Phone Calls


Introduction to Spruce phone calls

Once you have set up your Spruce phone number, you can place outbound calls to patients without disclosing your personal phone number. Patients will see your Spruce number on their caller ID, and all inbound and outbound calls and voicemails will be documented in chronological order within Spruce, along with call time and duration.

Making calls from the mobile app

There are three places where you will be able to initiate a call from the mobile app: the inbox (go to + icon and select Phone Call), from the Contact Card, and within Conversation Details. 

Using the Dial Pad from Your Inbox

From the inbox tab, Select the Plus + Icon in the lower right corner of the screen, then select Phone Call.
Select a number from your Spruce contacts by selecting "Contacts" in the upper right-hand corner, or type in a phone number and select the blue call icon at the bottom of the screen.
A call box will pop up with a different number displayed; this is part of the unique Spruce routing system that disguises your personal phone number.
Select Call, and you will be connected to the patient phone number that you input in step 2. The call recipient will see your Spruce number appear on their caller ID.

Calling from Conversation Details 

Select a patient conversation, then select the Info Icon in the top right corner. This will open up the Conversation Details.   
Select the phone icon on the top row next to the person or number you wish to call.
Note: If you do not see the Phone Icon, that means you are not in a conversation where there is a phone number saved to the contact you are trying to call. 
Confirm you want to call the patient by selecting the phone number that pops up at the bottom of the screen, then select the number.    
A call box will pop up with a  different number displayed; this is part of the unique Spruce routing system that disguises your personal phone number.
Select Call, and you will be connected to the patient phone number associated with the conversation you selected in Step 1. The call recipient will see your Spruce number appear on their caller ID.

Call from your Contacts

From the Contacts tab, select the patient you wish to call.
Select the Call icon listed under the patient's name or select a specific number from their contact details below. This will open the dial pad view where you can select the blue call icon at the bottom of the screen.
A call box will pop up with a different number displayed; this is part of the unique Spruce routing system that disguises your personal phone number.
Select Call, and you will be connected to the patient phone number that you input in step 2. The call recipient will see your Spruce number appear on their caller ID.

Making a call from any phone (not connected to Spruce)

If you or a teammate does not have access to a cell phone with the Spruce app or to a Spruce desk phone we have a method to let you call from any desk phone, virtual phone or VoIP you may have. This is a common occurrence if you work with a virtual assistant that is out of the country or if you have not converted your in office phone system to Spruce. To make a Spruce call from any phone, you will log into Spruce from the web and get a unique number to dial that will disguise the phone number of the phone you are calling from and have the person you are calling see your Spruce phone number.  

Select the patient thread and tap on the phone icon on the top level or while in the contact card (see images below.) A box will pop up with instructions and options on making a call.

  1. This section allows you to specify which of your Spruce phone numbers you want to show up on caller ID to the patient when you call. This is what the person you are calling will see on their caller ID. 
  2. This section is where you must select the phone number of the phone you will be making the actual call out on. This defaults to your login phone number that you created your account with (where you received SMS codes when you login.) If the users account was created with their virtual number then you won't have to edit this field. If you want to call out using a different phone number or device with a different number, edit this section by clicking on the number and typing in the new number.
  3. This section with the number written in bold, is a temporary, auto-generated number that you will dial from the external phone system you are using to make calls. When you dial this number, you will be connected to your patient and have the Spruce number appear in their caller ID to the patient. The patient will not see this number. 

Note: To make calls with your Spruce number you must use a phone line with established service, we do not make calls over the internet through the Spruce app on your computer this time. You can make calls from the Spruce app, or Spruce desk phone or another phone system that has an active phone line. 

Receiving calls

When a patient calls your Spruce number, it will ring to your cell phone as well as to any additional phone number listed in the  Numbers to Ring list. For example, if you have your number and a medical assistant's number listed as Numbers to Ring, both phones will ring simultaneously, and whoever picks up first will receive the call. Note: if you have set up a phone tree and chosen sequential dialing, phones will ring in a round-robin style rather than simultaneously. 

There are two unique notes about receiving a Spruce call that you should be aware of:

  • Incoming calls from patients will appear as your Spruce number on your caller ID. This is an important HIPAA safeguard that prevents your patient's information from showing up on your phone screen along with keeping patient phone numbers and names out of the call history on your personal phone. It also helps you immediately identify that the call is a patient phone call. You can then choose not to answer if you are not in a professional environment. 
  • When you answer a Spruce call, you will hear a voice that tells you the name or phone number of the patient who is calling, and then you will be asked to press 1 to be connected. This allows you to screen your calls before answering, and also ensures calls are always answered intentionally. You can choose to press 1 to be connected, or you can hang up to send the call to your Spruce voicemail.

