Healthcare · Mental health

An answering service for therapists that puts crisis first

An answering service for therapists has two jobs: point a person in crisis to help at once, and give everyone else a calm, private first call. Your AI receptionist answers while you’re in session, tells crisis callers to call 911 or 988, answers new-client, fee and insurance questions from your rules and books first consultations in your connected calendar. One rule keeps it from confirming who your clients are.

For HIPAA-covered practices, with a signed BAA. Call data is stored in the United States, for customers in the United States and Canada.

Hear it answer — call our AI receptionist(450) 367-9990

If you or someone else is in crisis

Call 911 in an emergency. In the US, call or text 988, the 988 Suicide & Crisis Lifeline. In Canada, call or text 9-8-8, open 24 hours a day, every day (988.ca).

Every 365vox agent is set up to tell callers this. It isn’t a crisis service.

Crisis first: how every call to a therapy practice is routed

The first two questions are built into every 365vox agent and can’t be turned off. Your virtual receptionist follows the rest from rules your clinicians write. It doesn’t assess risk: it acts on what the caller says.

A call comes in, often while you’re in session. The greeting says it’s an AI and that the call is recorded.

1Does the caller say they may harm themselves or someone else?

YesBuilt in Told to call 911 now, and that in the US and Canada they can also call or text 988. If your rules say so, it then offers to put them through to your on-call clinician. When to tell a caller to call 911
2Does the caller describe a life-threatening emergency?

YesBuilt in Told right away to hang up and call 911. The agent can’t call 911 or send help itself.
3Is it a current client, or a clinician or hospital calling about one?

YesYour rule A message for the clinician, or the call put through, by your rules. With the step 10 rule below, it doesn’t confirm to anyone else that a person is a client.
4Is the caller looking for a therapist?

YesRoutine Answers from your rules: who has openings, fees and plans. Then asks your few intake questions and books the first consultation or session your rules name, in your connected calendar. Intake questions to ask, and never ask
5Is it a cancellation, a change or a late fee?

YesRoutine Moves or cancels the session in your calendar and states your cancellation policy. It never charges or waives a fee.
6Is it about insurance, a superbill, a Good Faith Estimate or EAP sessions?

YesRoutine Answers from your rules and takes the details for your team.

Everything elseA message for your team in the portal. The email only says that a call came in.

General information, not legal or clinical advice. Rules differ by state and province and change over time, so check yours. 365vox isn’t a crisis service. Like any AI, it can mishear, so keep your own after-hours crisis message and on-call arrangements.

Mental health answering service: “Are you taking new clients?”

It’s the call most practices get, and the honest answer is often no.

In the APA’s 2024 Practitioner Pulse Survey (853 psychologists, September 2024), 53% had no openings for new patients, and 61% didn’t keep a waitlist. Two-thirds (66%) were in-network with some form of insurance.

So the call needs a clear answer from your rules: which clinicians have openings, for whom, and whether you keep a waitlist. If you don’t, the agent says so and names the alternatives you write, such as colleagues you refer to.

If a clinician has openings, it books the first consultation or session in your connected calendar. If you keep a waitlist, it takes the caller’s details for it. Either way, it asks only what you need. HHS’s minimum necessary standard asks covered entities to limit requests for health information to what the purpose needs, with exceptions such as requests by a provider for treatment. Even where it doesn’t apply, it’s a useful test. Your rules can keep a first call to a name, a safe number, voicemail permission and how they’ll pay. It sends no text messages and makes no outgoing calls: it answers the calls that come in.

Therapy practice intake calls: a new client during a session

Both clinicians are in session, so the call goes to the AI after 20 seconds. The caller starts to share details, and it gently says they don’t need to.

Sample call · Quiet Harbor Counseling (example practice) · Wednesday 11:20 AM, Overflow. Example call with made-up names. The recording, transcript and summary are in your 365vox portal for the days you choose.

