Where AI suggestions appear: On the full Comms > Chat page only. They do not appear in the mini chat windows that pop up elsewhere in the platform.
Prerequisites: Your organization needs an AI texting assistant configured under Settings > Assistants > Texting. A primary patient must be set on the conversation for suggestions to appear. See Assistants Settings for setup details.
What AI Suggestions Look Like
After a patient sends a message, a highlighted card appears below their message in the conversation. This card is labeled Suggested Response with an AI badge. It contains the AI’s draft reply and three actions:- Use — Send the suggestion as your reply.
- Regenerate (redo icon) — Ask the AI to rewrite the suggestion with your feedback.
- Dismiss (X icon) — Remove the suggestion and write your own reply.
Use a Suggestion
If the AI’s suggestion looks good, click Use. The message is sent to the patient immediately, just as if you had typed it yourself. The conversation is automatically marked as resolved.Tip: Always read the full suggestion before clicking Use. The AI pulls from the patient’s records and your clinic’s settings, but it can occasionally get a detail wrong — especially appointment times or provider names. A quick glance takes seconds and prevents confusion.
Regenerate a Suggestion
If the suggestion is close but not quite right, click the regenerate icon. A window titled “What is wrong with this response?” opens with a text area where you can tell the AI what to change. For example:- “Make it shorter”
- “Include the appointment date and time”
- “Use a warmer tone”
- “Don’t mention the payment — just confirm the appointment”
Your feedback makes the AI smarter over time. When you tell the AI what to fix, it uses that feedback to improve future suggestions — not just for this conversation, but across your clinic. The more specific your feedback, the better the results.
Dismiss a Suggestion
Click the X icon to dismiss the suggestion and write your own reply. There’s no penalty for dismissing — the AI will still suggest replies on the next incoming message.AI Actions
The AI doesn’t just suggest text replies. It can also suggest actions — things like sending an invoice, notifying the billing team, or texting a form link to the patient. When the AI suggests an action instead of a text reply, you’ll see:- The action name (e.g., “Send Text Invoice” or “Notify Billing Staff”)
- A description of what the action will do
- An Execute button instead of a “Use” button
AI actions save your team real time. Instead of switching to the Billing page to create an invoice, the AI can handle it from right within the conversation. But always review the action description before executing — make sure the right patient, amount, or form is being referenced.
When to Trust the AI vs. Write Your Own Reply
The AI works best for common, routine messages:- Confirming or rescheduling appointments
- Answering questions about office hours or location
- Directing patients to the right department
- Sending payment or form links
- The patient is upset or dealing with a sensitive situation
- The message involves a clinical decision or medical advice
- You need to communicate something nuanced that the AI might oversimplify
- The AI’s suggestion doesn’t sound like something your clinic would say
Configure the AI Texting Assistant
The AI assistant’s behavior is controlled by settings under Settings > Assistants > Texting:| Setting | What It Controls |
|---|---|
| Assistant Name | The display name on AI-generated messages. |
| Custom Prompt | Instructions for tone, length, specific phrases, and what topics to avoid. This is the most powerful setting — the more specific your prompt, the better the AI matches your clinic’s voice. |
| AI Model | Which AI model generates suggestions. |
| Phone Number | The phone number used for outbound AI messages. |
AI Scheduling
When the right tools are enabled on the Inbound Texting assistant, the AI can handle appointment booking, cancellation, rescheduling, and confirmation entirely over text — without staff involvement.What the AI Can Do
| Action | What Happens |
|---|---|
| Book an appointment | The AI finds available slots, presents options, discloses any booking fees, confirms details with the patient, and creates the appointment. |
| Cancel an appointment | The AI identifies the appointment, states any cancellation fee, waits for patient confirmation, then cancels. |
| Reschedule an appointment | The AI finds a new slot, confirms the change with the patient, cancels the old appointment, and books the new one. Previously paid booking fees are not charged again. |
| Confirm an appointment | When a patient replies to a reminder with “yes”, “confirm”, or similar, the AI confirms all pending appointments within the reminder window. |
| Escalate to staff | If the AI cannot help (clinical question, fee dispute, complaint), it contacts a staff member with the patient’s name and request details. |
Enable AI Scheduling
To turn on scheduling, enable the relevant tools on the Inbound Texting assistant under Settings > AI Assistants > Inbound Texting > Tools.| Tool | What It Enables |
|---|---|
| FindAvailability | Searches for open appointment slots. Required for booking and rescheduling. |
| CreateAppointment | Allows the AI to book new appointments. |
| CancelAppointment | Allows the AI to cancel appointments and handle fee disclosure. |
| RescheduleAppointment | Allows the AI to reschedule existing appointments. |
| ConfirmAppointment | Allows the AI to confirm pending appointments from reminder replies. |
| ListProvidersAndServices | Allows the AI to look up providers, services, locations, and pricing. |
If you enable booking or rescheduling, make sure FindAvailability is also enabled — the AI needs it to search for open slots.
