A practical guide to what it means to use Aesthetix CRM as your phone system, what your team's experience looks like day to day, and how to configure everything for your practice.
When we say Aesthetix CRM is your VOIP provider, it means your practice's phone numbers live inside the CRM — powered by Twilio — and calls are made and received directly through the Aesthetix CRM web app or mobile app, rather than through a traditional phone system or desk phones.
This gives your practice:
Every call automatically logged to the contact record
Call recordings attached to the conversation thread
Missed-call text-back automation that actually works
Call reporting across all numbers and staff
Outbound caller ID showing your practice number
Voicemail managed inside the CRM
What it does not replace is a full-featured business phone system. If your practice currently uses a system with hold music, call queuing, extensions between staff, or an auto-attendant ("Press 1 for scheduling, Press 2 for billing"), those features are not available in Aesthetix CRM. Practices that need those capabilities typically keep their existing phone system and use Aesthetix CRM numbers alongside it for tracking, automation, and messaging.
Most Aesthetix CRM clients use one of these setups — or a combination:
Approach. How it works Best for
Native app calling | Staff answer and make calls through the Aesthetix CRM web or mobile app. No external phone system involved. | Practices going fully into the CRM, remote staff, or those replacing an old system |
Call forwarding | Aesthetix CRM numbers receive calls and forward them to an external number (mobile, landline, or existing phone system). | Practices keeping their existing phones but wanting CRM tracking and automation |
Both approaches can be used simultaneously — for example, forwarding a main line to a front desk landline while having providers use the mobile app directly.
When a patient or lead calls one of your Aesthetix CRM numbers:
The CRM checks if it recognizes the number from your contact database
If the number matches an existing contact, the call is logged to that contact's record
If the number is new, Aesthetix CRM automatically creates a new contact record from the inbound call
The call routes to your configured destination — app, mobile, forwarding number, or voicemail
If no one answers, the CRM voicemail plays and the missed-call text-back automation fires
That last point is important. The missed-call text-back only works if your voicemail is correctly configured and your phone is not forwarding to a number with a call tree. If a patient reaches a "Press 1 for..." menu at the forwarding destination, the CRM treats that auto-answer as a connected call and does not send the text-back.
Before configuring individual numbers or users, it's important to understand the account-level voice settings. These are the master switches that control which routing rules are active across your entire account.
Access these at Settings → Phone Numbers → Advanced Settings → Voice Calls.
These settings work as on/off toggles. The routing priority order explained below only activates for the rules that are turned on here.
When enabled, if a specific Aesthetix CRM phone number is assigned to a user, all calls to that number always route to that user — regardless of who the contact is assigned to in the CRM.
This is the highest-priority routing rule. Enable this if you want specific numbers to always reach specific staff members — for example, a provider's direct line should always ring to that provider.
When enabled, inbound calls route to whoever the contact is assigned to in the CRM. If a lead is assigned to a specific staff member and that lead calls in, the call goes to that staff member's configured destination.
Important: If both "Ring user assigned to called number" and "Ring user assigned to contact" are enabled, the called number assignment takes priority. A number assigned to User A will always ring User A even if the contact is assigned to User B.
When enabled, calls that don't match any user assignment rule fall back to the phone number set in Settings → Business Profile → Company Phone. Enable this as a safety net so no call drops due to a gap in your routing configuration.
When enabled, calls that don't match any user rule fall back to the forwarding number configured on the individual phone number itself. This is typically more precise than the business phone fallback since it can be set per number.
How these two forwarding fallbacks interact: If both are enabled, the per-number forwarding number takes priority over the business phone number. Most practices enable both — the per-number forwarding catches most fallthrough, and the business phone catches anything that slips through.
