Client story

They kept hiring people to answer the phone. Then it stopped ringing all day.

Michigan’s largest independent outpatient imaging network had thirty-three people in its call center and had just added most of them, because the volume kept winning. Confirmation calling now takes two hours a week instead of forty.

10 centers in MichiganNo hospital affiliation250 employees
Carrie Berlin
Co-Chief Executive Officer,
Regional Medical Imaging
Read what she says ↓
Practice profileIndependent, ten centers, Michigan
10
outpatient centers, none hospital-affiliated
250
employees, more than 90% of them women
33
people in the call center
40→2hrs
a week spent on confirmation calls
In her own words

Five parts of the problem, from the person who has held most of the jobs.

Carrie Berlin joined RMI in 1989 and has run the front desk, the billing department and the IT department on her way to co-chief executive. She is precise about where the time went.

The call center
“We actually have like 33 people in our call center, and a lot of those people were added within the past year or two because we just couldn’t handle the call volumes. So they’re on the phone all day long.”
Where automation fits
“There’s opportunities within the call center to provide automation with the calling itself, whether it’s inbound or outbound. There is a vast opportunity at the front desk for automation. And then make the employees even better, right?”
Why it is survival
“When they started cutting reimbursements, it’s nearing 20 years ago now. We never imagined that we would still be taking cut after cut after cut. And we’ve only been able to stay ahead of that through efficiencies.”
One login, not five
“The ease and your willingness to integrate other features and products, like our revenue cycle management system, and it could live and be housed inside of your system. We no longer wanted our employees having to log into five different things.”
What happens to the staff
“It gives you the opportunity to kind of keep your superstars, and with AI together with them, now they’re even better, right? And now the referrings are having a better experience. The patients are having a better experience.”
33
people in the call center,
most of them recent hires
40 hrs
a week of confirmation
calls, made by hand
2 hrs
a week of the same work,
once it was automated
01 · Monday morning

Hundreds of voicemails, every week

Patients who tried to reach RMI over a weekend could not, so Monday began with hundreds of messages waiting. On top of that, agents worked across several systems, insurer databases and paper checklists, and every appointment type carried its own preparation: some patients had to fast, some needed paperwork, some needed safety screening that could not be skipped. The arithmetic only went one way: hire more agents, or let hold times and no-shows grow.

  • Hundreds of weekend voicemails waiting on a Monday
  • Agents moving between several systems and paper checklists
  • Different preparation instructions for every appointment type
  • Thirty-three people in the call center, most added recently to keep up
02 · The call that makes itself

The confirmation stopped needing a person

As soon as an order lands, Voice AI calls the patient and talks through the preparation for that specific procedure. The patient confirms by speaking or by keypad, and the schedule updates itself. A patient who needs to move the appointment, or who has a pacemaker that needs screening, or who simply wants a person, is handed to the right member of staff with the context attached. Because it runs around the clock, the weekend backlog never forms.

  • The call goes out as soon as the order arrives
  • Preparation instructions specific to the procedure booked
  • Confirmation by voice or keypad, updating the schedule directly
  • Reschedules, safety screening and human hand-offs passed on with context
  • Running 24/7, so Monday no longer starts with a backlog
Why it matters
“We’ve only been able to stay ahead of that through efficiencies, and working with people that are on the cutting edge of technology and willing to partner with us.”
Carrie Berlin, Co-Chief Executive Officer
Regional Medical Imaging
03 · What it protects

An independent that hospitals stopped competing with

Ten outpatient centers in Michigan with no hospital affiliation at all is, in Carrie Berlin’s words, very rare, and it survives on service. One hospital in their main market closed its own imaging and now sends RMI its patients, including its own employees. Holding that position while reimbursement falls means finding the time somewhere, which is why the confirmation calls mattered: the thirty-three people are still there, doing work that needs a human.

  • Ten centers, none of them hospital-affiliated
  • A hospital in their market closed its imaging and refers to RMI instead
  • Revenue cycle management brought inside the same system, not a sixth login
  • Agents kept and redeployed rather than replaced

The results RMI sees

95%
Less staff time on appointment confirmation calls
40 hours→2
A week spent making confirmation calls
7.9%
fewer same-day
cancellations
Measured pre/post, 1 May 2024 – 1 Mar 2025 against 1 Aug 2025 – 10 May 2026, on effectively identical appointment volume.
11.5% → 10.5%
total appointment disruptions
+4.1 pts
confirmation rate, 41.5% to 45.6%

Phones winning?

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