Inspiration
Solo therapists, dentists, and physios lose real revenue every day to voicemail and phone tag. A full-time receptionist costs $2,000–3,000/month — impossible for a one-person practice — yet every missed call can be a lost patient. We asked: what if an AI could genuinely operate the front desk — not just transcribe calls, but hold a natural conversation, check the real calendar, book the appointment, text an intake form, and know when to hand a crisis off to a human? That's Nova.
What it does
Answers every call like a real receptionist — natural conversation, not a phone tree Checks your live calendar and books appointments in real time Texts new patients their intake forms automatically Handles rescheduling and cancellations without you lifting a finger Recognizes urgent or crisis situations and immediately routes them to a human Works 24/7, so no call ever goes to voicemail again
How we built it
Nova is a full-stack React + FastAPI + MongoDB app with a voice-first agent loop:
The agent brain runs on Gemini 3 Flash, driven by a strict JSON contract (reply / intent / booking / emergency) so every turn is both spoken and machine-actionable. The system prompt is assembled per-call from the clinic's live FAQs, hours, and — crucially — its real open appointment slots. Voice loop: browser speech-to-text → Gemini → OpenAI TTS speaks Nova's reply back, with a live transcript and a real-time agent execution trace panel (STT → intent → calendar → SMS) — perfect "product evidence." Availability awareness: Nova only offers times you're actually free, computed from Google Calendar free/busy (or an internal schedule that subtracts existing bookings), so it never double-books. Real telephony & calendar, ready to flip on: a Twilio TwiML turn-taking webhook lets a real patient call a real number and talk to Nova end-to-end, with an SMS intake link after the call; Google Calendar OAuth writes real events. Both degrade gracefully to a fully-working demo mode when keys aren't set. Clinic dashboard: a "$X recovered this month" hero stat, playable call recordings, transcripts, upcoming bookings, an emergency-escalation banner, and a self-serve onboarding wizard ("live in 20 minutes"). Auth via Google sign-in; a Settings page lets clinicians edit everything Nova says instantly. Rough ROI intuition behind the pricing: if Nova recovers even one patient worth $V a month at a $P subscription, payback is immediate whenever $V \geq P$ — and for a $180 therapy session against a $99 plan, that's a single saved call.
Challenges we ran into
Turn-taking over the phone without heavyweight media streams — solved with Twilio's loop keyed on the CallSid. Keeping conversation state consistent across stateless HTTP turns while still creating real calendar events and SMS at exactly the right moment. Emergency safety: reliably detecting crisis language and pivoting Nova to route callers to 988/911 while alerting the clinician — a hard requirement for anything touching healthcare. Reconciling free-text human phrasing ("sometime next Tuesday afternoon") into a precise ISO timestamp the calendar could accept.
Accomplishments that we're proud of
An AI that genuinely runs the front desk — end to end. Nova doesn't just transcribe calls; it greets, answers FAQs, screens patients, checks real availability, books the appointment, texts an intake link, and escalates emergencies — every step visible in a live agent execution trace. Bookings you can trust. By grounding the model in real, filtered open slots (Google Calendar free/busy or an internal schedule that subtracts existing bookings), Nova never hallucinates a time or double-books. Real phone calls, not a mockup. A Twilio turn-taking loop lets an actual patient dial a number and hold a natural back-and-forth with Nova — with SMS intake follow-up — while OpenAI TTS gives it a human-sounding voice in the browser demo. Healthcare-grade safety. Reliable crisis-keyword detection that pivots Nova to route callers to 988/911 and instantly alerts the clinician. Always shippable. Every integration has a graceful demo fallback, so the product is fully demoable and functional even before a single API key is added — real Google Calendar + Twilio activate automatically the moment credentials are set. Clinician self-serve. "Live in 20 minutes" onboarding, a one-page dashboard with a "$X recovered this month" hero stat, playable call recordings + transcripts, and a Settings page that lets clinicians edit everything Nova says — applied to the very next call. Rock-solid quality. 27 backend tests + full frontend end-to-end coverage, all green across every iteration.
What we learned
Forcing the LLM into a structured JSON schema (instead of free text) is what makes an agent operate a business rather than just chat. Grounding the model in real, filtered availability eliminated the classic "AI hallucinated a time slot" failure and made bookings trustworthy. Designing every integration with a graceful demo fallback meant the product is always shippable and demoable, even before a single API key is added.
What's next for Nova — AI Front Desk for Small Clinics
Stripe subscription billing — turn on the $99 Starter / $299 Pro plans with the 30-day, card-required free trial to convert clinics from day one. Reschedule & cancel flows — let Nova move or cancel an existing booking and sync the change back to the calendar automatically. Outbound no-show recovery — Nova proactively calls patients who miss appointments to rebook them, turning lost slots back into revenue. Deeper calendar & Calendly support — richer two-way sync, per-provider calendars, and working-hours rules that precisely drive the slots Nova offers. Multilingual expansion — Spanish and Hindi first, to reach the huge US Hispanic market and international clinics. Custom voice cloning — let each clinic give Nova a branded, on-voice persona. Insurance verification agent — check patient coverage during the call so the front desk is truly hands-off.
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