Silent churn
A patient finishes a cleaning, says "see you in six months," and never books. They did not leave a review. They did not call to complain. They moved, or their schedule changed, or the reminder card went in a drawer and the six months turned into fourteen.
This is the most expensive thing happening in a dental practice and it is invisible on every report you look at, because nothing failed. There is no error state for a patient who simply stops appearing.
The 45 day window
The gap since the last visit is the only signal you need, and it goes cold faster than most practices assume. RexRuby treats 45 days as the lapse threshold: past that point, a patient who has not rebooked gets worked as a lapsed contact rather than an active one.
Contacts reached in that window come back at 5.4 percent. Contacts nobody touches come back at 0.8 percent. Both numbers look small in isolation. Put them against a list of a few thousand patients and the gap is the difference between a full hygiene schedule and a light one.
What the message has to contain
A generic "we miss you" performs like the postcard it is imitating. What moves a patient is a message that already knows the answer to the questions they would have to ask:
- Their name and what was done at the last visit
- Two specific open times, pulled live from the schedule, with the right provider
- A one-tap way to confirm without calling during business hours
The last one matters more than the copy. A patient who has to call the front desk between 9 and 5 to rebook is a patient who is going to keep meaning to.
What Ruby runs for a dental practice, and what she does not
Dental practices get four triggers: the lapsed recall described above, no-show follow-up, first-visit check-in, and NPS. That is the whole list, and the list is short on purpose.
Birthday messages and win-back promotions are switched off for HIPAA verticals at the capability layer, so they cannot fire even if someone toggles at them. Consumer-style reactivation marketing aimed at a patient list is the wrong instrument, and the enforcement lives in code rather than in a policy document.
Voice, and why dental gets one engine
Rex answers the phone for dental practices, in 11 languages, and books into the schedule. Practices choose a voice like everyone else, but the choice is narrower: HIPAA verticals are locked to the OpenAI engine, because xAI does not offer a BAA covering call audio. Ten OpenAI voices are available and each one has real preview audio you can listen to during signup.
That lock is not a limitation we work around. It is the reason a dental practice can put this on the main line.
What it does not do
It does not write into Dentrix, Eaglesoft, Open Dental, or any other practice management system. That integration does not exist in this product, and any page that told you otherwise was wrong. The agent works alongside your PMS and books through RexRuby's own calendar, Acuity, Jane, Google Calendar, or Cal.com.
Outbound messages pass a PHI guard that blocks before send and logs the block. SOC 2 work is an audit in progress, not a certification, and we will say so until a report exists.
What it costs
$999 a month for medical and dental. That includes the HIPAA module, a signed BAA at onboarding, document intake for ID and insurance cards, and the per-provider day calendar. Flat, with no per-patient or per-call charge.
Onboarding is four steps for a dental practice rather than three, because the BAA screen comes before you go live. Start a trial, or see the dental page.