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Advanced voice settings

The Advanced tab fine-tunes the timing and turn-taking of your AI — how long it waits before replying, when a caller can interrupt, what it says during silence, how it detects voicemail, and how it signs off. Defaults work well for most practices; this guide explains exactly what each control does and when to change it.

Updated August 7, 20267 min read

The Advanced tab controls the rhythm of a conversation — the split-second timing that makes an AI feel natural or awkward. Open it at Settings → AI Voice → Advanced.

Read this first: the defaults are tuned to sound natural for healthcare front desks. Change these only if calls feel off. When in doubt, adjust the simple Patience control and leave the rest alone. Everything can be restored with Reset to defaults at the bottom.

Changes are applied when you click Save changes.


Pacing

Controls when the AI speaks and how quickly it responds.

Who speaks first

OptionBehavior
Assistant greets (default)The AI opens with your greeting the moment the call connects.
Caller firstThe AI stays silent and waits for the caller to speak before responding.

Most inbound lines should use Assistant greets so callers immediately know they've reached you.

Patience

A one-click preset for how long the AI waits before it starts replying:

PresetFeelGood for
SnappyResponds quickly, shorter pausesFast talkers, simple calls
Balanced (default)Natural pausesMost practices
RelaxedWaits longer before jumping inOlder callers, slower speech, patients who pause mid-sentence

Each preset sets the underlying timing values below. If you hand-edit those numbers, the preset shows Custom.

Fine-tune the exact timing

Click Fine-tune the exact timing to expose the raw controls behind Patience. You rarely need these.

ControlDefaultWhat it does
Wait before responding (sec)0.4How long the AI waits after the caller stops before it starts speaking. Higher = more polite pauses; lower = snappier.
Smart endpointingLiveKitThe engine that decides when the caller has actually finished talking (vs. just pausing). Options: Off (legacy heuristic), LiveKit, Vapi, Krisp.
Pause after a sentence (sec)0.1Extra wait when the caller ends on clear punctuation — they probably finished.
Pause mid-thought (sec)1.5Wait when the caller trails off without finishing — gives them room to continue.
Extra pause after a number (sec)0.5Added wait after the caller says digits (phone number, date), which often come in bursts.
Words before caller can interrupt2How many words the caller must say before the AI treats it as a real interruption and stops.
Voice before interrupt (sec)0.2How long the caller must be speaking before the AI yields.
Cooldown after interrupt (sec)1How long the AI stays quiet after being interrupted before resuming.
Wait function (LiveKit only)(blank)An optional math expression for advanced dynamic timing. Leave blank to use defaults.
Ambient background soundOffPlays subtle ambience under the call. Options: Off (silence) or Office ambience. Some callers find a faint office hum more natural than dead silence.

Hang up after silence

Ends the call automatically when nobody has spoken for this long. Default 30 seconds (range 5–120). Prevents dead lines from staying open indefinitely.


When callers interrupt

Fine control over what counts as an interruption.

SettingWhat it does
Keep talking throughPhrases the AI should ignore as interruptions — filler like "uh-huh," "okay," "right." The AI keeps talking instead of stopping for these.
Stop immediately onPhrases that make the AI go quiet instantly — e.g. "stop," "wait," "hold on."

Type a phrase and press Enter to add it as a chip; click the ✕ to remove it. Use Keep talking through if your AI keeps stopping every time a caller says "mm-hm," and Stop immediately on if you want hard stop words to always cut it off.


When callers go quiet

Nudge quiet callers

When ON, the AI speaks up after a stretch of silence instead of waiting indefinitely. Turning it on reveals:

SettingDefaultWhat it does
What to sayThe nudge line(s), e.g. "Are you still there?" Add multiple; one is chosen per nudge.
Wait before speaking up (sec)10Silence to allow before the first nudge.
Max times per call2How many times the AI will nudge before giving up.
Reset the timer when the caller speaksOnRestarts the silence timer whenever the caller talks, so nudges only fire on fresh silence.
Send a stronger nudge if still quietOffAdds a second, firmer nudge (with its own message and timeout) if the first is ignored. The escalation timeout must be at least 5s after the first nudge.
Hang up if the caller stays silentOffEnds the call with a goodbye message if silence continues. Its timeout must be at least 5s after the previous prompt.

