Well, why do you want to do SIP trunking yourself when there are loads of providers available to just buy minutes from, Xcast and Point1 being a few. They are SIP compliant and handle far end media traversal as well as efficient in converting VoIP to PSTN and vice versa.....I suggest you go that path rather than try and do the trunking as it might get complicated.
Being a techie myself I really appreciate the effort you have put in and sounds good, I do agree that companies are springing up here and there making a dialer. A dialer is just not something that picks up a lead and dials, there is more to it and that's where the real ROI is......best time to call, timezone calling, abandonment checks, state rules compliance, recordings, dashboards, Barge in, Coach, List prioritization, choosing best number of a lead at a time of the day.....can get pretty complex and some complex algo's come into play.
I myself have been associated with 3CLogic for long, we developed this unique VTAG (Virtual Telephony application Grid) that allows us to scale like no other solution. Distribution is our key, agent PC's computing power is used to simulate a large central dialer.
Do check out 3clogic website to learn more or google on health insurance 3clogic, register and get someone give you a call, agent UI and dialer customized for the Health Insurance Domain.
Hope this helps
I think he does not want to complicate with billing issues due to Trunk termination charges, I'm running a small Beta testing of a similar product, and billing still holding me down from production.