Phone Calls – Spruce Health

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 your Spruce number displayed; this is part of the unique Spruce routing system that disguises your personal phone number. You won't actually be calling yourself / your own practice.
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 your Spruce number displayed; this is part of the unique Spruce routing system that disguises your personal phone number. You won't actually be calling yourself / your own practice.
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 your Spruce number displayed; this is part of the unique Spruce routing system that disguises your personal phone number. You won't actually be calling yourself / your own practice.
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) using the web version of 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, open up the conversation or contact with the phone number that you want to call, and then click the phone icon. You will see a dialog with information for placing the call. You will be told to dial your Spruce phone number, which will disguise the phone number of the phone you are calling from and have the person you are calling see your Spruce phone number. See below for a step-by-step guide.

Note: To make calls with your Spruce number, you must use a phone line with established service, unless you have mobile softphones enabled. Spruce does not have web-based softphones (calling from your computer) at this time. You can make calls from the Spruce mobile apps, the Spruce desk phone, or another phone system that has an active phone line.

Calling From a Contact or Conversation:

Select the conversation or contact of the person you wish to call. To call from a conversation, select the conversation thread and click the phone icon at the top.

To call from a contact, select the name of the contact in a conversation or from the Contacts tab and click the phone icon at the top.
The new call dialog will open and you will see the following fields:

Select the phone number which should appear on Caller ID — Allows you to specify which of your Spruce numbers the person you are calling will see on their caller ID.

Please note that this is only applicable if you have multiple Spruce phone numbers. If you do not see this, it is because you only have one Spruce number and that is the number that will be shown on the recipient's caller ID.
Specify the number from which you will place the call — You must enter the phone number of the device you will be making the actual call on. This defaults to your login phone number that you created your account with (where you receive SMS codes when you log in). 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.

For example, you might want to call from a personal cell phone, a landline, or a virtual system like Google Voice. To do so, you must enter the number tied to that device in this section.
Dial the following number and we'll connect you — This section will display your Spruce number, which is what you will dial to place this call. This does not mean that you will be calling your practice but is actually the way that the system will place the call, mask your personal number and display your Spruce phone number on the CallerID. In the image below, (908) 555-2222 is the caller's Spruce number.

3. To place the call, dial the number in the final step and we'll connect you to the contact.

Please note that when you select the phone icon, you will have a few minutes to place the call while the connection is active. After this time, if you dial your own Spruce number, the call will instead connect to your practice, as it normally would for all callers.

Common Troubleshooting Steps to Try

Here are some common configuration issues that might be causing you trouble when placing calls on Spruce.

Dual SIM: If you have a device with a dual SIM, you'll need to make sure that the number you are calling out on matches your Spruce account phone number (the number listed under Settings > Account > Mobile Phone Number). You can either update your account phone number, or select the correct SIM on your device for calling.
1. iPhone: navigate to settings > Cellular (or Mobile Data) > Default Voice Line
2. Android: navigate to settings > Network & Internet (or SIM cards, depending on the device) > Look for Calls, Preferred SIM for Calls, or Default SIM for Calls
Incorrect outgoing CallerID: If you are using Google Voice, or another third-party calling application, you'll need to make sure that the outgoing Caller ID matches the mobile number associated with your Spruce account.
Incorrect user credentials: Ensure you are logged into Spruce under your own account. Since the number on your Spruce account must match the number of the device you are using, if you are logged in under another user, you will not be able to place outgoing calls.
CallerID hidden: It's possible that you have your callerID hidden. Below are the steps for unhiding your CallerID for both iPhone and Android.
1. iPhone: navigate to settings > Phone > Show My Caller ID, then make sure it's turned on.
2. Android: on the dialpad screen, click on the 3 vertical dots > Settings > Supplementary service > Show your caller ID, then ensure 'Never' is NOT selected.
3. Note for Verizon customers: Please note, you may not be able to change this setting on your device if Verizon is your carrier. If that is the case, and you have gone through the steps above, please reach out to us in the Spruce support thread.
Redirecting to Google Voice (Android): to prevent your phone from automatically redirecting you from Spruce to Google Voice to place calls, you need to clear the default on your device. Here is what to do to clear that default so you can place your call:
1. Settings >> Apps >> Voice (Google Voice app) >> Set as default and press the "Clear defaults" button.

Receiving calls

When a patient calls your Spruce number, the call will ring on your cell phone, as well as on any teammates' devices, phone numbers, or VoIP desk phones listed in the Numbers to Ring list. All phones in the list will ring simultaneously, and the first to answer will receive the call.

