Trusted calling on Spruce uses STIR/SHAKEN attestation and carrier-level registration to ensure your practice’s outbound calls are not labeled as spam or blocked by call-screening apps. This improves patient answer rates and prevents your practice calls from being mistaken for robocalls.
IN THIS ARTICLE
- Major Carriers Are Increasingly Blocking Business Phone Calls
- Phone Number Reputation
- Factors Affecting Phone Number Reputation
- What to Do if You’re Still Experiencing Blocked or Mislabeled Calls
- Frequently Asked Questions
Major Carriers Are Increasingly Blocking Business Phone Calls
Under pressure from the FCC, and angry consumers, the major telecom carriers (Verizon, AT&T, and T-Mobile) have increased their efforts to identify unwanted commercial phone calls and either block them outright or label them with cautionary caller IDs, such as "Spam Risk" or "Scam Likely."
The intent of this increased enforcement is positive, but it has had the negative side effect of misidentifying much legitimate business phone traffic, leading to an escalating number of blocked and mislabeled non-spam calls. This unfortunate collateral damage can be frustrating and dangerous, especially when the impacted business is a medical practice.
Spruce is committed to helping organizations on our platform establish a business telephony presence that is trusted and that will not be subject to call blocking or mislabeling.
Spruce takes many steps to ensure that your organization's phone calls will connect as expected. Much of this is done automatically for you, and we will additionally sometimes request specific important information about your business that will let us register your phone traffic with the major carriers. We also strongly advise you to follow industry best practices for establishing and maintaining your "phone number reputation."
Phone Number Reputation
The major phone carriers are increasingly relying on phone number "reputation scores" to decide whether to block or label phone calls that pass through their networks.
Many factors affect phone number reputation, but new numbers obtained for business use are particularly likely to begin life with a low reputation. It is critical to raise this score quickly so that calls will not be blocked or mislabeled.
Factors Affecting Phone Number Reputation
Factors that affect phone number reputation include:
- SHAKEN/STIR Caller ID Authentication - SHAKEN/STIR is a framework for an industry-wide caller ID authentication technology. Verification of a phone call's caller ID by SHAKEN/STIR protocol is critical for phone number reputation, and numbers obtained through Spruce start with an elevated level of trust via this mechanism. After you register your complete business information with our platform, we then work behind the scenes on your behalf to improve your SHAKEN/STIR "attestation level" to the most trusted status.
- "Analytics Provider" Registration - The major carriers rely on phone number reputation information that is collected and curated by third-party "analytics provider" services. When you submit your phone registration, Spruce will register your your phone numbers and verified business information directly with these analytics providers. This is a critical step toward ensuring a satisfactory reputation score with major telecom carriers.
- Low Answer Rate - If a high proportion of a phone number's outbound calls go unanswered, this will negatively affect its reputation score. Calls to disconnected numbers also count toward this.
- Short Call Durations - Calls of very short duration can lower a phone number's reputation score if they make up a large amount of its traffic.
- High Number of Daily Calls - A phone number that places an atypically large number of calls per day, such as more than 100, may take a hit in its reputation score.
- "Unwanted Call" Reports - If call recipients have reported or blocked a phone number for spam calls, this will definitely lower its reputation score. Newly obtained business numbers may have been used previously by an entity that elicited such reports and harmed the number's reputation.
- CNAM Registration - CNAM is your caller ID name. Spruce can help you submit a preferred CNAM registration; just contact us via in-app support or email and request it. Not all carriers use CNAM data in the same way, but it can sometimes be important in making your caller information display as desired.
What to Do if You’re Still Experiencing Blocked or Mislabeled Calls
If you have followed all of the guidance above and are still seeing your organization's calls being blocked or mislabeled, please contact Spruce Support immediately. You can reach us directly in your Spruce app's support conversation thread, or you can email support@sprucehealth.com.
We consider call blocking and mislabeling to be urgent and unacceptable problems, and we will work with you to rectify the situation as fast as possible.
Frequently Asked Questions
What is trusted calling in Spruce?
Trusted calling uses STIR/SHAKEN carrier attestation to ensure your practice’s outbound calls display correctly rather than being flagged as potential spam.
Why are my practice’s calls being labeled as spam on patients’ phones?
Without completing business registration, outbound calls are often mislabeled by call-screening apps. Trusted calling registration resolves this with the telecom carriers.
How do I set up trusted calling in Spruce?
Most of this is done automatically for you by Spruce, once you have completed the business registration. However, it is worth reviewing and understanding the factors that impact phone number reputation (listed above).