The staged timers are cumulative — each stage must fire at least 5 seconds after the one before it, so nudges never overlap.


Recovery & sign-off

How the AI handles voicemail, noise, errors, and ending the call.

Detect voicemail

When ON, the AI recognizes when it has reached an answering machine instead of a live person (this matters most on outbound calls). When OFF, a voicemail is treated as if a person picked up.

SettingWhat it does
Detection providerThe engine used to detect voicemail: Vapi (default), Google, OpenAI, or Twilio.
When voicemail is reachedHang up (default) or Leave a message.
Voicemail messageShown only when "Leave a message" is chosen. The message spoken after the beep. Personalize with {{patientName}} and {{practiceName}}.

Filter background noise

When ON (default), suppresses noise on the caller's side so the AI hears them more clearly. Leave on unless you have a specific reason not to.

Acknowledge interruptions

When ON, the AI says a quick line (e.g. "Go ahead") when a caller cuts it off, so the hand-off feels natural instead of abrupt. Add the phrases under What to say.

Ask callers to repeat when unclear

When ON, the AI asks the caller to repeat themselves instead of guessing when the audio is hard to make out.

SettingDefaultWhat it does
Clarification message"Sorry, could you repeat that?"What the AI says when it's unsure.
Confidence min / max0.2 / 0.4The transcription-confidence band that triggers a clarification. Below the range the audio is too poor to act on; above it the AI is confident enough to proceed.

Apologize on technical errors

When ON, the AI speaks a fallback line if something breaks mid-call, and can optionally transfer.

SettingWhat it does
Fallback messagee.g. "I apologize for the technical difficulty…"
Transfer to (optional)A phone number in E.164 format (e.g. +15551234567) to send the caller to on error. Leave blank to skip transferring.

Sign-offs

How the AI ends calls:

SettingWhat it does
Sign-offsA set of closing lines; one is picked at random per call for natural variety. Keep a single chip for a fixed sign-off. Avoid exclamation marks — the voice engine reads them as high energy.
Fallback sign-offUsed only when no sign-off chips are set above.
Caller phrases that end the callPhrases from the caller that tell the AI to wrap up (e.g. "that's all," "goodbye").

Reset to defaults

At the bottom, Reset to defaults clears all your advanced tuning and reverts to the platform defaults. Use it any time an experiment doesn't pan out — your voice, greeting, and capabilities on the other tabs are untouched.

Troubleshooting quick reference

SymptomTry this
AI talks over callersIncrease Words before caller can interrupt, or set Patience → Relaxed.
AI feels slow/laggyPatience → Snappy, or lower Wait before responding.
AI stops every time I say "uh-huh"Add those fillers to Keep talking through.
Awkward silence on callsTurn on Nudge quiet callers.
Outbound calls talk to answering machinesTurn on Detect voicemail and choose Hang up or Leave a message.
Sign-off sounds over-excitedRemove exclamation marks from your Sign-offs.

What's next

Frequently asked questions

I haven't changed anything here — is that a problem?
Not at all. Every practice starts on platform defaults that are tuned for natural, healthcare-appropriate conversations. Only open the Advanced tab if calls feel off — too fast, too slow, cutting people off, or awkward in silence.
What's the fastest way to fix "the AI talks over me" or "feels laggy"?
Use the Patience control at the top. Snappy replies faster (good for quick callers), Relaxed waits longer before responding (good for older or slower callers). You rarely need the fine-tune numbers underneath.
How do I undo my changes?
Click "Reset to defaults" at the bottom of the tab. It clears all your advanced tuning and reverts to the platform defaults.
Do these settings apply to both inbound and outbound calls?
They apply to your practice's AI voice behavior. Voicemail detection and the sign-off phrases matter most on outbound calls, while pacing and interruptions matter on every call.

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