inbound vs outbound
The simplest case is inbound. When a patient calls your practice and an AI answers, the patient started the conversation. The main duties are honesty about the AI, a recording notice, and protecting what they tell you.
Outbound is where the rules bite. Calling a form lead back, following up after a missed call, or reminding someone about a consult all mean your system is placing the call. That's where consent matters most.
ai voices count as artificial voices
In 2024 the FCC ruled that calls using AI-generated voices are "artificial or prerecorded voice" calls under the Telephone Consumer Protection Act. In practice, that means an AI callback to a patient's cell phone generally needs the patient's prior express consent, and marketing calls need prior express written consent.
For implant practices, the fix is simple and it belongs on the form: clear language that the patient agrees to calls and texts from the practice, including calls that use AI and automated technology, with a checkbox or equivalent they actively agree to. Store proof of that consent with the lead.
disclose the ai, and the recording
Even where the law doesn't strictly require it, say it up front. Some states have their own AI disclosure laws, and several states require every party's consent before a call is recorded. An opener that names the practice, says the caller is speaking with an AI assistant, and notes the call is recorded covers all of that in one sentence.
It's also better business. Patients who feel tricked hang up and tell their friends. Patients who are told the truth and then get real answers at 9pm on a Sunday tend to book.
texting has its own rules
Confirmations, reminders, and financing links by text are some of the most useful things an AI setter does. A few rules keep them on solid ground:
- Get consent to text on the form, alongside consent to call.
- Include an easy opt-out on every message, and honor it right away.
- Register your business texting through the carriers' 10DLC program before sending from a local number.
- Never send sensitive details by text. Send a link to the lender's secure page instead.
timing and opt-outs
Federal telemarketing rules prohibit calls before 8am or after 9pm in the patient's local time, and some states set narrower windows. Build those limits into your callback logic, along with a sensible cap on attempts per day.
Patients can withdraw consent in any reasonable way, including by simply telling the AI to stop calling. Your system should recognize that, stop, and record it.
patient privacy
Once a caller shares their dental situation with your practice, treat it as protected health information. Every vendor that touches it, including the voice platform, texting provider, and scheduling tools, should be under a Business Associate Agreement.
Two easy rules prevent most problems: the AI never asks for Social Security, card, or bank numbers by voice, and it never tells a caller anything about how they were found or targeted.
how we handle it
Every Pinecone Dental Marketing setup ships with consent language on the forms, an opener that discloses the AI and the recording, calling windows and attempt limits, opt-out handling on calls and texts, and vendors under Business Associate Agreements. Ava never cold calls anyone. We still recommend a quick review with your own counsel during onboarding, because state rules vary.
This guide is general information, not legal advice.