Guide · AI Receptionists
The compliant AI receptionist shortlist for dental and medical offices is four names, not forty
If you handle PHI, the vendor that signs a BAA matters more than the sticker price — and only four vendors in this market publish both HIPAA support and a signed BAA.
A dental or medical office that takes appointment calls is handling protected health information the moment a patient says their name and why they’re calling. That means the relevant question isn’t “which AI receptionist is cheapest” — it’s “which one will sign a Business Associate Agreement.” On that filter the field collapses hard. Of the twenty-plus vendors we track, exactly four publish both HIPAA support and an available signed BAA: Phonely, Bland, Vapi, and Retell AI. For a practice that wants a flat, managed plan, Phonely’s Pro tier at $150/mo (750 included minutes) is the most straightforward compliant pick. If you’d rather pay only for talk time, Bland’s $0.14/min all-in rate is the honest pay-as-you-go floor.
The BAA filter, and what it eliminates
Most of this market simply doesn’t publish a compliance position. The popular cheap-and-friendly options for small businesses — Rosie (Professional $49/mo for 250 minutes) and Goodcall (Starter $79/mo, unlimited minutes) — list no HIPAA support and no BAA at all in their published material. For a PHI-handling practice that absence is disqualifying, not a footnote: without a signed BAA you can’t legally route patient calls through the service, regardless of how good the demo sounds or how low the price is.
One near-miss is worth flagging. Trillet lists HIPAA as available but does not publish BAA details — and “HIPAA-ready” without a signed agreement doesn’t satisfy the requirement. That’s why it sits below the line here.
What the four compliant vendors actually cost
To compare across billing models we fix a workload borrowed from our 200-calls analysis: 200 inbound calls a month at 3 minutes each, or 600 talk-minutes — a realistic small-practice front desk.
| Vendor | Cost @ 600 min/mo | Plan | What you actually sign for |
|---|---|---|---|
| Bland | $84 | Start | $0.14/min all-in — model, speech, telephony included |
| Phonely | $150 | Pro | Flat, 750 minutes included; overage $0.30/min |
| Vapi | $2,030 | Build (PAYG) | $0.05/min platform = $30, plus the $2,000/mo HIPAA add-on |
| Retell AI | $42–$186 | Pay As You Go | $0.07–$0.31/min range; floor is $42, ceiling $186 |
A few things in that table matter more than the raw ordering.
Phonely is the only one of the four that offers a flat managed plan with HIPAA and a BAA, which is why it’s the cleanest answer for a practice that doesn’t want to assemble anything. Its smaller tiers — Free at 100 minutes and Starter at $50/mo for 250 minutes — undershoot a 600-minute workload, so a busy office lands on Pro; but a low-volume specialist might genuinely run on the $50 Starter and pay $0.30/min for the occasional overage.
Bland’s $0.14/min is the number you can take at face value: it’s explicitly all-in, covering the language model, speech-to-text, text-to-speech, and telephony in one rate. At 600 minutes that’s $84, and there’s no platform fee on the Start tier — the cheapest compliant figure in the table.
Vapi looks cheapest on the per-minute line — $0.05/min works out to just $30 of platform fee for 600 minutes — but HIPAA on Vapi is a $2,000/mo add-on, which inverts the entire ranking. The compliant cost isn’t $30; it’s $2,030 before you’ve paid for a single language model, which Vapi passes through on top. For a small practice that’s a non-starter; for a multi-location group doing serious volume, the math changes.
Retell publishes a range rather than a single rate: $0.07–$0.31/min depending on which LLM you wire in (its voice infrastructure is $0.055/min, telephony $0.015/min, model on top). At 600 minutes that’s anywhere from $42 at the floor to $186 at the ceiling — so your real cost is a function of model choice, not a posted price.
How to read this
If you’re a dental or medical office, the decision tree is short. First filter to the four vendors that will sign a BAA — Phonely, Bland, Vapi, Retell — and ignore everyone else no matter how the pricing looks, because Rosie’s $49 and Goodcall’s $79 plans aren’t legal options for PHI. Among the four, Phonely’s $150/mo Pro plan is the simplest flat answer, Bland’s $84 all-in is the cheapest if you’re comfortable with pay-as-you-go, Retell ($42–$186) trades a single price for model flexibility, and Vapi’s $2,000/mo HIPAA add-on rules it out for anyone below enterprise scale. Compliance comes first; price ranks the survivors.