls forward to Iris when the desk is busy or the office is closed, and you read every transcript and every action she takes. AdvancedMD scheduling stays yours: connecting live booking is a later step that needs AdvancedMD's partner certification.
03
Hand off
When you trust her, she takes more of the line. You get the 7:00 AM brief, and the work that used to wait for the morning is already in the staff queue.
Built for Cherry Creek Neurology by ATERNA.
We build AI coordinators for small practices that run on the phone. Fifteen minutes is enough to see whether Iris fits.