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International Calls on Spruce

Spruce supports inbound international calling and SMS for qualifying organizations on Spruce's Communicator Plan. An administrator can reach out to Spruce Support for more information.

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Inbound International Calls and SMS

Inbound calls and text messages from international numbers work just like calls and texts from U.S. numbers on Spruce. All organizations can receive inbound international calls and sms messages without incurring additional charges or needing the feature to be turned on by Spruce Support.

Outbound International Calls and SMS

Due to additional costs and regulatory complexity, outbound international calling and texting is currently reserved for larger organizations on Spruce who subscribe Spruce's Communicator Plan. An administrator can request this feature to be enabled by contacting the Spruce Support Team through the Spruce app or by emailing support@sprucehealth.com

Important Notes on International SMS

If two-way international SMS is critical for your practice, we recommend using Spruce secure messaging instead.

Due to carrier restrictions worldwide, we cannot guarantee that international SMS will always deliver successfully.

  • Example: In the UK, text messages sent from standard 10-digit U.S. numbers cannot be delivered to UK mobile phones when they come from a business or app (this is called application-to-person, or A2P, messaging). Spruce phone numbers are considered A2P.

Caller ID behavior varies by country. Some carriers may not display your Spruce phone number as the sender. More details can be found here under International two-way SMS.

Patients with International Numbers

Since you may not be able to call or text patients with international numbers, we recommend utilizing secure messaging and video calls for these patients. To ensure that these patients can connect with your practice:

  • Ensure that you include the patient's email address in their contact when you invite them to Spruce
  • Direct the patient to click the link in their invite email on a desktop computer
  • The patient will then be able to set up their account in their desktop web browser - when patients are prompted to secure their account with a text to their phone, direct them to click 'Secure account with email instead'
  • Once your patient has created their Spruce account, they can download the Spruce mobile app to communicate with your practice from their mobile device
  • With their account created, you can now correspond with the patient via secure message and invite them to video calls - the camera can be switched off for video calls to provide an experience close to voice calling

Providers Traveling Internationally

Spruce can forward calls to your U.S. number no matter where you are physically located.

  • If you travel internationally with your U.S. mobile phone, Spruce will still forward calls to that phone.
  • Your mobile carrier’s international rates will apply.

You can use the Spruce app from anywhere with a strong internet connection to:

  • Send/receive secure messages
  • Send/receive SMS messages
  • Listen to voicemails
  • Conduct video calls

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