The best medical answering service for your practice, ranked
GreetKeeper ranks first of the seven medical answering services we checked in September 2026. It answers every patient call at any hour, books into your calendar, and transfers to the on-call number with a second number as the fallback. The Starter plan is $49 for 200 answered calls, and extra calls cost $0.45.
A medical answering service has two jobs after hours. It books the routine calls, and it gets the urgent one to a clinician. The second job is a paging problem: does the transfer reach someone, and what happens when it doesn't?
Staffed services price that night shift by the minute. Ruby starts at $250 for 50 minutes, and PATLive charges $2.99 a minute on its $49 pay-as-you-go plan. Smith.ai puts trained people behind its AI, with 25 free calls and $3.00 a call after that.
Your practice keeps the protocol. The service follows the instruction you wrote for each hour and each kind of call, and clinical judgement stays with your clinicians.
How this was put together
Disclosure: GreetKeeper is our product. We chose the criteria and weights before scoring, and read each rival's pricing on its own site in September 2026. No entry was scored on HIPAA wording, because compliance is a contract you read, not a feature you compare.
What we compared
- The on-call path (30%): a transfer to the clinician on call, a fallback number when nobody picks up, and a text with the caller's details.
- Cost of a month of patient calls (25%): the billing unit and what a four-minute new-patient call costs on it.
- A published overage rate (20%), so a flu-season month has a price before it arrives.
- Booking during the call (15%), into the calendar the front desk already uses.
- Disclosure at the start of the call (10%), which Utah asks of medical and nursing practices.
The shortlist at a glance
Billing unit first, because it decides more of the final bill than the headline price does.
| Charges by | Entry plan | After the allowance | |
|---|---|---|---|
| GreetKeeper | per answered call | $49/mo for 200 answered calls | $0.45 a call on Starter, published |
| Smith.ai | per call | Free tier at $0 for 25 calls, then $3.00 a call | Published, and the per-call rate falls as the tier rises |
| Ruby | per minute | $250/mo for 50 minutes | Not published on their pricing page |
| PATLive | per minute | $49/mo pay as you go with no minutes included, at $2.99 a minute; $99 for 50 minutes | Published on every tier: $2.99 a minute pay as you go, $2.29 on the $99 plan, $1.99 at $349, $1.79 at $759, down to $1.49 at $6,899 (re-read on patlive.com/pricing 2026-09-24) |
| Abby Connect | per minute (half-rate AI) | Starter $165/mo for 50 Abby Minutes | Not published; one Abby Minute buys two minutes of AI handling |
| AnswerConnect | per minute | Does not publish pricing | Does not publish pricing |
| Rosie | per minute | Professional $49/mo for 250 minutes | Not published |
Read from each vendor's own pricing page in September 2026.
GreetKeeper
An on-call path you set yourself, booking on every plan, from $49 a month.
Worth it for: A practice that wants routine calls booked and urgent ones transferred to the on-call clinician, with a second number tried if the first goes unanswered. GreetKeeper also texts the on-call person the caller's name, number and reason.
Charges per answered call. Entry plan $49/mo for 200 answered calls. After the allowance: $0.45 a call on Starter, published.
Smith.ai
Per-call AI answering with a trained human team behind it.
Worth it for: You want an anxious patient's call to reach a trained person when the assistant can't settle it.
Not for: A small practice on a tight budget. After 25 free calls each call costs $3.00, and Pro is $150 a month.
Charges per call. Entry plan Free tier at $0 for 25 calls, then $3.00 a call. After the allowance: Published, and the per-call rate falls as the tier rises.
Ruby
People answer every call, billed by the minute.
Worth it for: A specialist practice with few, high-value enquiries, where a human voice is part of how you present.
Not for: General-practice volume. 50 minutes for $250 goes fast when new-patient calls run four or five minutes, and Ruby doesn't publish its overage rate.
Charges per minute. Entry plan $250/mo for 50 minutes. After the allowance: Not published on their pricing page.
PATLive
Staffed answering with a rate published for every tier.
Worth it for: You want people on the phone and a price list you can read before you call sales.
