How AI Phone Systems Are Helping MSOs and DSOs Scale Across Multiple States

Scaling a healthcare or dental organization across multiple states is exciting — and exhausting. On paper, expansion means more patients, more revenue, and stronger negotiating power with payers. In practice, it often means late-night emails about call overflow, compliance questions from one state that don’t apply in another, and frustrated staff who feel stretched too thin.

One of the least glamorous, yet most mission-critical pieces of this puzzle is the phone system. It’s the front door to your practices — and if that door gets jammed with hold music and dropped calls, growth grinds to a halt. It might seem small, but it can be the thing holding an entire business up.

At SuperDial, we’ve seen more than one DSO and MSO hit the brakes on adding new locations, not because demand wasn’t there, but because their phone infrastructure couldn’t keep up. AI phone systems are rewriting that story. And we want to share it with you.

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The Multi-State Scaling Challenge

So you've established a reputable MSO or DSO in your state, but you naturally, you want to grow. Now, to move into a new state, you have to contend with new rules, staffing gaps, payor differences, and more.

Every MSO or DSO leader knows the headaches of expanding beyond their home turf:

• Different rules, same goal: HIPAA is universal, but states like California add extra privacy layers (hello, CCPA).
  
  
• Payor patchwork: Medicaid in Texas doesn’t look like Medicaid in New Jersey, which means verification calls take different scripts, different portals, and usually more time.
  
  
• Staffing gaps: Try hiring call center staff in New York City vs. Birmingham, Alabama — the wage difference alone can make your budget whiplash.
  
  
• Technology silos: Practices acquired in different states often come with different EHRs or scheduling systems, and it’s rarely a clean fit.
  
  
• Patient expectations: Whether a patient is calling from Dallas or Miami, they expect the same fast, friendly service.
  
  

One DSO we worked with had six different states running six different phone systems. Patients in New Jersey waited five minutes on average to confirm appointments, while patients in Florida got through in under a minute. The inconsistency wasn’t just frustrating — it was costing them patients.

But if these problems are so obvious, why weren't phone systems programmed for them? 

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Why Traditional Phone Systems Fall Short

Like many obstacles in business, it's an issue of scale. Conventional phone systems weren’t designed for this kind of sprawl. They tend to:

• Route calls locally with limited logic.
  
  
• Force managers to manually shift call loads when one region gets swamped.
  
  
• Struggle to integrate with multiple EHRs or payer portals.
  
  
• Demand more and more staff as call volume grows.
  
  
• Scatter data into silos so leadership can’t see the full picture.
  

Every phone system was built in a vacuum, in a time when phones were still a novelty. Consequently, there is no standardization across state lines. It’s like trying to run a national airline with six different reservation systems — eventually, something breaks.

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How AI Phone Systems Solve the Problem

AI phone systems are built for scale. Instead of duct-taping local systems together, they provide a central nervous system for patient communication.

• Consistent experience, flexible logic: AI can offer the same polished experience everywhere while quietly adjusting behind the scenes for state-specific rules.
  
  
• Elastic scalability: Flu season in Ohio? Open enrollment surge in Florida? AI can spin up thousands of concurrent calls without hiring a single extra FTE.
  
  
• Automated payor calls: Instead of staff waiting on hold, AI handles eligibility checks and prior auth follow-ups across different state payors.
  
  
• Uniform compliance: HIPAA is enforced across all calls, with state-specific privacy baked in.
  
  
• One analytics hub: Every call across every state transcribed, logged, and analyzed in the same dashboard.
  
  

A six-state MSO we support cut benefits verification handle time by 60% once AI took over routine payor interactions. Staff who used to spend half their day chasing faxes suddenly had hours back to focus on higher-value patient support.

Now their business runs a lot more smoothly, and that's just in terms of efficiency. Imagine the improvement in morale!

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The ROI of AI in Multi-State Growth

If you have ever tried expanding your labor force at an MSO or DSO, you know the headache that can be. Scaling with traditional phone systems means ballooning costs and constant firefighting. Scaling with AI looks different:

• 30–50% labor cost reduction as routine calls shift to AI.
  
  
• Unified patient experience across every location, no matter the state.
  
  
• Faster expansion into new states without needing to build new call centers.
  
  
• Revenue lift as fewer claims get stuck in eligibility or prior auth limbo.
  
  

One DSO we worked with faced a choice: build two new 50-seat call centers or try something different. They chose AI. Today, those two call centers exist only on paper — and the organization is saving over $5M annually.

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Practical Considerations for MSOs & DSOs

Adopting AI isn’t just plug-and-play. We treat each client as a valued customer, asking for their feedback on how implementation of our AI voice agents is going. Here are a few lessons we’ve learned with clients:

• Integrations matter: AI is only as good as its connections to EHRs, CRMs, and payers.
  
  
• Set up governance: Multi-state compliance requires someone steering the ship.
  
  
• Train your people: When staff understand that AI is there to handle the boring stuff, adoption skyrockets.
  
  
• Plan your fallbacks: AI is powerful, but edge cases happen — have clear escalation paths to humans.
  
  

The groups that thrive are the ones that see AI not as a threat to jobs, but as a way to finally let staff work at the top of their license. You have to remember, AI is here to save their spare time, not take their jobs, especially when it comes to routine busy work like claim status checks, prior authorizations, benefits eligibility checks, and more.

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Looking Ahead: The Future of Multi-State Operations

Look at how far AI agents have come in the past few years. These recent gains are only the tip of the iceberg. In the not-so-distant future, AI phone systems won’t just support growth — they’ll drive it.

• AI-to-AI conversations between payer bots and provider bots will slash call volume.
  
  
• Agentic AI will string together multi-step workflows, not just handle one-off tasks.
  
  
• Continuous learning will optimize performance by region, payer, and call type.
  
  
• Auditable logs will become standard as regulators demand transparency.
  
  

Our take? Within five years, the MSOs and DSOs scaling fastest will be the ones where 95% of call center work is AI-driven — and patients will barely notice, because their experience will feel seamless.

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Why It Matters

Multi-state growth doesn’t have to come with multi-state headaches. AI phone systems give MSOs and DSOs the ability to standardize patient interactions, cut millions in avoidable labor costs, and expand faster into new markets without breaking their infrastructure.

At SuperDial, we’ve seen what happens when organizations make the switch: smoother patient journeys, happier staff, and CFOs who finally stop dreading the call center budget line.

Curious how this could work for your organization? Book a SuperDial demo — we’ll show you exactly what scaling with AI looks like in your state.

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