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

Over the past few months I've sat in on a lot of voice AI conversations with plastic surgery groups and medspas. The pattern is the same one we've seen across specialties. Every demo sounds smooth, every pitch promises more booked consults, and practices end up choosing on vibes and price. Some have already pulled the plug on a pilot that sent patients answers that had nothing to do with their question. Others walked away because the pricing was built for hospitals or because the agent sounded robotic and couldn't follow a caller off script.

Aesthetics has its own set of nuances that a generic AI receptionist isn't built for.

Leads come from paid social, and most of them arrive after hours. One multi-location group told us roughly half their leads come in outside business hours and about three quarters come from Meta ads. Their patient coordinators work 8am to 5pm. A patient who scrolls past your ad at 9pm and can't book will often book with whoever answers first.

Scheduling is harder than it looks, too. A surgical consult, a filler appointment and a laser package each need a different provider, room, and set of rules. Getting that wrong costs you a consult slot, not just a bit of admin time.

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

The 10 questions

1. "Book me a surgical consult with the right surgeon, the right consult type and the deposit."

Don't let the demo stop at "here's an open slot." Ask the vendor to book a real consult: a breast augmentation consult with a specific surgeon, at a specific location, with your consult fee or deposit rules applied. Then ask for a Botox touch-up with an injector, and a laser treatment that needs a particular room or device.

Many AI tools only read a provider's calendar. They don't read your scheduling templates, so they don't know that Dr. A only does facial consults on Tuesdays or that new filler patients need a longer slot. If the agent can't follow those rules, your coordinators will spend every morning fixing what it booked overnight.

The rules go beyond the calendar. Many practices charge different late-cancel or no-show fees for cosmetic and medical visits inside a 24-hour window. If you also see insurance patients, such as medical dermatology or reconstructive work, the agent needs to collect insurance details the same way your online booking form does. Ask it to cancel a filler appointment 12 hours out and listen to what it says.

Test deposits on their own. If online booking requires a card on file for aesthetic appointments, the phone agent has to require one too. Otherwise patients learn that calling is the way around your deposit policy. Ask how the agent takes the card, whether over the phone or by a secure text link during the call. Also check that it collects every field your system requires to create a patient, down to the zip code.

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 'I saw your ad and want to get my stomach done.' What happens next?"

Patients don't speak in appointment types. "Stomach" might mean a tummy tuck consult, a body contouring package, CoolSculpting, or a medical weight loss visit. "My lips" might be filler, a lip lift, or a revision. Ask how the agent narrows down the request, what questions it asks, and what it does when it's still not sure.

Many practices want the first question to be "Is this a medical or cosmetic visit?" The answer changes everything after it. A Botox patient may not need to give insurance at all. A medical patient may only be able to see the providers who take their plan, and some plans need authorization before you can book.

Then test the wrong guess. Booking a 15-minute injector slot for someone who needs a 60-minute surgical consult wastes two appointments and a lead you paid for.

Also ask about the caller who says "I don't know if I need Botox or filler." Most agents won't explain treatments at launch. That's fine, as long as the question reaches your team with a transcript or recording instead of hitting a dead end.

Existing patients bring their own version of this. If someone has a facial and a toxin appointment the same week, the agent should name each one so the caller moves the right one. And if two patients share a birthday, ask how the agent tells them apart.

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

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

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

"We integrate" can mean anything from a real two-way connection to a coordinator copying details out of an email. If the demo runs on a sandbox the vendor built, ask why.

Watch two details. Does the agent create a duplicate chart when a caller doesn't spell their name? And does it respect the texting consent already on file? Many practices require written consent before texting patients. An agent that ignores an opt-out in your system creates a compliance problem.

Ask how long it takes to go live and who does the setup. Practices checking references on some vendors heard the same thing: The agent can be customized, but only after you spend time teaching it. A vendor that reads your existing scheduling rules should need far less of that.

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

4. "A lead calls at 9:30pm from a Meta ad. Show me what happens."

This is the question that matters most in aesthetics. Paid social leads show up when people are scrolling, which is evenings and weekends. If the only option after hours is "we'll call you back in the morning," a good share of those leads will have booked somewhere else by then.

Ask the vendor to run an after hours call end to end. Can the agent book a new patient consult right then? Can it collect what your coordinators would collect? Can it text a booking link if the caller prefers to pick a time themselves? Ask for after hours booking rates from other aesthetics practices, not a general benchmark.

Listen as well as watch. A two-second pause at the start of a call is long enough for a caller to start pressing buttons or hang up. A simple booking should take about a minute, not 10. Ask what voices and languages are available too. If many of your patients prefer Spanish, an English-only agent misses them.