AI receptionistThanks for calling Quiet Harbor Counseling. I’m an AI assistant. This call is recorded and transcribed so we can handle your request. How can I help you today?
CallerHi. I’m looking for a therapist. Are you taking new clients?
AI receptionistYes. Dana Reyes has openings for adults on weekday evenings. Would you like to book a free 15-minute phone consultation with Dana first?
CallerYes. It’s been really hard since my divorce, and the panic attacks are getting—
AI receptionistThank you for telling me. You don’t need to share details on this call. Dana will talk with you about that herself. Can I get your full name?
CallerChris Novak.
AI receptionistWhat’s the best number for Dana to call, and is it okay to leave a voicemail there?
CallerMy cell, (503) 555-0129. A voicemail is fine.
AI receptionistDo you plan to use insurance, or pay yourself?
CallerI have insurance through work. Is Dana in-network?
AI receptionistDana isn’t in-network with any plan. Her fee is $160 a session, and she gives you a monthly superbill to send to your insurer. If you decide not to use insurance, you can ask for a Good Faith Estimate.
CallerOkay. Can she call me after 6?
AI receptionistDana has Thursday at 6:15 p.m. or Monday at 6:30 p.m. Which suits you?
CallerThursday, please.
AI receptionistYou’re booked for a 15-minute phone consultation with Dana on Thursday at 6:15 p.m. She’ll call you at (503) 555-0129. If you ever feel unsafe, call 911, or call or text 988 at any time.

What the agent says, and what it never says

The same answers on every call, from your rules. The right-hand column matters as much as the middle one.

What an AI receptionist for a therapy practice says and never says
On the phone	It says	It never says
A caller in crisis	“Please call 911 now. You can also call or text 988.”	Anything that weighs how serious the risk is
“Is my husband seeing someone there?”	“I can’t share who our clients are. I can take a message.”	Yes, no, or a hint either way
Openings	Who has openings and for what, from your rules	A start date you haven’t set
Fit	Your clinicians’ specialties, as your website lists them	Which clinician is “right” for the caller, or what therapy they need
History	“You don’t need to share details on this call.”	Questions about trauma, diagnosis, medications or past treatment
Insurance	Your in-network plans, and how your superbills work	What a plan will pay, or whether a session is covered
Self-pay	Your fees, and that a Good Faith Estimate is available	A discount, a sliding-scale decision or a fee waiver

HHS says practices may leave messages for patients but should limit what they say (HHS FAQ 198). General information, not legal or clinical advice. Rules differ by state and province and change over time, so check yours.

Out-of-network, superbills, Good Faith Estimates and EAP sessions

First calls turn to money quickly. The agent answers from what you write, and stops there.

Out-of-network. It names your in-network plans and explains your superbill process: the client pays you and sends your superbill to their insurer. It never says what a plan will reimburse. It can take plan details for your team to check.

Good Faith Estimates. Under the No Surprises Act, a provider gives uninsured or self-pay clients a Good Faith Estimate of expected charges. CMS says it’s due within 1 business day when a service is scheduled at least 3 business days ahead. It’s due within 3 business days when scheduled 10 or more business days ahead, or when the client asks. A bill at least $400 over the estimate can be disputed (CMS, 2021).

The rule says staff explain orally that an estimate is available when someone schedules or asks about cost. An estimate for recurring sessions may cover up to 12 months (45 CFR 149.610). Your rules can include that sentence. Your team prepares and sends the estimate.

EAP sessions. Some employee assistance programs authorize sessions first. Penn Medicine’s EAP, for example, sends the authorization to the provider the client chooses (Penn Medicine EAP). The agent takes the EAP’s name and any authorization number.

Why it never quotes coverage

Coverage depends on the plan, the deductible and things the agent can’t see. A wrong answer on a recorded line becomes a billing dispute. Your rules can say: “Our billing team will check your benefits and call you back.”

Answering service for counselors: privacy on every call

In a therapy practice, even confirming that someone is a client discloses something.

With the rule Never confirm or deny that someone is a client in step 10, the agent doesn’t confirm or deny that a person is a client, whoever asks: a spouse, the parent of an adult, an employer or a lawyer. It offers to take a message, and your clinician decides what happens next.