Example: If both your number and a medical assistant's number are in the Numbers to Ring list, both phones will ring simultaneously, and the first person to pick up will connect with the caller.

You can find the Numbers to Ring list in your call handling settings under Settings > Phone & SMS > Phone Numbers.

Note: If your phone number’s call handling settings use Call Flows (phone tree), the specific Saved Ring List (Ring Group) will determine which phones ring when there’s an incoming call.

Customizing Your Call Settings

You can view and manage your personal settings for incoming calls that are directed to you in Settings > My Call Settings. You can view these settings in the web apps, however, mobile phone settings will only be editable in the Spruce mobile app. My Call Settings will only apply to your own account. If you instead would like to manage your organization's phone numbers, you can go to Settings > Phone System (Phone & SMS).

Incoming Calls

Note: Even if your user is toggled on in the Numbers to Ring list, the "Accept Incoming Calls" toggle in Settings > My Call Settings must be turned on to receive calls directed to you.

Mobile Calling Preferences

You can configure your mobile calling preferences in My Call Settings > Mobile Phones (Edit) > Mobile Calling Preference (Edit). There are two options for mobile calling preference:
1. Cellular Network: This setting will use the network that your device's carrier is on to place calls and will require a cell network signal. For example, if you have Verizon, you will be using your regular Verizon carrier to place and receive calls.
  - Caller ID: By default, incoming calls to your cellular device will appear as calls from your Spruce number. This allows you to immediately recognize work-related calls. When you answer, you will hear an audible prompt with the caller’s name or phone number. You can then press “1” to connect with the caller or hang up to send them to your Spruce voicemail, allowing you to screen calls.
  - Note: When using the cellular network, make sure that the mobile phone number set in Mobile Phones is the number of the device you will be calling from and that will be receiving your phone calls. This must be the number that belongs to the SIM card on your mobile device.
2. Softphone: Instead of using your device's carrier, the softphone will use the internet to place and receive calls through the Spruce app itself. You can read more about softphones here.

Caller ID: With softphones enabled, you can customize how incoming calls appear. To enable softphones, refer to this article on activation. Once enabled, adjust caller ID settings by navigating to Settings > Personal Preferences > Devices and Numbers to Ring. Tap on Edit > Softphone Settings and choose one of the following options:
- Display Full Name: Shows the full name of the caller if available.
- Display Partial Name: Shows a partial name of the caller.
- Do Not Display Caller ID: Keeps caller ID hidden.

These options allow for a more flexible call-handling experience based on your preferences and needs.

Receiving calls on Spruce VoIP desk phones

To start receiving inbound calls on your VoIP phone, ensure the following:

Ensure that appropriate Call Flows (Phone Tree) are set up to route calls to your VoIP phone and that your phone number's call handling includes schedules for business and after-hours if needed.
Your VoIP phones have been added to the appropriate Saved Ring Lists or Numbers to Ring list if your phone number’s call handling is not managed by a call flow.

Note: If you want calls directed specifically to your user account to ring on a VoIP phone (e.g. your account is toggled ON in a Saved Ring List or Numbers to Ring List), you can manage this in 'Settings > My Call Settings > VoIP Desk Phones' on the mobile or web app. Here, you can enable 'Allow Incoming Calls on VoIP Desk Phones' and then click 'Edit' under 'VoIP Desk Phone Call Settings' to select which specific VoIP phone should ring.

Outgoing Calls

When making outgoing calls from your VoIP phone, you can choose which of your Spruce phone numbers appears as the caller ID. To set this up, please reach out to Spruce Support for assistance.

Transferring Calls

Inbound Call Transfer

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.

Outbound Call Transfer

Your Spruce phone number supports Outbound Warm Transfers. You can only transfer outbound calls from a Spruce VoIP desk phone or via the mobile app if you have softphones enabled.

Follow the steps below to transfer an active outbound 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 Spruce VoIP desk 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. If you have moved addresses and want to update the address associated with your desk phone, please reach out to support in the app.

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 America Numbering Plan, meaning you can call out to countries that use NANP 10-digit phone numbers with a +1 country code. Here is the list of countries you can dial using a Spruce number:

United States/Canada (+1)
Puerto Rico (+1-787, 1-939)
Virgin Islands, U.S. (+1-340)

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).

If you'd like to learn about call recording on Spruce, navigate here.

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