CASE STUDY — SLEEP MEDICINE • AFTER-HOURS CARE
new appointments booked / month
recovered from after-hours callers
added lifetime patient revenue
from a single year with Central
return on investment
vs. staffing a 24/7 care team
appointments recovered / year
that would have been lost
Minnesota, USA
5+ physicians
200+ calls / day
EHR: athenahealth
Insurance: Availity
A note on confidentiality. This customer operates under a mutual NDA. With their permission, we’re sharing the broad strokes of their story — the problems they faced, the work we did together, and the outcomes — while withholding anything that could identify the practice or its patients. Names, locations, and protected health information have been deliberately omitted.
THE PRACTICE
In a busy corner of Minnesota, this practice has grown into one of the largest dedicated sleep centers in its market — more than 5 physicians, a clinical and front-desk team that fields 200+ calls on an average day, and hundreds more that arrive after the lights go out.
Their work centers on something the rest of us take for granted: a good night’s sleep. For their patients, that means diagnosing sleep apnea, dialing in CPAP therapy, and standing by through the messy, human reality of adjusting to a device you have to wear every single night. These are some of the most important relationships in medicine — and many of them are tested at the worst possible hour.
THE CHALLENGE
A mask leaks. A machine throws an error. The pressure feels wrong. And a patient who is exhausted, anxious, and a little frightened reaches for the phone — at 2 a.m., when no one is there to pick up. These are among the most important calls a sleep center receives, and historically the hardest to answer.
Standing up a 24/7 clinical care team to troubleshoot devices in the middle of the night simply wasn’t realistic — not for the staffing, not for the cost. So night after night, those calls went to voicemail, or nowhere at all. And the calls a practice misses are rarely recovered:
of callers hang up without leaving a voicemail
never call back — and often move on to a competitor
Alexander Scott
Practice leadership
WHAT WE BUILT TOGETHER
01
PHASE ONE
The first thing we automated was the call no one could staff: non-clinical “tech support” for CPAP equipment. The practice’s care team is fluent across 30+ machines, masks, and accessories. To stand beside them, Central had to be too.
We tracked down every manufacturer manual we could find — across devices, accessories, and multiple languages — and folded them into Central’s knowledge base. We built simulations so the agent could rehearse real troubleshooting conversations, and after extensive testing, authored targeted, plain-language guidance for it to draw on. Crucially, Central learns from every call: its automated quality assurance reviews conversations, incorporates feedback, and researches external sources so the next answer is sharper than the last.
When leadership was satisfied, we brought Central to their weekly leadership meeting and invited the team to try to stump it. They couldn’t. From there we tuned the finer details — a voice that felt right for their region, and a speaking pace that matched how their patients actually talk.
Illustrative example — not a recording of a real patient interaction.
30+ devices & masks
Multilingual manuals
Simulation-trained
Automated QA & self-improvement
Region-matched voice
02
PHASE TWO
With tech support handled, we turned to the calls that quietly cost the most: after-hours patients who were ready to book. Central connected natively to the practice’s EHR — athenahealth — and worked directly inside Athena’s own scheduler.
When a new patient called, Central could create the record, run the intake, collect insurance details, verify coverage through Availity, call payors directly when something needed confirming, and drop a billing alert with the correct copay attached — all before the office opened the next morning.
1
Create the new patient in athenahealth
2
Run intake & collect insurance details
3
Verify eligibility via Availity — call the payor if needed
4
Book the visit & raise a billing alert with the copay
The result was immediate. Central began booking 45+ appointments a month that would otherwise have slipped away into voicemail — patients who, in the old world, would likely have given up and called a competitor instead.
DOING THE MATH
Valued at the practice’s lifetime patient value, those bookings add up to more than $1.16M in lifetime revenue from a single year with Central — on top of the cost avoided by not staffing a round-the-clock care team. All told, roughly a 200× return on what they invested.
Appointments recovered / yr
Added lifetime revenue
Return on investment
03
PHASE THREE
Next, our engineers taught Central to handle billing questions. It looks up billing data in the practice’s EHR, reads any notes the accounting team has left on the account, and answers compliantly based strictly on what it finds — resolving routine questions in the moment without pulling a staffer off the floor or putting a patient on hold until morning.
SAFEGUARD
When a question crosses into clinical territory, Central knows its limits. During office hours, it routes the patient straight to the nurse triage line. After hours, it reassures them that a ticket has been escalated and that someone will call back the next day. Patients are never left guessing, and clinical judgment always stays with the clinical team.
WHERE THINGS STAND TODAY
calls handled every month
for this practice alone — clinical-adjacent, scheduling, and billing
in added revenue each year
from appointments that previously went unanswered
the cost of one full-time hire
replacing non-revenue front-desk work, around the clock
athenahealth
Availity
