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The Front-Office Capacity Gap: Build, Borrow, or Automate · Presented at MGMA Annual

The Worksheet From Our MGMA Annual Session,
With the Math Done for You

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Over 100 practice leaders sat in on this session at MGMA Annual 2026 in San Antonio.
If you missed it, everything they took home is on this page

Run my four numbers
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What We Covered in 30 Minutes

01
Size the gap
Which admin workflows eat the most front-office labor, and what the gap costs in patient access and revenue. Four numbers tell you.
02
Score the options
Build, borrow, or automate, compared on time to productive, fully loaded cost, coverage continuity, compliance exposure, and staff impact.
03
Decide what moves first
Sort tasks by two questions: does it need judgment, and does it need to be here? Then a 30/60/90 to act on it.

Below is the whole thing, with your numbers in it.

Run the Four Numbers
15 minutes with your phone report and your EHR. Rough is fine.
Calls abandoned per day at peakYour 8 to 10 AM number, not the daily average
Days to third next availableYour busiest provider
Front-office overtime hours per weekLast 90 days
Average visit valueNet collected per visit, blended
$
%
%
$

Defaults reflect a medium-size practice with two or three locations. Abandoned calls and third next available come from MGMA Stat polls (2025 to 2026) and MGMA DataDive Practice Operations (2023); MGMA DataDive put primary-care new-patient third next available at 5 days in 2022. Overtime, visit value, and the two percentages are illustrative starting points. Poll results describe respondents, not all practices. Use them to manage your own practice, not to coordinate with others.

What Your Gap Costs Today

$160,000/yr

About $13,300 a month in appointments that wanted to book and couldn’t get through, plus $21,100 in overtime. That’s before anyone’s salary enters the picture.

10 appointment-intent calls lost per day
10 days to third next available
15 overtime hours a week

For reference, well-run practices hold call abandonment under 5% (HFMA target). Morning peaks in most practices run 25 to 30% (MGMA).

That number is 20 booked visits a week. Bring it to a demo and see the two ways to close it: a Wing healthcare assistant for the judgment work, Central for the rule-based volume, or both.

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Compare the three options first
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Your gap is about $160,000/yr. Let’s talk through the mix.





    Download the session worksheet (PDF)

    Three Ways to Close the Gap. Most Practices Have Only Tried One.

    Build Borrow Automate
    Time to productive
    3 to 6 months
    2 to 4 weeks if the workflow is documented
    Days for narrow use, months if it touches your EHR
    Fully loaded cost
    Salary plus 25 to 35%, plus 50 to 200% of salary when someone leaves
    A monthly rate, plus 2 to 4 hours a week of your time
    A subscription, plus the labor to handle what it can’t
    Coverage continuity
    One person, single point of failure. PTO means zero
    A bench absorbs absence. Ask about retention
    24/7, but it degrades quietly and fails at the exception
    Compliance exposure
    You own training and HIPAA posture
    BAA, minimum-necessary access, data location
    AI governance, documentation, patient disclosure
    Staff impact
    More hands on the same tasks, one more to manage
    Removes the payer grind. Needs an honest internal message
    Removes tedium. Adds exceptions if manual steps remain

    Sort Tasks, Not Departments

    Two questions per task: does it need judgment, and does it need to be here?

    Tasks Where it goes
    Needs judgment, needs to be here
    Check-in and check-out, escalations, collections conversations
    Stays with your team
    Needs judgment, not here
    Eligibility, prior auth follow-up, denials, referrals, message triage
    Borrow. Move this first
    Rule-based, needs to be here
    Lobby flow, rooming
    Keep lean, automate around it
    Rule-based, not here
    Reminders, waitlist fill, after-hours routing, self-scheduling, refill intake
    Automate, with a person on exceptions

    Document the workflow, automate the rule-based volume, borrow the judgment work that isn’t local, then rebuild in-house around what’s left.

    • Day 30
      run the four numbers.
    • Day 60
      one automation live, one function scoped
    • Day 90
      re-measure

    Two of the Three, in One Demo

    Borrow is a Wing healthcare assistant

    HIPAA-trained, dedicated, live in 48 hours, supervised by a success manager, replaced free within 24 hours if the fit is wrong. Full-time from $1,799 a month.

    Automate is Central, our front-office AI

    Overflow calls, after-hours routing, reminders, self-scheduling, 80+ EHR integrations, and anything unusual goes to a person. Your team keeps the patient in front of them. The seat gets redefined, not backfilled.
    wing-and-central-image

    You’ll see how a Wing healthcare assistant works, how Central handles calls and scheduling, and how the two fit together, with your four numbers as the backdrop.

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    What It Looked Like For One Practice

    Illustrative Composite

    Internal medicine, two locations, seven providers, about 28,000 visits a year. Central took overflow and after-hours first, then one Wing assistant took eligibility and prior auth.

    Before After 12 weeks
    Missed calls, 8 to 10 AM
    23%
    6%
    Third next available
    21 days
    Inside 2 weeks
    Front-office overtime
    22 hrs a week
    3 hrs a week

    FAQ

    You see how Wing healthcare assistants work and how Central handles calls and scheduling, and we talk through where each would fit your practice. One, the other, or both. No pressure to decide on the call.

    No. Your team keeps the patient-facing work and the judgment calls. The payer grind and the after-hours overflow move off their plate. If someone on your team is worried about it, we'll be on the call where you explain it.

    Yes to all three. Every healthcare assistant completes HIPAA training before placement and works under a signed BAA and NDA with role-based access you control. Wing is ISO 27001 compliant and SOC 2 certified. Central integrates with 80+ EHR providers; we'll confirm yours on the demo.
    Typically live within 48 hours, productive on a documented workflow in two to four weeks. If the person isn't a fit, we replace them free, usually within 24 hours. Cancel any month.

    Your Gap Is About $160,000/yr. Let's Talk Through the Mix.

    Nothing to prepare. We'll show you how Wing assistants and Central work, and where each fits the gap you just measured. Day 30 on the worksheet is running the four numbers, and you just did that. If Wing isn't the fit for your practice, we'll say so.





      Download the session worksheet (PDF)
      50% faster workflows

      “The recruitment process was wonderful. Everyone at Wing was knowledgeable, and the assistants integrated into our workflows immediately.”

      — Provida Family Medicine, Manager of Operations, Healthcare

      • MGMA Corporate Member
      • Live in 48 hours
      • Free replacement in 24 hours
      • Cancel any month

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