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9-month audit · Anonymized

We audited their phone.
Found $31,000 falling on the floor.

Real psychiatric practice in the Northeast — TMS, Spravato, medication management. Identity withheld at their request. Conservative floor estimate, verified caller-by-caller against their EHR.

Tebra EHR Weave VoIP Aug 2025 → Apr 2026
Before · what we found

Their phone is leaking new patients.

  • →2,982 of 4,720 calls (63%) went unanswered over 9 months.
  • →30 callers explicitly asked to schedule a first appointment, never appeared in the EHR.
  • →20 callers were Optum/Anthem opening 24-hour PA peer-review windows. Miss the window — auth auto-denies.
  • →17 callers were referring providers (highest-LTV lead class). Most went to voicemail; many were never returned.
After · what AI would change

Every call answered. Every window caught.

  • ✓AI answers every inbound call live, on the first ring, 24/7. New patients booked into Tebra during the call with live VOB.
  • ✓Provider referral calls answered live: chart created during the call, then AI calls the referred patient outbound.
  • ✓Web-form leads (Psychology Today, your site) get an AI outbound call within 60 seconds.
  • ✓Time-sensitive payer callbacks (Optum/Anthem peer-to-peer) answered live; clinician paged inside the 24-hour window.
  • ✓Admin (FSA cards, refills, reschedules, records) handled directly. Crisis calls warm-transferred to on-call (~3 sec).

We haven't deployed this at scale yet — MindBill is early. This is what the audit data says is recoverable, not what we've already recovered.

The math

How we got to $31,000.

Floor number — only counts patients we can verify by name in the voicemail.

5
callers asked about TMS / Spravato / ketamine
$10,000 LTV each
23
callers asked about medication management or psych intake
$2,000 LTV each
2
therapy-only / referred-out
$0 (not a fit)
5 high-LTV × 25% conversion × $10,000$12,500
23 mid-LTV × 25% conversion × $2,000$11,500
2 referred-out$0
9-month subtotal$24,000
Annualized$31,000+

Why "+": This counts only callers who left a voicemail explicitly asking for a first appointment. It excludes the 462 silent hang-ups (some unknown fraction are real new patients), after-hours leads (analysis was business hours only), existing-patient retention damage, and auto-denied PAs. The real number is meaningfully higher; we're showing the floor we can prove.

Methodology

How we did the audit.

1

Pulled 9 months of call logs.

4,720 inbound calls + 1,099 voicemail transcripts from their Weave system, Aug 2025 – Apr 2026.

2

Cross-referenced every unanswered caller against the EHR.

For each of the 1,142 unique unanswered phone numbers: searched Tebra by name (when known) and by phone. If matched, pulled their full encounter history and checked whether any visit happened on or after the missed call.

3

Read every voicemail, by hand.

Classified intent for each one — new-patient inquiry, existing-patient concern, pharmacy callback, insurance/PA, care coordination, vendor sales. Manually reviewed by a clinical operations analyst. The 30 confirmed-lost-leads count is verified caller-by-caller.

4

Computed the floor.

Conservative LTV assumptions ($10K TMS/Spravato, $2K medication management). 25% conversion rate (industry-conservative; recovered-call data suggests actual is ~47%). Annualized 9 months → 12.

In their own words

The voicemails behind the 30.

Real callers. All identifiers redacted.

High-revenue lost lead

"I had called a few months ago for my daughter. We canceled it back then, but we're ready to try Spravato and possibly TMS as well."

Returning prospect, ready-to-buy. Never re-engaged.
The future 1-star review

"I've called you guys several times… I have clinical depression, anxiety, and PTSD. I need a new doctor."

Multiple ignored calls + texts. Never matched.
Provider-driven referral

"My psychiatrist asked me to find a different psychiatrist…"

Highest-converting class. Called 3× over multiple days. Never matched.
Time-sensitive TMS

"I'm looking for TMS treatment for my son… he's home from London for a month, we're looking at the accelerated treatment."

UnitedHealthcare PPO. Called 2× in 2 days. Never reached.
What AI handles

5 call types. 5 workflows.

From the same audit data — every call type the practice gets, and what AI does with it.

🤝 Revenue · 20%

Provider referrals → booked patient

AI parses the referral voicemail, auto-creates the patient chart in your EHR, then auto-calls the referred patient to schedule.

Human: Active clinical concern → triage queue.
📞 Revenue · 15%

New patient intake

Captures name, DOB, insurance card. Runs live VOB during the call. Books straight into AdvancedMD or Tebra.

Human: Self-harm or active crisis → on-call clinician (~3s).
⚡ Revenue · 16%

Insurance PA callbacks

Captures payer + reference number. Resolves status checks and routine clarifications.

Human: Optum/Anthem 24-hr peer-review windows → pages clinician immediately.
💊 Admin time · 9%

Pharmacy callbacks

CVS Specialty, Acaredo, dose confirmations. AI confirms patient + medication against your EHR and resolves directly.

Human: Clinical issue (allergic reaction, sub) → prescribing nurse.
📅 Admin time · 7%

Existing patient admin: billing, FSA, refills, reschedules, records

FSA card updates → forwarded to billing. Reschedules → updates the calendar. Refills → routed to pharmacy. Records request from another provider → AI drafts the packet from your EHR, loads it for human review + 1-click send.

Human: Billing dispute requires judgment OR clinical question → routes to right person (biller or nurse).
Honest limits

What the audit can't see.

·
Silent hang-ups (462 callers). No voicemail, no Tebra match. Some unknown fraction are real new patients — could push the lost-revenue number significantly higher. Not in our floor estimate.
·
After-hours calls. This audit only covered business hours. Nights and weekends are unmeasured.
·
Existing-patient retention damage. Spravato billing disputes, urgent psych concerns going unaddressed — operational drag we didn't quantify.
·
Auto-denied PAs. Optum's 24-hour peer-to-peer windows. Missing one costs the entire TMS authorization. Not in the $31K.
·
Clinical liability. One voicemail in our dataset was a patient leaving 6 messages about Spravato termination — board-complaint-class situation if mishandled.
·
Phone-number matching is imperfect. Patients sometimes call from a different number than the one in the EHR. Up to ~17% of "no_match" callers may already be in the EHR. The 30 lost-leads count is conservative on this dimension too.

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