How Booking Works
When a patient texts asking to book an appointment, the AI follows this flow:Gather Requirements
The AI asks the patient what service they need, and optionally their preferred provider, location, or time. If the patient has a preferred provider or primary location on file, the AI uses those as defaults.
Disclose Fees
If the service has a booking fee, the AI tells the patient the exact amount and the cancellation fee policy before searching for availability. The patient must acknowledge before the AI proceeds.
Find Availability
The AI searches for open slots (up to 10 at a time, within a 14-day window) and presents them conversationally — for example, “We have openings on Friday at 9:15 AM and 10:00 AM.”
Confirm with the Patient
The AI restates the service, provider, date, time, and location, and waits for the patient to confirm. The AI never books without explicit confirmation.
How Cancellation Works
Identify the Appointment
The AI finds the appointment to cancel, either from context in the conversation or by looking up the patient’s upcoming appointments.
Check for Fees
If the appointment is within the service’s cancellation window, the AI tells the patient the exact fee amount. There are two fee models:
- Flat fee — a fixed dollar amount if within the cancellation window.
- Percentage-based tiers — a percentage of the service price, with different rates for within 24 hours vs. within 48 hours. Any previously paid booking fee is credited against the cancellation fee.
The AI cannot waive or reduce fees. Fee disputes are always escalated to a staff member.
How Rescheduling Works
The AI cancels the old appointment (silently, without sending the patient a cancellation SMS) and books a new one. The patient can request a different time, provider, or location. If the patient already paid a booking fee for the original appointment, the new appointment is created without charging the fee again.Identifying AI-Created Appointments
Appointments booked or rescheduled by the AI are labeled with the note “Scheduled by Decoda.” in the appointment record. Cancellations made by the AI include “via AI Conversation” in the cancellation reason.Safeguards
The AI has several built-in safeguards:- Fees are always disclosed before action. Booking fees are disclosed before searching for availability. Cancellation fees are disclosed before cancelling.
- Patient confirmation is required. The AI reads back the full appointment details and waits for a “yes” before booking or cancelling.
- Complaints are escalated, not cancelled. If a patient wants to cancel because of a bad experience, the AI contacts staff instead of proceeding — giving your team a chance to retain the patient.
- Patient identity is validated. The AI checks that the patient has a first and last name on file before booking. If not, it asks the patient for their name first.
- Emergencies are redirected. The AI advises patients to contact emergency services for medical emergencies.
- Language matching. The AI responds in the same language the patient uses.
Limitations
- The AI searches up to 14 days ahead by default for availability.
- Appointments within 24 hours cannot be rescheduled (cancellation is still possible with fee disclosure).
- The AI cannot waive fees, provide medical advice, or modify provider schedules.
- If the AI cannot find availability after trying different dates, times, and providers, it shares your clinic’s self-scheduling link as a fallback.