echo
AI receptionist directly integratedwith Karisma
Every call, text, and web form answered in under a second and booked straight into Karisma, under the scheduling rules you already work by.
On this page
- 01What is Karisma?
- 02Key takeaways
- 03What does Echo read and write in Karisma?
- 04Why do Karisma practices miss patient calls?
- 05What does Echo do inside Karisma?
- 06How does Echo connect to Karisma?
- 07How Echo Booking compares
- 08How is Echo different from a generic AI receptionist?
- 09Everything on one phone
- 10Frequently asked questions
Radiology RIS integration guide
How Echo works with Karisma
Echo Booking is an AI receptionist for Karisma, built for imaging practices. It answers every call 24/7, reads the Karisma diary, each worksite's rooms and resources, and your service types with their preparation instructions, then turns the caller's referral into a diary booking, with prep given and safety questions asked, while the patient is on the line.
Karisma runs the imaging practice from the referral in: the referral is captured, becomes a booking in the diary against a room and a resource at a worksite, and moves through protocolling, the reporting worklist and report distribution to the Medicare claim. That is what makes the phone expensive in radiology. The patient ringing at 6 p.m. holding a referral for a knee MRI, or the GP surgery ringing at 8:15 to squeeze in a chest X-ray, is asking a question about a service, a modality and a site, and answering it well takes someone who knows which room has the right resource free and what the patient has to do before they arrive. Echo answers that phone, every call and text, day and night, reads the diary, the services and the preparation instructions out of Karisma, and books the exam into a real slot at the right worksite while the caller is still on the line.
Background
What is Karisma?
Karisma is a Radiology RIS (radiology information system) that radiology groups, imaging centers, and hospital imaging departments use to manage imaging orders, exam scheduling, and reporting.
Echo is the AI receptionist that integrates directly with Karisma: it answers every patient call and text 24/7, reads your the Karisma diary at every worksite, rooms and resources, service types with their durations and preparation instructions, referrers, and patient records, and turns the caller's referral into a booking against the right room and resource at the right worksite, with the referrer attached, and reschedules or cancels it in the diary in real time, writing every result back into Karisma in real time.
Karisma is made by its own vendor and is not affiliated with Echo. See the official Karisma site for their product details.
Hear it for yourself
A real call from inquiry to booked appointment.
Echo in action
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What Karisma practices see
- Fewer front desk labor hours
- 50–80%Fewer front desk labor hours
- More appointments booked
- 20–30%More appointments booked
- To full ROI
- 1 monthTo full ROI
- After-hours calls answered
- 100%After-hours calls answered
- Pickup time
- < 1 secPickup time
- Always answering
- 24/7Always answering
In a live practice, Vanguard Interventional Pain Specialists runs reminders, intake forms, and after-hours calls through Echo across three locations, in English, Spanish, Mandarin, and Cantonese.
In short
Key takeaways
- A direct, 100% two-way integration with Karisma: Echo reads your the Karisma diary at every worksite, rooms and resources, service types with their durations and preparation instructions, referrers, and patient records and writes appointments, reschedules, and notes back in real time, not a message queue.
- Your Karisma scheduling logic is Echo's: which provider, which exam types, how blocks are grouped and sequenced, how tightly the day packs. It books the slot your staff would have chosen, not simply the next open one.
- Insurance eligibility and benefits are checked before the visit, so patients arrive verified rather than surprised at check-in.
- Practices book 20–30% more appointments and cut front desk labor hours by 50–80%, and most reach full ROI within the first month.
- 100% of after-hours calls are answered, triaged against your protocols, and booked or escalated, nothing goes to voicemail.
- Up to 80% of inbound referrals are booked automatically, so referrals stop expiring in a fax tray while the patient books elsewhere.
- Live in about 2 hours: roughly 30 minutes to enable the Karisma API, then up to 2 hours configuring your booking rules with Echo's team.
- HIPAA-compliant by design and covered by a signed Business Associate Agreement (BAA). Keep your number and your Karisma workflows, no migration.