Transferring Calls

Your Spruce phone number supports Inbound Warm Transfers. You can transfer calls from your cell phone or a Spruce VoIP desk phone. If you use the Spruce VoIP phone system, you can transfer active inbound calls to other phone numbers or Spruce extensions. At this time we do not support transferring outbound calls (i.e., those that you have initiated with a patient).

A warm transfer is the process by which you speak to the person you are connecting the call through before the transfer processes. For example, let's say you are on the phone with Alice, and you'd like to transfer her call to Bob. By following the instructions below, you will first connect with Bob, where you can set context for the call, and then complete the transfer by connecting Bob and Alice. We are unable to transfer calls directly to a voicemail box, so unfortunately if Bob is not available the transfer cannot happen. 

Follow the steps below to transfer an active inbound call:

Press the * key to start the transfer process and put the caller on hold.
You will hear a menu that says: “Press 1 to transfer the call, or press 2 to return to the caller.”
Press 1 and dial the phone number you’d like to transfer the call to, followed by the # key. You can dial any 10 digit phone number or known extension for a Spruce desk phone in your practice.
You will be connected to the number or phone you are transferring to. You can speak to the person receiving the call to set context for the transfer.
Press the * key again. You will hear a menu that says: “Press 1 to complete the transfer, or press 2 to cancel the transfer and return to the original call.”
Press 1. You will be disconnected, and the original caller will be connected with the number or phone you transferred to.
If you press 2 at either audible menu, you will be connected back to the original caller.

Calling 911 from your mobile phone

You can call 911 from your Spruce app, but the process will look a bit different than calling any other number from the app. 

When you open the dial pad within the Spruce app and try to dial out 911, a pop-up will show up in the bottom of the screen that prompts you to dial the number from your normal cell phone’s dialer, not from within Spruce. We prompt you to dial out from your personal number because the phone carrier that we use to support your Spruce number, Twilio, does not support calling 911. Once you follow the prompts to dial out from your personal phone, you'll be connected to 911.

Because of this, when you call 911, the operator will see your personal cell phone number and the call will not be placed through or logged in Spruce. In most cases, when you call 911 from a cell phone, it will route to the local dispatch based on your area code. Your location is determined by a process called Enhanced 911 (e911), and routing your call is the responsibility of your personal cell phone carrier, not Spruce. 

Dialing 911 from your desk VoIP phone

If you use a Spruce VoIP desk phone, you can dial 911 just as you would any other number. When you call 911 from a VoIP phone, the call will be routed to your local dispatch, as we register each phone number with the local address of the practice.

Calling 988 (Suicide Crisis Hotline) from your mobile phone

Previously we allowed for calls to be forwarded to 988 via an automated Phone Tree, but we have found that this was resulting in failed transfer requests. In working with our upstream provider we have determined that the most effective way to ensure all 988 calls reach their destination is to treat the number the same as you would dialing 911. Please instruct your patients to hang up and dial 988 directly from their mobile phone. The call will then immediately be routed to the Suicide Crisis Hotline.

International calls on Spruce

International calling on Spruce is limited to certain numbers. Spruce supports the North American Numbering Plan, meaning you can call out to countries that use NANP 10-digit phone numbers. This includes the United States, Canada, Mexico, and about 20 other countries and territories. There are also some online telephone services that use 10-digit numbers. Outside of the NANP, international calls cannot be initiated via Spruce. 

Spruce offers partial support for receiving voicemails from international callers. While you will be able to listen to a voicemail left by an international caller, you will not be able to see the caller's phone number. If you expect to receive international calls, please state clearly in your voicemail greeting that the caller should say their phone number. 

If you need to contact a patient who is located internationally, please reach out to the Spruce Support team for additional assistance.

Providers traveling internationally

Spruce supports forwarding calls to your U.S. number regardless of where you are physically located. If you travel internationally with your U.S. mobile phone, Spruce will still be able to forward your calls to that mobile phone. However, you will be charged according to your cell phone plans international usage rates. 

As long as you have a strong internet connection, you will be able to access the Spruce app to view secure messages, SMS text messages, and voicemails regardless of where you are. 

Patient app requirements

Please note, in order for a patient to download the Spruce app and engage in secure messaging and video calls, they must have a 10-digit phone number to receive verification codes during the login and password reset process. Additionally, the Spruce App is only available in the United States or Canadian app store (on either iPhone or Android).

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