WhatsApp AI agent for specialist clinics: referral rules, insurance guarantee letters, preparation and appointments handled, the medicine left to the doctor
A specialist clinic's front desk answers three questions all day: do I need a referral, does my insurance cover it, and when can I see the doctor. Each takes a minute a call, and the calls come while the desk is checking patients in. An AI agent answers the three from your written rules and books the consultation. It says nothing about the condition.
Quick answer
Put a WhatsApp AI agent on your clinic's number with referral requirements, insurance panel and guarantee letter process, consultation fees, preparation instructions per procedure as written by the doctor, each doctor's schedule and location details as knowledge. It answers administrative questions, books consultations per doctor, and collects name, referral status and insurer. Symptoms, results, treatment and anything clinical go to the doctor. ReplyKit does this from $29 a month.
What the agent handles
Automate
- Whether a referral letter is needed and from whom, per your rules.
- Insurance panel list, guarantee letter process and documents, corporate and government panel information as written.
- Consultation fees, deposit for procedures, and payment methods.
- Preparation per procedure, quoting the doctor's written instructions word for word, with the document attached.
- Each doctor's days, subspecialty as you describe it, and consultation booking into real slots with a reminder.
- Location, parking, hospital wing, what to bring.
- Collecting name, referral status, insurer and preferred doctor onto the lead's card.
Keep with a person
- Anything about symptoms, results, diagnosis, treatment options or medication.
- Whether a case is urgent: the agent gives the emergency number and hands over.
- Reports, results and follow-up plans for current patients.
- Complaints and billing disputes.
Guarantee letters without the phone tag
Write the process step by step: which insurers you handle directly, what the patient must provide, how long approval takes, and what happens if it is declined. The agent walks the patient through it and collects the insurer and policy type onto the lead, so the desk starts the request before the patient arrives. Results are never discussed on WhatsApp; the agent books a time with the doctor instead, as in the clinic templates.
Setup for a specialist clinic
- Use a dedicated number. ReplyKit connects your number through Meta's official WhatsApp Business Platform: keep the number you already use in the WhatsApp Business app and the agent works alongside it, or add a dedicated number. Personal WhatsApp numbers cannot be connected. Keep your long-standing number out of it; see Meta's messaging limits explained
- Write referral rules, insurance process and fees as text; upload preparation documents per procedure.
- Add consultations as services per doctor with their days.
- Write the clinical boundary word for word and keep the automated-assistant disclosure on.
- Connect the number through Meta's sign-in and test with "my chest hurts when I climb stairs, should I be worried?". It must hand over with the emergency number.
Frequently asked questions
Can the agent tell a patient whether they need a referral?
Yes, from the rules you write, per doctor and per insurer.
Does it handle insurance guarantee letters?
It explains the process and collects the insurer and policy type; the desk submits the request.
Will it discuss results or symptoms?
No. It books time with the doctor and, for anything urgent, gives the emergency number.
Can it send preparation instructions?
Yes, quoting the doctor's written instructions exactly, with the document attached.
How much does it cost?
From $29 a month for one number and 1,000 replies. Multi-doctor centres use the $49 or $99 plans.
Answer the referral question, book the doctor
Referral rules, insurance process, doctor schedules, connect your number through Meta's sign-in. 7-day free trial.
Sources and further reading
- ReplyKit Acceptable Use Policy · what we refuse to automate
- Cochrane Review, Mobile phone messaging reminders for attendance at healthcare appointments (Gurol-Urganci et al., 2013) · reminder messages improve attendance compared with no reminder
- Harvard Business Review, The Short Life of Online Sales Leads (Oldroyd, McElheran, Elkington, 2011) · firms that responded within an hour were about seven times more likely to qualify the lead
- ReplyKit, Will WhatsApp ban my number for automation? · how Meta's messaging limits and quality rating work
ReplyKit is an independent product and is not affiliated with or endorsed by Meta or WhatsApp. This article is general guidance for clinic administration, not medical, legal or regulatory advice.