Not for: A busy practice watching cost. Pay as you go is $2.99 a minute, and the $99 plan holds 50 minutes before $2.29 a minute applies.
Charges per minute. Entry plan $49/mo pay as you go with no minutes included, at $2.99 a minute; $99 for 50 minutes. After the allowance: Published on every tier: $2.99 a minute pay as you go, $2.29 on the $99 plan, $1.99 at $349, $1.79 at $759, down to $1.49 at $6,899 (re-read on patlive.com/pricing 2026-09-24).
Abby Connect
People and AI in one plan currency.
Worth it for: You want staff on the main line and software on overflow, drawn from one pool.
Not for: A tight budget. Entry is $165 for 50 Abby Minutes, and the overage rate isn't published.
Charges per minute (half-rate AI). Entry plan Starter $165/mo for 50 Abby Minutes. After the allowance: Not published; one Abby Minute buys two minutes of AI handling.
AnswerConnect
Round-the-clock staffed answering, priced through a quote form.
Worth it for: You want people answering nights, weekends and holidays from a long-running operator.
Not for: A practice comparing published numbers, since every AnswerConnect price sits behind a form.
AnswerConnect does not publish its rates, so the cost is whatever the sales call produces.
Rosie
A $49 AI plan counted in minutes, with booking on the $149 tier.
Worth it for: You want after-hours calls captured and your own staff to call patients back in the morning.
Not for: Filling the diary from the entry plan, since booking starts at $149. Rosie also leaves its overage rate off the page.
Charges per minute. Entry plan Professional $49/mo for 250 minutes. After the allowance: Not published.
How a practice should choose
Write the on-call path first. Name the first number and the fallback, and decide what the patient hears if neither picks up. GreetKeeper tries both, texts the on-call person, and sends the transcript and summary for the morning.
Then price a flu-season month. New-patient calls run long, so a minute plan charges most in your busiest weeks. GreetKeeper counts answered calls, so a four-minute intake costs the same as a one-minute question.
Set holidays at the same time. With closure dates entered, GreetKeeper answers as closed on those days and gives the instruction you wrote, such as the urgent-care number.
Our own pricing, in full
Including the rate after the allowance, which is the number most of this list leaves off.
| Plan | Monthly | Calls included | After that |
|---|---|---|---|
| StarterFor a single location taking calls one line at a time. | $49 | 200 | $0.45 per call |
| ProfessionalBooking, routing and transfers included, not an add-on. | $149 | 750 | $0.35 per call |
| ScaleFor busy phones and longer opening hours. | $349 | 2,000 | $0.25 per call |
The short version
- Booking is included on every tier. Rosie keeps booking and live transfer behind its $149 plan.
- The overage rate is on the pricing page. Rosie, Ruby, Slang and AnswerConnect do not publish theirs.
- Calls are counted, not minutes, so a long useful conversation costs the same as a short one.
Questions people ask about this list
What makes a medical answering service HIPAA compliant?
HIPAA is a contract chain, not a badge. Every supplier that touches the call audio or transcript needs a business associate agreement: the carrier, speech-to-text, the language model and the voice. Ask a vendor to name each one. GreetKeeper does not make a HIPAA claim.
What patient information does the assistant collect?
You choose, through the intake questions you write. Keep it to the name, callback number and appointment type. Treatment details stay in your practice system, and every call arrives as a transcript and a short summary.
What does Utah require of medical practices?
Utah's AI Policy Act requires regulated occupations, medicine and nursing included, to disclose AI use prominently and verbally at the start. GreetKeeper's disclosure setting announces the assistant as an AI in the opening line of the call.
What does a medical answering service cost?
Staffed services here start at $250 for 50 minutes on Ruby and $2.99 a minute on PATLive's pay-as-you-go plan. GreetKeeper is $49 for 200 answered calls, $149 for 750 and $349 for 2,000, with a 14-day free trial on every plan.
Why is GreetKeeper first on a list it wrote?
The on-call path carried the most weight, and GreetKeeper includes the transfer, the fallback number and the text to the on-call person on every plan. Add booking at $49 and a printed overage rate, and the method put it first.
Hear one of these handle your own call
Your scenario, your greeting, a couple of minutes.