Substance use programs. 42 CFR Part 2 applies to federally assisted programs that provide substance use disorder diagnosis, treatment or referral for treatment (HHS). It is stricter than HIPAA in places; the 2024 final rule’s compliance date was February 16, 2026 (HHS fact sheet). For a facility publicly identified as providing only those services, acknowledging that someone is a patient needs their written consent or a court order (42 CFR 2.13(c)). Check with your privacy officer before you write rules for that line.

Canadian practices. Call data is stored in the United States, for customers in the United States and Canada. See PIPEDA and PHIPA.

Who sees the details

For an agent that hears health information, the call email only says that a call came in. The details stay in your 365vox portal, behind your sign-in. Recordings are kept for the number of days you choose in Settings: 7, 14 or 30. For a health agent, the transcript and summary are deleted on the same schedule.

Build it yourself

Build your answering service for therapists in 365vox

Answer Yes to the health question when you create the agent, and accept the health-information agreement. Then set these on the Customize screen.

Build yours free for 7 days

You set all of this yourself in the 365vox portal, on the Customize screen. Everything saves as you type; then you submit, test the agent with a real call and activate it.

Customize · your agent

Step 1, IndustryMedical clinic, the closest healthcare choice.
Step 2, GreetingKeep the AI and recording sentence. Add If you’re in crisis, call or text 988, or call 911 in an emergency.
Step 3, Questions to askName, phone and email are there. Add Is it okay to leave a voicemail at this number? and Will you use insurance, pay yourself or use an EAP?
Step 4, Forward to a personYour on-call clinician, if you keep one. If nobody answers within 20 seconds, the agent takes a message. Leave it off and every call ends with a message, after the built-in safety response.
Step 5, IntegrationsConnect the calendar your clinicians book in, and your practice management or EHR system if it has an open API.
Step 7, When your agent answersOverflow: your phone rings first, and the agent answers after 20 seconds while you’re in session.
Step 8, Call notificationsYour clinicians and intake coordinator. The email only says a call came in; calls your rules mark urgent get their own.
Step 9, Business rulesOpenings by clinician, what a first booking is (a consultation or a session), fees, cancellation policy, in-network plans, superbills and the EAPs you accept.
Step 10, Things your agent will never doAdd Never confirm or deny that someone is a client and Never ask about diagnosis, trauma or past treatment.
Step 13, Test your agentCall as a new client, a current client and a caller in crisis, to hear the 911 and 988 response.

Starter rules for a therapy practice

Paste these into step 9, Business rules, and replace everything in brackets. The safety response comes first and can’t be turned off. A caller who says they may harm themselves or someone else is told to call 911 now, and that in the US and Canada they can also call or text 988, the suicide and crisis line.

Business rules · therapy practice

Starting point only: review with your clinicians and your privacy officer before you use it.

After the built-in safety response, if a caller is in crisis, offer to put them through to [our on-call clinician].

Never confirm or deny that anyone is a client. Say: “I can’t share who our clients are, but I can take a message.”

New clients: [Dana Reyes] has openings for [adults, weekday evenings]. [Jordan Lee] has none. We [do / don’t] keep a waitlist. Take the name, a safe number, whether a voicemail is okay, who the therapy is for and how they’ll pay. Then book a [free 15-minute phone consultation] with that clinician in an open time.

Never ask why someone wants therapy, or about diagnosis, trauma, medications or past treatment. If a caller starts to share details, say: “You don’t need to share details on this call.”

Fees: [$160] a [50-minute] session. Less than [24 hours’] notice: [$80]. Never waive a fee.

Insurance: in-network with [plans]. Others pay us and get a monthly superbill for their insurer. Never say what a plan will pay.

Say: “If you’re uninsured or won’t use insurance, you can ask us for a Good Faith Estimate.”

EAPs we accept: [names]. Take any authorization number.

