This case study builds on our earlier work with Swing Care around automating appointment reminders and real-time rescheduling. You can read the first case study here → [Automating Appointment Reminders & Rescheduling for Swing Care]

Client Overview

Our first use case with Swing Care focused on automating appointment reminders and enabling real-time rescheduling through an AI scheduling agent integrated with Swing Care’s electronic medical record system. That initiative addressed a clear operational bottleneck: reducing the manual work required to confirm appointments while improving attendance and patient experience.

(You can read the full case study here →Swing Care is a groundbreaking practice focused on treating fibromyalgia, a chronic pain condition that affects 10 million people in the US. They provide coordinated telemedicine-based care and comprehensive treatment, including evidence-based medication management, behavioral health, virtual physical therapy services and FDA-cleared digital therapies. .)

As that system went live, a second opportunity emerged. While reminders and rescheduling reduced no-shows, last-minute cancellations created unused appointment slots with too little time for staff to refill them manually.

Based on Swing Care’s evolving needs, we expanded the scope of the AI agent to address this next layer of the problem: automating waitlist refill to protect utilization.

The Next Challenge: Waitlist Management & Utilization Gaps

After successfully automating appointment reminders and rescheduling with Puppeteer’s AI agent, Swing Care identified a second, closely related problem:

Cancellations and no-shows were leaving unused appointment slots - often too late for staff to manually refill them.

Specifically, Swing needed to:

1. Refill Cancelled Slots Quickly
   
   Cancellations often occur 24–72 hours before an appointment, leaving little time for manual outreach.
2. Reduce Manual Waitlist Work
   
   Staff had to track waitlists, identify eligible patients, and call them one by one — a time-consuming process.
   
   
3. Improve Overall Utilization
   
   Even a small number of unused slots per week impacted utilization capacity across the care team.
   
   

Swing Care’s goal was clear: turn cancellations into opportunities, without adding operational overhead.

Puppeteer’s Solution

AI-Driven Waitlist Refill Agent

Puppeteer extended the existing scheduling agent with a smart waitlist refill flow, designed specifically to maximize appointment utilization.

When a slot becomes available, the AI agent:

• Automatically checks the calendar for patients who already have that same appointment scheduled later, so it can offer them the earlier slot.
• Proactively reaches out via phone to offer the newly available slot.
• Handles accept / decline in real time with no staff involvement.
• If the patient declines, it immediately calls the next eligible patient and continues down the list until the slot is booked.
• Immediately updates the schedule in Swing Care's electronic medical record, booking the accepted slot.

All outreach is handled through Swing Care’s existing phone number, preserving trusted Caller ID recognition and improving response rates.

Benefits

• Higher calendar utilization without increasing staff workload.
• Faster access to care for patients eager to be seen sooner.
• Zero manual coordination for waitlist outreach and booking.
• Full visibility through the existing Swing Care analytics dashboard, including outreach attempts, acceptance rates, and time-to-fill metrics.

Implementation Approach

1. Waitlist Logic Design – Defined eligibility rules, prioritization, and outreach cadence with Swing’s team.
2. Electronic Medical Record Integration Extension – Enabled real-time detection of cancellations and slot availability.
3. Pilot Rollout – Tested waitlist refill flows with a controlled subset of cancellations.
4. Production Deployment – Activated automated waitlist refill across applicable appointment types.

Results & Metrics

The following metrics will be added after the first full reporting period:

• Average time to refill a cancelled slot: 24 minutes
• Average calls per rescheduling: 5 calls
• Increase in appointment utilization (%): 36%

Why This Matters

For care models like Swing Care’s, utilization isn’t just an operational KPI; it directly affects patient access, clinician efficiency, and revenue predictability.

By layering waitlist refill automation on top of reminder and rescheduling workflows, Swing moved closer to a fully self-healing schedule, one where cancellations no longer translate into lost care opportunities.

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