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 starting point — though Phonely publishes its BAA signature as available on Enterprise, so confirm the BAA terms before PHI touches it. 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, with the same caveat: Bland’s signed BAA sits on its Enterprise tier.
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 sells a flat managed plan alongside HIPAA and a BAA, which is why it’s the cleanest answer for a practice that doesn’t want to assemble anything — though the BAA signature is published as available on its Enterprise tier, not on Pro itself. 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 figure in the table, though the signed BAA that makes it compliant is published on Bland’s Enterprise tier, so expect that contract to price differently.
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.