You don't have to go all in on day one. Some practices plan to put the agent on after hours calls first, for aesthetic bookings only, and keep daytime calls with staff. Ask whether the vendor supports that.

Red flag: After hours calls are "captured" as a lead record but nothing is booked.

5. "What happens when my patient says 'I want to talk to a person' and nobody's in?"

Patients considering surgery often want to talk to someone. Ask what triggers a handoff, where the call goes, and whether the conversation details go with it or the patient has to start over.

Remember who's calling. Many established practices have long-time patients who would rather talk to a person and who chose you partly because a person answers. A good handoff is how you keep them.

The after hours version is harder. If your coordinators are offline, does the agent forward to an answering service, schedule a callback for the morning, or offer to book the consult now? You should be able to choose, location by location.

Ask whether callers hear up front how to reach a person, such as "press 1 at any time." 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.

Get specific about triggers. Can you set words that send a caller straight to a person? Does the agent notice when a caller is getting frustrated? If a patient hangs up on the AI and calls right back, can that call skip the agent and ring your team? Some callers, such as patients on special insurance programs, may need a priority transfer with no wait. And when the call reaches staff, does a short summary come with it?

Red flag: "Transfer to a human" is the only option, with nothing defined for when no human is available.

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

Some visits need a person. Post-op concerns, possible complications, revisions, procedures like Mohs surgery and anything clinical should go to your team. Many groups also start small. One practice we work with launched online booking for medspa services first and held surgical consults back for a month while operations got comfortable.

You need controls at the appointment type and location level, so you can turn things on in stages. Ask how the agent recognizes a post-op patient calling about swelling and where that call goes.

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

7. "Will my call tracking and attribution survive?"

Most aesthetics groups run different tracking numbers per location, per campaign, and per channel. Ask exactly how the vendor connects to your phones. Do your tracking numbers forward to them? Does the source of the call carry through to the booked appointment? Does it work with your existing phone system, whether that's RingCentral, Weave, Zoom Phone, or another provider?

Then ask where the agent sits in your phone tree. Does it answer first and pass what it can't handle to your existing menu? Does it sit behind a "press 2 to book" option? Or does it get its own number for your website and after hours line? Each choice means work for whoever manages your phone system, so find out who does that work: you or the vendor.

If your marketing team can no longer tie a booked consult back to the ad that drove it, you've traded one problem for another.

Red flag: A vague answer on telephony or a requirement to replace your numbers.

8. "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. Be wary of any vendor that wants a percentage of revenue from the patients it books. One group we spoke with walked away from a vendor asking for a cut of everything that came through. Their point was simple: The host who seats you at a restaurant doesn't get a share of the bill.

Then run the per-call price against your real volume. A busy multi-office group can handle hundreds of calls a day, and usage pricing adds up fast. The agent should cost less than the staff time it frees up, and the vendor should be willing to show you that math.

Watch for pricing designed for someone else. One practice we spoke with was quoted thousands of dollars a month by a vendor whose pricing was clearly aimed at hospital systems.

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: Revenue share or an annual contract with no performance out.

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

Pick metrics you can check: answer rate, speed to lead, after-hours consults booked, consult show rate, and calls resolved without staff. Ask to see the dashboard, and ask whether calls show up alongside your online bookings, texts, and web chats in one patient record.

For each call, you should see whether the agent completed it or sent it to staff, and be able to play the recording. Recordings let you spot-check quality and find the exact call when a patient complains.

Also ask what share of your calls the agent can complete, not just answer. If your online booking already handles simple requests, the calls left over are often harder ones about pricing, financing, or a specific procedure. The vendor should show you call type data from similar practices.

If you don't know your call mix, you're not alone. One group we spoke with has 20-30 people answering phones across offices and no record of why patients call. A good vendor will help you measure that before promising results. And be realistic about staffing: The near-term win is shorter hold times and coordinators freed up for consults, not an immediate headcount cut.

Expectations vary widely. One operations leader we spoke with estimated about half their calls are simple scheduling. Another practice administrator hopes AI will eventually handle 90%. Ask the vendor which number is realistic for your mix and by when.

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

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 separate anyone. What lasts is the layer underneath: your scheduling rules, appointment logic, integrations, and the patient record that ties every channel together.

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

Ask about the roadmap, too. Calling no-shows to rebook, recall reminders, and a text assistant that works alongside voice all depend on that same scheduling layer. Be wary of any add-on that creates back-and-forth your staff has to clean up. A text bot that can't see the schedule just adds to the task list.

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 whom, from which ad, and what happens when nobody's at the desk.

Aesthetics practices that get this right will answer the 9pm lead, book the right consult the first time, and still know which campaign paid for it. Practices that get it wrong will have a new tool for their coordinators to babysit.

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