AI Receptionist Contracts: The Terms That Set Your Real Bill

The quote says $99 a month. That number is real, and it is also the smallest number in the document. What you actually pay is decided by a meter you have not been shown, a renewal clause you have not read, and a set of add-ons that appear on the second invoice rather than the first.

This is not a case of vendors behaving badly. It is how usage-priced software works everywhere. But a practice comparing three AI receptionist quotes on their headline monthly price is comparing the one figure that is least likely to describe next year's bill. Published plans in 2026 sit around $22 to $65 a month with 60 to 250 minutes included, and overage between $0.10 and $0.50 a minute. Those two ranges do not interact gently.

This post covers the clauses that decide the real number: the meter and how it rounds, the overage rate, auto-renewal, who owns your recordings and call flows, what happens to your phone number, and the add-ons that never make the pricing page. Cart Gaze sells in this category, so treat the list as the questions to put to us as readily as to anyone else.

The monthly price is the smallest number in the contract

Every usage-priced plan has three numbers, and vendors advertise one. There is the base fee, the allowance of minutes it includes, and the rate charged once you pass it. A plan is only cheap if your call volume stays inside the allowance, and most practices have never counted their minutes.

Vendor-published ranges for 2026. Confirm each against the quote in front of you.

Work an example. A practice on a plan with 200 included minutes and a $0.35 overage rate takes 900 minutes of calls in a busy January. That is 700 minutes over, or $245 on top of the base fee. The headline plan was $49. The invoice is $294, and nothing went wrong.

Modeled from published ranges. Run it again with your own busiest month.

Those figures are modeled from published ranges rather than measured, so run the same arithmetic with your own numbers. The input you need is minutes, not calls, and your phone system can usually export it in a couple of clicks.

The second thing to check is what consumes minutes at all. On some systems only the conversation counts. On others the meter starts at answer, which means every wrong number, every hang-up after two seconds, and every automated pharmacy call is billable. A practice line takes a lot of those.

Rounding is a pricing decision, not an accounting detail

Ask how a minute is counted. Some systems bill by the second, some round every call up to the next full minute, and a few round up to the nearest 30 seconds. On a line that takes a lot of short calls, that choice moves the bill more than the advertised rate does.

Medical front desks take a great many short calls. A wrong number, a patient checking your hours, an automated call from a pharmacy: each is 15 to 30 seconds of real conversation. Under per-minute rounding, 100 of those a month bill as 100 minutes rather than the 40 they actually consumed.

There is a fair counter-argument from the vendor side. Per-minute rounding is simpler to reconcile, and a system that has to spin up for a 20 second call has still done most of the work. That is reasonable. It is still a cost you should price rather than discover.

The question to ask is plain. Is billing per second or per minute, and does an unanswered or abandoned call consume anything at all? Get the answer in the contract rather than in an email from a sales rep.

Auto-renewal and the window you will forget

Annual terms with automatic renewal are standard here, usually with a 30 to 60 day cancellation window before the anniversary. Miss it and you own another year. Volume discounts often sit behind 3 year commitments, which is a reasonable trade if the system works and an expensive one if it does not.

A long term is not automatically bad. If a vendor is doing real integration work into your practice management software, they carry setup cost they need to recover, and 12 months is a fair way to do it. The version to push back on is a long term with no exit for non-performance. Ask what happens if the system misroutes urgent calls in month 2, and listen for whether the answer involves anything beyond support tickets.

Who owns your recordings, transcripts, and call flows

Three assets accumulate once a system is live: the call recordings and their transcripts, the configuration you tuned over months, and whatever analytics sit on top. Some vendors treat all three as theirs. That is worth knowing before it matters rather than during a migration.

Ask the question concretely rather than abstractly. Not "do we own our data" but "if we terminate on the 30th, what can we download on the 31st, in what format, and for how long." A vendor with a good answer will give you one immediately, because they have been asked before.

The recordings question has a compliance edge as well as a commercial one. Once a recording holds patient details it is protected health information, so the vendor is a business associate and needs an agreement covering it, along with anyone they hand it to. The wider version of that conversation is in what a HIPAA-aware setup requires.

Eight clauses. Every one of them is answerable in a sentence.

The configuration is the underrated one. Six months of tuning how the system greets patients, which questions it asks, when it escalates, and what it must never say is real work you paid for. Ask directly whether you can export it, and accept the answer as information rather than an argument. Plenty of vendors will say no, and that is a fair reason to negotiate a shorter term instead.

Your phone number is yours, and a contract cannot change that

Practices often believe their vendor holds them hostage through the phone number. Federal rules say otherwise. Carriers are required to port a number when they receive a valid request, and an outstanding balance is not a lawful reason to refuse. Whatever the contract implies, the number follows you.

What genuinely delays a port is administrative rather than legal. The most common cause of a rejected request is mismatched account information: a business name that does not match the account, an old service address, a wrong digit on the account number. Keeping a current copy of your carrier account details makes a future migration a week rather than a month.

One nuance worth knowing: if the vendor supplied you a brand new number rather than porting your existing one, patients may now know that number from your website, your listings, and their own contact lists. The number is still portable, but the practical cost of losing it is real, which is a good argument for keeping your main line on a carrier you control and pointing it at the vendor.

That said, do not test the theory during a crisis. The porting mechanics, and how to move a practice line without dropping calls, are worth planning in advance and are covered in moving a practice phone system without losing calls.

The add-ons that never reach the pricing page

The headline plan usually covers one number, one voice, and voice minutes. Everything else is priced separately, and the extras are individually small enough to approve without noticing. Extra numbers commonly run $10 to $25 a month each, and a custom or cloned voice can run $50 to $300 a month.

Texting is often passed through at cost plus a margin, on top of the carrier fees that patient messaging already carries.

Setup and onboarding is the other line to pin down. Some vendors include configuration, some charge a one-off fee in the hundreds, and some bill professional services hourly for anything beyond a template. None of those is wrong, but a $49 plan carrying $1,200 of onboarding is a different proposition in year one than the pricing page suggests.

Before you sign

Most of this comes down to four questions, and none of them needs a lawyer to ask. What is the rate once I pass the allowance, and how is a minute counted. What does it take to leave, and when. What of mine leaves with me. And does the agreement covering patient information cost extra.

Four questions. Any one of them unanswered is a reason to wait.

Walk it once. No written overage rate means stop and get one. A term you cannot exit in 30 days means pricing the whole commitment rather than the month. No export rights over recordings and call flows means you are renting them, which may be fine as long as the term is short. And a business associate agreement has to cover every subprocessor, not just the vendor whose logo is on the quote.

If you are earlier than this and still deciding what the system needs to do at all, start with what an AI receptionist actually does, then work the numbers in what an AI receptionist costs. If you want the size of the problem before the size of the invoice, the free Growth Leak Audit works from your own call data.