Depth of integration
What does Echo read and write in Karisma?
Echo works inside Karisma rather than alongside it. It reads the schedule before it answers, books while the patient is still on the line, and writes the result back to the chart in real time. Nothing waits in a queue for your front desk to re-key in the morning.
Reads
What Echo can see in Karisma
- the Karisma diary at every worksite
- rooms and resources
- service types with their durations and preparation instructions
- referrers
- patient records
Writes
What Echo does back to Karisma
- turns the caller's referral into a booking against the right room and resource at the right worksite
- with the referrer attached
- reschedules or cancels it in the diary in real time
Stays the same. Your Karisma worksites, rooms and resources, service types, preparation instructions, and SMS notifications stay exactly as they are. There is no migration and no rebuild, and patients keep calling the number you already publish.
In an imaging practice the caller is holding a referral, not making a request. A knee MRI with contrast is a specific service on a specific resource at one of several sites, with fasting and implant questions that decide whether the exam happens. Echo books the service the referral calls for, at the site that can see the patient soonest, and gives the prep on the call.
Three ways software connects to Karisma, and which one this is
- Message capture.
- The service never touches Karisma. It collects the patient’s details and hands your team a message to enter. The work is recorded, not removed, and the appointment does not exist until somebody types it.
- Scheduled sync.
- Data moves between Karisma and the tool on an interval. It is a real integration, but the tool is quoting a schedule as it stood at the last sync, so two callers can be offered the same slot and double-bookings surface after the fact.
- Real-time read and write.
- The tool queries Karisma live during the call and writes back before the call ends. The slot it offers is open at that moment, and the booking is in the chart by the time the patient hangs up. This is how Echo connects to Karisma.
The problem
Why do Karisma practices miss patient calls?
The solution
What does Echo do inside Karisma?
- A RIS runs the journey but does not pick up the phoneKarisma carries the patient from referral to report: the booking, the protocol, the worklist, the distribution, the Medicare claim. What it cannot do is answer the call from the patient holding a referral at 6 p.m., or the GP surgery ringing at 8:15 to squeeze in a chest X-ray before the patient leaves. Every one of those calls that rings out is a referral that walks to the imaging practice down the road, and the referrer notices where their patients end up.
- Answers before the second ring, 24/7Echo picks up in under a second on every call, and handles texts, emails, and web forms on the same footing. Evenings, weekends, public holidays, and the morning rush of referrer calls are all covered, so the phone stops capping how many referrals the practice can turn into bookings in a day, and the referrer keeps sending patients to the practice that answered.
- The caller has a referral, not a requestPatients ring holding a piece of paper they cannot fully read. What is on it is the referrer's name, an exam and a body region, sometimes contrast, sometimes a clinical note that changes the modality entirely. The receptionist's first job is translating that referral into the right service in Karisma before a single time is offered, and doing it while the next line is already ringing.
- Books the service the referral calls forEcho takes the referrer, the exam, the region and any contrast or clinical note from the caller, maps it to the service type your practice defines in Karisma, and asks the clarifying question when the referral is ambiguous. It records the referrer against the booking so the report goes back to the right practice. If the referral names something you do not perform, it says so and takes the details for your team rather than booking it anyway.
- A booking is a room and a resource at a site, not a timeKarisma schedules against the diary at the worksite level: a specific room and resource, for a service with its own duration, at one of several sites. A caller who wants an MRI on Thursday is really asking which site has the right scanner free that day, and only someone with the diary open across every location can answer without a callback.
- Books the right room and resource at the right worksiteEcho reads the Karisma diary across every worksite: which rooms and resources each site has, which services each one performs, and the duration each service takes. A caller who wants an MRI on Thursday is offered the site that can actually see them, and if the soonest slot is across town Echo says so and lets the patient choose. Nothing lands in a room that cannot run the exam or a slot too short to finish it.