Current clients: move or cancel a session in an open time and state our cancellation policy. Anything else: take a message for their clinician.

Clinicians call new clients at the consultation time. Never promise a start date for therapy.

General information, not legal or clinical advice. Rules differ by state and province and change over time, so check yours.

What it costs a group practice

$0.75 a conversation minute, billed by the second. No monthly plan, no setup fee and no long-term contract. Taxes where applicable. First calls from new clients run longer than reschedules, so the example uses 3.5 minutes a call.

See AI receptionist pricing Estimate your cost

Example: a 6-clinician group practice on Overflow

Calls nobody picks up within 20 seconds while clinicians are in session.

Calls to the agent a week: 30
Calls a month: 130
Average call: 3.5 min

Monthly cost$341

30 calls × 4.33 weeks × 3.5 min × $0.75 USD = $341, about $57 a clinician. Example numbers chosen by 365vox, not a customer’s. Taxes where applicable.

Comparing virtual receptionist services?

Live answering services usually sell monthly plans of minutes or calls. 365vox is an AI virtual receptionist that answers forwarded calls on the first ring, day and night, follows your approved answers and costs $0.75 a minute, billed by the second, with no plan.

The virtual receptionist, minus the call center

Answering service for therapists FAQs

What should an answering service for therapists do with a caller in crisis?

Point them to help at once. A caller who says they may harm themselves or someone else is told to call 911 now, and that in the US and Canada they can also call or text 988, the suicide and crisis line. If you keep an on-call clinician, your rules can then offer to put the caller through. The agent doesn’t assess risk, can’t call 911 itself and, like any AI, can mishear. It isn’t a crisis service, so keep your own on-call arrangements.

Will it tell a spouse or parent whether someone is a client at our practice?

No. Add “Never confirm or deny that someone is a client” in step 10, and it answers every such caller the same way: it can’t share who your clients are, and it can take a message. Your clinician decides whether and how to respond. It reads no records, so it has nothing else to share.

Can it manage our waitlist and call people when a spot opens?

No. It sends no text messages and makes no outgoing calls: it answers the calls that come in. It can tell callers whether you keep a waitlist and take their details with a safe number and voicemail permission. Your team calls people back when a spot opens. When a clinician has openings, it books the first consultation in your connected calendar instead. Most psychologists in the APA’s 2024 survey (61%) didn’t keep a waitlist at all, so write down which you do.

How does it answer out-of-network and superbill questions for a therapy practice?

From your rules. It names the plans you’re in-network with and explains your superbill process: the client pays you and sends your superbill to their insurer. It never says what a plan will reimburse or whether a session is covered. It can take the plan name and member details for your billing team to check.

Does it give self-pay clients the Good Faith Estimate?

No: your team prepares and sends it. The rule says the availability of an estimate is explained orally when someone schedules or asks about cost (45 CFR 149.610). If your agent answers fee questions, your rules can include a sentence that uninsured or self-pay clients can ask for one. General information, not legal or clinical advice. Rules differ by state and province and change over time, so check yours.

Can a mental health answering service take EAP referrals?

Yes. Add the EAPs you accept to your business rules. The agent tells callers whether you accept their program, takes the EAP’s name and any authorization number, and books the first session in your connected calendar. Your team checks the authorization before that session. It never says how many sessions a program covers unless your rules do.

Is it a fit for a substance use disorder program covered by 42 CFR Part 2?

Possibly, with care. Part 2 is stricter than HIPAA in places. For a facility publicly identified as providing only substance use disorder services, even acknowledging that someone is a patient needs written consent or a court order (42 CFR 2.13(c)). Review your rules with your privacy officer before an agent answers that line.

What does an answering service for counselors cost for a solo therapist?

A solo counselor on Overflow with 8 calls a week that ring past 20 seconds, at 3.5 minutes each, pays about $91 a month. $0.75 a conversation minute, billed by the second. No monthly plan, no setup fee and no long-term contract. Taxes where applicable. See pricing, or try it free for 7 days.

Crisis first. Then a calm, private first call.

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