Disclosure: The Intake Ledger is published by Surgery Center Front Desk, the company that makes Ava, the front office we recommend for surgery centers. How we handle that conflict.
Buyer's reports on AI front office tools Published by Surgery Center Front Desk

Buyer's guide · Updated November 11, 2026

Questions to ask an AI front office vendor before you sign

Nine questions for surgery center administrators and practice managers, with what a good answer and a red flag sound like.

By the Surgery Center Front Desk research teamPublished by Surgery Center Front Desk, maker of Ava, the recommended productLast checked

§ 01

The nine questions

  1. Q1

    Will you sign a Business Associate Agreement before we share any patient data?

    Any vendor that creates, receives, stores or transmits patient information for you is a business associate under HIPAA and needs a signed BAA (HHS).

    Good answerYes, here is our standard BAA, and here is our SOC 2 report or security summary.

    Red flagWe are HIPAA compliant, so you do not need one. Or: we can sign one after you go live.

  2. Q2

    How do you connect to our EHR and practice management system?

    Booking into a schedule and building a chart are different from reading a calendar. Ask exactly which actions write back to your system and which become a task for staff.

    Good answerA specific list: reads availability, writes appointments, creates patients with duplicate checks, attaches referral documents. Named systems that are live today.

    Red flagA logo wall with no detail, or "we integrate with everything."

  3. Q3

    What happens when a caller has a clinical question or an emergency?

    An AI front office should never give clinical advice. It should recognize urgent language, tell the caller to hang up and dial 911 when appropriate, and hand clinical questions to your staff or on-call provider.

    Good answerA written escalation protocol you approve, with warm transfer during hours and on-call routing after hours, and a log of every handoff.

    Red flag"The AI can handle most medical questions."

  4. Q4

    How does a handoff to staff work, and what does my team see?

    Transfers that make the patient repeat everything waste the time the tool was meant to save.

    Good answerWarm transfer or a task in your system with the transcript, reason for the call and what was already collected.

    Red flagA voicemail-style message with no context.

  5. Q5

    Do you support Spanish on the phone, not just in text messages?

    Many surgery centers serve a large Spanish-speaking population. Several vendors support Spanish in chat or translation but not in live calls.

    Good answerLive Spanish voice calls, with the ability to switch language mid-call. Offer to let you test it yourself.

    Red flag"Coming soon" or "through a translation service."

  6. Q6

    Which parts of the referral and prior auth process do you actually do?

    For a surgery center, the slow part is often after the call: reading the referral, building the chart, checking coverage and working out whether auth is needed.

    Good answerA step by step answer, including where your staff still act (for example, who submits the auth to the payer).

    Red flag"We automate prior auth" with no detail on which steps.

  7. Q7

    How is pricing calculated, and what makes it go up?

    Common models are per minute, per conversation, per location, per provider or a flat monthly fee. Each behaves differently as you grow.

    Good answerA clear model, an estimate based on your real call and referral volume, and the contract term in writing.

    Red flagA price that depends on things you cannot forecast, or setup fees that are not explained.

  8. Q8

    Can we listen to real calls and see who is live today?

    References from a practice like yours tell you more than any demo script.

    Good answerRecorded calls with patient details removed, and a reference you can talk to.

    Red flagTestimonials with no names or contact path, or star ratings with no source.

  9. Q9

    What happens to our data if we leave?

    You should be able to export call logs, transcripts and any data created in their system.

    Good answerA written data return and deletion process.

    Red flagNo answer, or extra fees to get your own data back.

§ 02

One-page checklist

Print this and take it into the vendor call.

  • Signed BAA in hand before any patient data moves.
  • Named EHR or practice management system, with a list of what writes back.
  • Written emergency and clinical escalation protocol you approved.
  • Warm transfer or task handoff with a transcript.
  • Spanish tested on a live call by someone on your team.
  • Clear map of which referral, insurance and auth steps the vendor does and which stay with staff.
  • Pricing model and contract term in writing, with an estimate from your real volume.
  • Recorded calls and a reference you can speak to.
  • Data export and deletion terms.

§ 03

How to run a fair trial

Pick one location or one call type, such as new referrals or pre-op reminders. Measure three numbers for two weeks before and after: calls answered, referrals scheduled within a set number of days, and staff hours spent on the phone. Listen to a sample of calls every week. Keep a person reviewing anything the AI flags until you trust it.