- Preparation instructions decide whether the exam happensFasting before an abdominal ultrasound, holding a full bladder, the questions about pacemakers and implants before an MRI, contrast and kidney function. Karisma holds the preparation instructions per service and sends the SMS, but the moment those instructions actually land is on the booking call, and a patient who was not told to fast is a wasted appointment on a fully booked list.
- Gives the prep and asks the safety questions on the callEcho reads the preparation instructions for the service it just booked, fasting, bladder, what to bring, and gives them before the patient hangs up, in the patient's language. It asks the screening questions you require before an MRI or a contrast study, and an answer that needs a radiographer's judgement is recorded and handed to your team instead of booked past. The SMS Karisma sends then confirms what the patient already heard.
- A cancelled scan is expensive capacityA cancelled CT or MRI slot is not an empty half hour, it is a scanner and a radiographer standing idle on a list that was full a week ago. Refilling it means someone ringing down the waiting patients between check-ins, and the window closes fast because the next patient needs time to prepare and to travel.
- Refills the scanner slot while the list is still warmWhen a CT or MRI cancels, Echo cancels it in the diary, then calls and texts your waiting patients who need that service at that site, in the order you choose, and only offers times that respect the preparation each service needs. The first patient who accepts is booked straight into the freed room and resource, so a scanner is not idle while a receptionist works the phone between check-ins.
- Every question stacks up at the one deskIs my report ready. Can my GP see it yet. Does Medicare cover this. Do I need to bring my films. Is there parking at the other site. The reception desk in an imaging practice is the front line for patients, referrers and radiographers at once, and every minute spent on a status question is a minute a new booking waits on hold or goes to voicemail.
- Answers, takes a message, or transfers, by your rulesEcho answers the practical questions from the information you give it, opening hours, sites, parking, what bulk billing and DVA mean for a patient, and takes a message or transfers the call for anything clinical or anything about a report. Every message is written as a note against the patient's record in Karisma with the caller's details attached, so nothing goes to voicemail and your desk sees it in the system it already works in.
How it connects
How does Echo connect to Karisma?
Connect to Karisma
We link Echo to Karisma and map your providers, exam types, and scheduling rules during onboarding.
Configure your front desk
Tell Echo how you greet patients, book, work recall, and handle after-hours. It learns your setup, so you don't rebuild around it.
Go live
After a dry run and the signed BAA, Echo starts answering calls and texts and writing every result back into Karisma.
How Echo Booking compares
Don't buy another tool. Buy less work.
One patient request
Turn calls, texts, and emails into booked appointments
Incoming call, text, email, or fax
Deep integrations, so Echo knows the patient before saying "Hello"
Custom scheduling rules, so no patient lands in the wrong slot
Booked on autopilot
Echo finishes
How does Echo handle an imaging order from fax to follow-up?
- Calls, texts, emails and faxes all land in one place
- Answered 24/7, including nights and weekends
- Speaks with each patient in their own language
- Identifies who it is and what they need
- Picks up the thread instead of leaving a message to return
Step 1 of 7
Incoming call, text, email, or fax
- Calls, texts, emails and faxes all land in one place
- Answered 24/7, including nights and weekends
- Speaks with each patient in their own language
- Identifies who it is and what they need
- Picks up the thread instead of leaving a message to return
Why practices choose Echo
How is Echo different from a generic AI receptionist?
Only three things matter: whether it knows your booking logic, whether it completes the work inside your system, and what it costs your front desk to adopt.
- Scheduling rules engineEcho lands the slot your front desk would have picked, inside Karisma, not whichever one happens to be open.
- Deep integrationsEcho reads and writes the fields your workflow actually runs on in Karisma, so the work leaves your desk instead of coming back as a task.
