Be skeptical of every AI vendor who calls your practice, including us.

If you manage an ENT practice, you're probably already paying someone to answer your phones. That might be an answering service after hours, virtual assistants who handle scheduling, or both. Some of those services already use AI behind the scenes. So the question isn't whether AI can answer a call. It's whether a new tool does the job better than what you pay for today, and whether the math works.

ENT is also harder to schedule than most vendors realize. One practice covers adult and pediatric ENT, audiology, hearing aids, allergy, sleep, and head and neck surgery. A new hearing-loss patient may need an audiogram before seeing the physician. Many plans need a referral or authorization before the visit. And insurance details aren't optional: If the agent books without them, your front desk spends the next morning calling patients back.

Here are the 10 questions I'd ask before signing with any AI vendor, us included.

The 10 questions

1. "Book a new hearing-loss patient: audiogram first, then the physician, same day."

Don't let the demo stop at "here's an open slot with Dr. Smith." Ask the vendor to book a visit that needs two resources in the right order, like an audiogram with an audiologist followed by an ENT visit. Then try an allergy test that needs a longer block, or a pediatric ear visit with a provider who sees children.

Many AI tools only read a provider's calendar. They don't read your scheduling templates, so they don't know which visits need testing first, which providers see kids, or how long each visit runs. If the agent can't follow those rules, your staff will spend every morning fixing what it booked.

Red flag: "We'll train the agent on your rules during onboarding," with no mention of reading them from your schedule.

2. "A patient says 'my ears have been bothering me.' What happens next?"

Patients don't speak in appointment types. "My ears" could mean a hearing test, a hearing aid adjustment, an ear infection, wax removal, or tinnitus. "I can't breathe through my nose" could be an allergy, sinus, or sleep issue. Ask how the agent narrows down the request, what it asks, and what it does when it still isn't sure.

Then ask what happens when the reason for the call is urgent. Sudden hearing loss, bleeding after a tonsillectomy, or trouble breathing should never end with "the next opening is in three weeks." Ask exactly which words send a caller to a person or tell them to seek care right away, and who in your practice signs off on that list.

Red flag: The vendor only demos callers who already know exactly what to ask for.

3. "Collect insurance the way my front desk does."

In ENT, a booking without insurance isn't complete. Watch whether the agent asks for the plan, the member ID, and, where needed, the referral. Ask whether a patient's plan changes which providers or locations they're offered. Ask what happens when a plan needs authorization before the visit or when you don't take the plan at all.

Ask how the details are captured too. Reading a 12-digit member ID out loud is error-prone. Some vendors are working on sending the patient a text link to photograph their card instead.

Red flag: The demo books a new patient without ever asking about insurance.

4. "Show me the write-back to my practice management system, live."

Ask to see a booking land in your actual system, whether that's ModMed, athenahealth, AdvancedMD, or something else. Watch whether it shows up on the first try, and with the right appointment type, provider, location, and insurance. Then watch a reschedule and a cancellation.

"We integrate" can mean anything from a real two-way connection to someone on your team copying details out of an email. If the demo runs on a sandbox the vendor built, or books a visit type you don't offer, ask why.

Red flag: Bookings arrive as a message or task that someone has to enter by hand.

5. "How does this fit with the answering service and assistants I already pay for?"

This is the question most practice managers care about first. If you already pay for an answering service and virtual scheduling assistants, a new AI tool has to replace some of that cost or do clearly more for the same money. Ask the vendor to lay out the comparison against what you spend today.

Ask where the agent sits in your phone setup, too. Most practices won't start with AI answering every call. A common first step is a branch in the phone menu for scheduling, rescheduling, and cancellations, with everything else going to staff or the answering service as it does now. Find out who sets that up on your phone system: you or the vendor.

Red flag: A plan that assumes AI answers every call on day one.

6. "What happens when my patient says 'representative'?"

Patients will ask for a person, especially when they're frustrated or the question is complicated. Ask what triggers a handoff, where the call goes, and whether the details go with it or the patient has to start over. Ask what happens after hours, when the handoff is to your answering service rather than your front desk.

Then ask what happens to calls the agent can't handle. Each one should land in front of your team with a transcript or recording, not vanish.

Red flag: "Transfer to a human" is the only option, with nothing defined for after hours.

7. "Which appointment types can I keep away from the AI entirely?"

Some visits need a person. Surgical scheduling, post-op concerns, sleep studies, procedures that need prior authorization, and anything clinical may belong with your staff. You need controls at the appointment type and location level, so you can start with simple visits and add more over time.

Red flag: It's all or nothing, or exclusions are a list in a prompt rather than a setting you control.

8. "Which three numbers will you commit to moving, and where's the dashboard?"

Pick metrics you can check: answer rate, hold time, calls completed without staff, and calls handed off. For each call, you should see what happened and be able to play the recording. Ask whether calls show up alongside your online bookings and texts in one patient record.

Also ask what share of your calls the agent can complete, not just answer. If you don't know your call mix today, ask the vendor to help you measure it before they promise results.

Red flag: Promises about revenue growth with no operating numbers behind them.

9. "How do you charge, and what are my exit terms at 90 days?"

Get the pricing model in writing: per call, per minute, per location, or a flat fee. Then run it against your real call volume and what you pay your answering service and assistants today. The agent should cost less than the work it takes off your plate.

Then ask about leaving. What's the notice period? Is there an annual lock-in? Can you cancel at 90 days if the numbers aren't there? In a market moving this fast, an easy exit protects you more than a perfect choice up front.

Red flag: An annual contract with no performance out.

10. "If my practice management system adds voice AI next year, why do I keep you?"

Putting a language model on a phone line is quickly becoming standard. Soon most vendors will offer it, and "do you have AI?" won't set anyone apart. What lasts is the layer underneath: your scheduling rules, appointment logic, insurance handling, and integrations.

Listen to how the vendor answers. If it's all about how natural the voice sounds, you're buying something easy to copy. If it's about how well they know your schedule, that's harder to replace.

Red flag: The product is a voice model with a thin layer on top, and nothing else.

The bottom line

Within a year, voice AI will be a standard feature, not a reason to pick a vendor. These questions will still matter because they're about how your practice runs: who gets booked, with which provider, under which plan, and what it costs compared to what you already pay.

ENT practices that get this right will book the audiogram and the physician together, collect insurance the first time, and spend less on overflow help. Practices that get it wrong will have one more tool their front desk has to check.

Put these questions to us too, including the ones where our answer isn't perfect yet. Book a conversation, and bring your most difficult scenario.