What is an answering service?
An answering service is an independent company whose trained operators answer calls on behalf of other organizations, such as medical practices, hospitals, utilities, towns and businesses, whenever they can't. Today many combine live operators with AI tools. WSTA is the professional association for these companies. It doesn't answer calls itself; it helps you find member companies that do.
From the first ring to the right person
Every member company sets things up its own way, but most calls follow the same four steps.
Your calls forward
After hours, at lunch, during overflow or around the clock, your line forwards to the member company. Callers hear your name, not theirs.
A trained operator answers
Live operators follow scripts written with you. In a hybrid setup, an AI voice agent may handle simple steps first, like taking a name or booking an appointment.
Urgent calls escalate
Your rules decide what's urgent. Those calls go to the right person (the on-call physician, the public-works supervisor, the technician) by phone, secure app, text or pager.
Everything is documented
Every call is logged and every message is time-stamped, with delivery confirmation and reports you can review.
Human voices when it matters. Smart tools that assist them.
Some member companies are human-first, with a trained person answering every call. Others are hybrid: an AI voice agent handles routine steps such as greetings, directions or appointment requests, and a live operator takes over for anything urgent, sensitive or unclear.
Both models can work well. What matters is that the approach fits your callers. Ask any provider how its AI works, how quickly a person takes over, and whether callers are told when they're speaking with an automated system.
- Human-first: a live operator on every call
- Hybrid: AI for routine steps, people for what matters
- Either way, your rules decide what goes to a person
step 1 call forwards to the member company step 2 AI greets caller, captures name & reason step 3 rule: "urgent / clinical" → person step 4 HUMAN operator takes the call step 5 on-call contact reached & confirmed # illustration only; each member company sets its own workflow
Built for the calls that can't wait
Medical practices, hospitals & home health
- After-hours and overflow lines for practices and clinics
- On-call schedules, so the right clinician is reached the first time
- Urgent messages relayed and confirmed
- Appointment requests, refill messages and hospital overflow
HIPAA: an answering service that handles patient information for a healthcare provider is generally a HIPAA business associate, so ask for a business associate agreement (BAA). [S7] Answering services relay messages. They don't provide medical advice unless they're specifically set up and qualified to do so.
Towns, utilities & public agencies
- After-hours lines for public works, water and streets
- Utility outage and service-interruption calls
- Overflow during storms and emergencies
- Dispatch of on-call crews, with full call records
Important: answering services support your non-emergency lines and on-call staff. They don't replace 911. Callers with an emergency should always dial 911.
Businesses & professional services
- Plumbing companies
- Electricians
- Law firms
- Funeral homes
- Order-taking companies
From doctors' exchanges to AI voice agents
The industry began with doctors who needed to be found fast. It grew up on cord boards and kitchen tables, and it has outlasted every prediction of its end.
- 1917
The doctors' exchange
Genevieve Kidd, a former nurse, starts the Doctors Exchange Service in Portland, Oregon: a 24-hour message service for doctors, dentists and nurses. It's the earliest claim we've found; other cities claim firsts in the early 1920s. [S2]
- 1920s
"Ghost secretaries"
In New York, operators keep a list of every place a doctor might be (another patient's home, a medical meeting, even a prizefight) because getting hold of the doctor could be a matter of life and death. [S1]
- 1930s–50s
Cord boards and glowing lamps
The phone company extends each client's line to the bureau, where it ends at a jack and a lamp on a switchboard. When the lamp lights, an operator plugs in a cord and answers in the client's name. [S3]
- 1956
On Broadway
Bells Are Ringing stars Judy Holliday as an answering-service operator. The role was inspired by real operator Mary Printz. [S4]
- 1957
1,500 bureaus
About 1,500 answering bureaus serve nearly a quarter-million clients, and lines are growing by about 30,000 a year. [S3]
- 1960s
Pagers
Pagers reach doctors on the move. When one beeps, the doctor calls the hospital operator or the answering service for the message. [S5]
- 1973
WSTA is established
WSTA is established as a nonprofit association where answering-service owners learn from one another. Today it is a national association for answering-service, contact-center, medical-communications and AI-voice companies. [S8]
- 1980s
Computers replace cords
Index cards and cord boards give way to computer screens. Client instructions and messages go digital. [S10]
- 1993
Still growing
Despite answering machines and voicemail, about 4,200 U.S. services handle some 1.3 billion calls a year. [S2]
- 2022
A $2.5B industry
U.S. answering-service revenue reaches about $2.56 billion. [S6]
- Today
People + AI
Platform makers ship AI virtual agents that work alongside live operators, handling routine steps and passing callers to a person when it matters. [S9]
Sources
- [S1] Jack Alexander, "The Man Who Answers Telephones," The New Yorker, April 1939.
- [S2] "That's One Ringy-Dingy," Chicago Tribune, Dec. 11, 1994.
- [S3] G. D. Stewart, "Switchboards for Telephone Answering Services," Bell Laboratories Record, Vol. 35, Jan. 1957.
- [S4] Wikipedia, "Mary Printz" (cites The New York Times, 2009 and 2016).
- [S5] Wikipedia, "Motorola Pageboy"; Motorola Solutions heritage pages.
- [S6] U.S. Census Bureau via FRED, Total Revenue for Telephone Answering Services (NAICS 561421).
- [S7] U.S. Dept. of Health & Human Services, "Business Associates" (HIPAA guidance).
- [S8] IRS exempt-organization record for WSTA (ruling date 09/1973), via NonProfitFacts.
- [S9] Platform-vendor announcements of AI virtual agents for answering services, 2025–2026.
- [S10] Peter Lyle DeHaan, "Messaging Systems," Connections Magazine, Dec. 2002.
History drawn from WSTA’s research brief, “Answering the Call” (Oct. 2026). Dates marked “earliest claim” are contested, and several cities claim early firsts.
8 questions to ask any answering service
- 1Do you answer live 24/7/365, including holidays?
- 2Have you served businesses like mine? Can I speak to a reference?
- 3Will you sign a HIPAA Business Associate Agreement (BAA) if I need one?
- 4How do you deliver urgent messages, and what happens if no one picks up?
- 5Do you use AI? Where, and how fast does a person take over?
- 6How are agents trained and monitored for quality?
- 7How is pricing structured, and what counts as a billable minute?
- 8How long is implementation?
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WSTA is a professional association. Services are provided by independent member companies.