- Mobile firstOne light app that pings your team only when a person is genuinely needed. No dashboard to check each morning.
| Capability | Echo BookingCarries the work to done | Generic AI voice botAnswers, then hands it back | Karisma on its ownThe system you already run |
|---|---|---|---|
| Custom scheduling logic | Your providers, visit types, block rules, and how tightly the day packs, inside Karisma. Echo lands the slot your staff would have chosen. | Reads out any open slot, with no way to know your preference | Holds your rules; someone still has to apply them on the call |
| Books directly in Karisma | Booked, moved, or cancelled in Karisma in real time, under your rules. | Read-only at best, so the request stops at a person who can enter it | Staff, by hand, once someone answers |
| Proactively reminds, recalls, and backfills cancellations | Works reminders, recall, and the waitlist on a schedule and books the result on the spot. | Inbound only. It waits to be called | Report only: it lists who's due, it doesn't call them |
| 70+ languages, spoken naturally | Spanish, Mandarin, Vietnamese, Tagalog and 70+ more, on the same number, switching automatically. | Usually one or two, often a separate number | |
| Writes back without transcription errors | Structured fields into Karisma: patient, visit type, provider, time. Nothing is re-typed. | Hands over a transcript for someone to key in | Only as accurate as what your staff type in |
| Verifies insurance before the visit | Checks eligibility and benefits as part of booking, and flags what the patient will owe. | Can discuss coverage, but not confirm it | A place to record coverage, not a way to check it |
Done, start to finishPartly. Someone at the practice still finishes itDoesn’t do it at all
Mobile first, light by design
AI receptionist, in the palm of your hands.
Everything Echo does inside Karisma reaches you the same way: one app, on the phone already in your pocket. There is no second dashboard to watch and no queue to work through in the morning, because the work is finished in Karisma before it would have reached one.
Ask an Echo a question or complete an outstanding task
- Ask it to call a patient back, from your palm.
- Pull today's numbers without opening a report.
- No extra tab to monitor or workflow to change.
- Built to stay hidden and work for you.
- Get push notification when a human needs to step in.
Incoming messages
Patients reach you
Booking requests
New patients and reschedules booked straight into the schedule, by your rules.
After-hours calls
Nights, weekends, lunch, and every busy moment in between, answered, never voicemail.
Patient messages
Texts, emails, and web forms answered on their own, handed to your team when it matters.
Outgoing messages
Echo reaches patients
Related reading
Keep exploring
Runs on another system? Echo reads and writes in real time, verifying insurance and booking, confirming, and logging every result directly in MedInformatix, AbbaDox, Exa RIS, RamSoft, Aura, Visage, Synapse RIS, Epic, Oracle Health, MEDITECH, eClinicalWorks, Athena, PrognoCIS, Practice Fusion, NextGen Office, Prompt, Acuity Scheduling, WebPT, Open Dental, Dentrix Ascend, Curve Dental, Oryx, Dentrix, Eaglesoft, and Denticon, with no separate queue to reconcile and no migration.
Questions
Frequently asked questions
Kestral publishes K-Link, an API integration gateway for Karisma that it says can be used by radiology practices, hospital networks and third-party developers. It documents per-integration credentials, centralised OAuth 2.0 authentication and role-based access control, but no public developer portal, endpoint reference or sandbox, so the route for a new integration is worth confirming with Kestral directly.
Yes. Kestral lists HL7 connectivity and FHIR eRequesting for Karisma, along with integration with leading PACS providers. Its partner page also names Kestral's Messaging Gateway (KMG), an open-source messaging gateway for HL7, EDI and X12, and an Interop API within the HL7 standards.
Either. Kestral states Karisma can run on-premise, at an offsite data centre, or via cloud technology, so where an integration has to reach depends on how your practice chose to deploy it.
Kestral publishes a partners page listing its technology partners and its in-house integration tooling, and directs partnership enquiries to enquiries@kestral.com.au. It does not publish partner requirements, an application process, or partner tiers.
Yes. It is a direct, two-way integration. Echo reads your Karisma diary at every worksite, the rooms and resources at each, the service types with their durations and preparation instructions, referrers, and patient records, and it books, reschedules, and cancels in the diary in real time. It creates the patient record when the caller is new and writes a note against the record for every call your team needs to see.
No. Echo reads which rooms and resources are at which worksite and which services each performs, so a caller who needs an MRI is only offered slots at a site that has the scanner, and only at sites you have told Echo are interchangeable for that patient. If the soonest opening is at the site twelve minutes further away, Echo says so and lets the patient choose.
Echo does not book around it. If a caller reports a pacemaker, an implant, a contrast reaction, or anything else your practice flags for a service, Echo records the answer, tells the patient the team will follow up before the exam, and routes it to your radiographer or booking team for a decision. The screening rules are yours; Echo asks them consistently and escalates the exceptions.
Yes. Echo speaks 70+ languages and switches automatically on the same published number, across calls, texts, emails, and forms. Preparation instructions and screening questions are delivered in the patient's language, which matters because a fasting instruction that was not understood is a wasted slot on a fully booked list.
Nothing in Karisma changes. Your worksites, rooms and resources, service types, preparation instructions, and screening rules stay exactly as they are, and patients keep ringing the number you already publish. We connect Echo to Karisma through Kestral's K-Link gateway, map your services, site rules, screening questions, and after-hours protocols, and Echo starts answering. The Karisma integration is currently in beta: the two-way read and write is live for beta practices, and we onboard each one with a member of our team watching the first bookings land in the diary.
It writes. Echo reads your live Karisma schedule during the call, books the appointment while the patient is still on the line, and writes it back into Karisma in real time, along with the patient record and the notes from the call. Nothing lands in a queue for your team to re-key, and there is no message waiting to be deciphered in the morning.
A message-taking service never touches Karisma. It collects the patient's details and hands your team something to enter, so the appointment does not exist until somebody types it. A scheduled sync moves data on an interval, so it quotes the schedule as of the last sync and two callers can be offered the same slot. Echo queries Karisma live during the call and writes back before the call ends, so the time it offers is genuinely open at that moment and the booking is in the chart by the time the patient hangs up.
Echo verifies insurance for Karisma imaging centers as part of booking. It checks the patient's eligibility and benefits before the visit and flags what they are likely to owe, so the appointment is confirmed with coverage already established rather than leaving a verification task on your front desk's list. Most AI receptionists can discuss insurance but cannot check it.
Echo books to the scheduling rules you configure, not to the next open gap in Karisma. It applies which provider or room an exam type belongs to, how long that exam really takes, how appointments are grouped and sequenced through the day, and how tightly the day should pack, so the slot it lands is the one your staff would have chosen.
Yes, and most imaging centers bring Echo in to replace the after-hours service and the daytime overflow line at once. A traditional answering service cannot see your Karisma schedule, so the best it can do is take a message your front desk re-keys the next morning, and it usually only picks up after hours. Echo answers every call and text in under a second, day or night, reads your live Karisma schedule, and books, reschedules, and confirms directly in it. Out of hours it triages against your protocols and escalates true emergencies to your on-call contact with the patient's details already attached. The patient leaves the call with a real appointment rather than a callback.
Yes. A self-service booking link only reaches the patients who go to your website, already know what they need, and never abandon the form, which is a small slice of demand. Most patients call, and they call to check insurance, reschedule, or describe a problem before they will book. Echo answers every one of those calls and texts, handles the questions and exceptions a form cannot, and books straight into Karisma, so you capture the patients an online link never reaches.
About two hours of your time. Enabling the Karisma API integration takes roughly 30 minutes, and configuring your specific booking rules, providers, exam types, and after-hours protocols takes up to two hours with Echo's team walking you through it. There is no migration and no rebuild, so most practices are live within days, not weeks.
Echo is one flat monthly fee, from $499, with unlimited AI calls, sized by providers and locations and quoted in writing before you sign. Texting, online booking, and insurance verification come with the Pro plan, and a one-time onboarding fee covers the Karisma connection and a two-week trial with real patients. See /pricing for current plans.
No. Karisma stays your system of record. Echo is a layer on top that handles the calls, texts, and forms, then writes the result back into Karisma. There is no migration and no rebuild, and patients keep calling the number you already publish.
Ready when you are
Bring Echo to your Karisma practice.
See exactly how Echo answers every call, text, and form for a practice running on Karisma.