With the account-level switches in mind, here is the complete order the system evaluates when a call comes in:
Is the phone number assigned to a specific user? (only applies if "Ring user assigned to called number" is on) → Route to that user's configured destination
Is the calling contact assigned to a specific user? (only applies if "Ring user assigned to contact" is on) → Route to that user's destination
Is Ring All enabled on the phone number? → Ring all selected users simultaneously
Is there a forwarding number set on the phone number? (only applies if "Forward to phone number on number settings" is on) → Forward to that number
Is there a phone number set in Business Profile? (only applies if "Forward calls to business phone number" is on) → Forward there
No match found → The call drops immediately
The first condition that matches wins. If a rule's corresponding account-level switch is turned off, that rule is skipped entirely.
Set this in Settings → Phone Numbers → three-dot menu → Edit Configuration.
Staff answer calls directly in the Aesthetix CRM browser or mobile app. No external phone system needed.
Go to Settings → My Staff → Edit the user who should receive calls
Scroll to Call & Voicemail Settings
Under Forward calls to, select Web app, Mobile app, or both
Important: If you select both web app and mobile app, the system always defaults to web app. Choose the one your staff will primarily use.
Remove any personal phone number from the user's forwarding field if you want calls to go only to the app
Set Incoming Call Timeout to 20 seconds
Upload a voicemail file — required for missed-call text-back to function
Calls ring to a mobile, landline, or existing phone system.
Go to Settings → Phone Numbers → Edit Configuration
Enter the destination number in the Forwarding Number field
Set Incoming Call Timeout to 20 seconds
Call tree warning: If the forwarding destination has a call tree ("Press 1 for scheduling..."), the CRM treats the auto-answer as a connected call. Missed-call text-back will not trigger. Forward only to numbers that ring directly without a call tree.
Useful for a shared front desk number where any available staff member can answer.
Go to Settings → Phone Numbers → Edit Configuration
Scroll to Ring Incoming Calls to Selected Users
Select up to 6 users — all their configured destinations will ring at the same time
The first person to answer gets the call
Note: Each user controls which device they receive Ring All calls on independently. Set this per user under Settings → My Staff → Edit User → Call & Voicemail Settings → Default channel for Ring All — this is separate from their normal call routing preference.
Aesthetix CRM offers three ways for staff to make and receive calls natively without a separate phone system. Understanding which one to use for which role makes a significant difference in daily reliability.
The web app dialer runs inside any modern browser — Chrome is recommended. Staff click the green phone icon in the top bar to open the dialer, which they can use to make outbound calls and receive inbound calls.
What staff can do from the web app dialer:
Make outbound calls by searching for a contact or dialing manually
Receive inbound calls when the browser tab is open and active
Mute themselves during a call
Place a call on hold
Warm transfer — call a second person first, speak to them, then patch both calls together
Blind transfer — redirect the call to another number and disconnect
Requirements for the web app dialer to work:
The browser must have microphone permissions enabled for the Aesthetix CRM tab. Click the icon to the left of the URL bar in Chrome to check.
The Aesthetix CRM tab must be open and active to receive inbound calls — a closed or backgrounded tab will not ring
Browser extensions and VPNs can interfere with the dialer. If calls are failing, try Chrome in incognito mode (which disables extensions) to isolate the issue
The outbound call timeout must be set to at least 20 seconds
Best for: Front desk staff and coordinators who are at a computer all day and can keep the browser tab open.
The Aesthetix CRM mobile app allows staff to make and receive calls on their iPhone or Android device. Inbound calls appear as push notifications — similar to a regular phone call — even when the app is not open.
What staff can do from the mobile app:
Make and receive calls from anywhere
Access the conversations inbox, contact records, and tasks on the go
Receive calls on up to 10 devices simultaneously logged into the same user account — the first to answer connects, all others stop ringing
Requirements for the mobile app to work for calls:
The app must be allowed to run in the background on the device
Push notifications must be fully enabled at the device level — go to the phone's Settings → Notifications → Aesthetix CRM and confirm Allow Notifications, Lock Screen, Notification Center, and Banners are all on
On iPhone, set banner style to Persistent so the notification stays on screen until dismissed
Do Not Disturb and Focus Mode must be off, or Aesthetix CRM must be added as an allowed exception
Battery optimization must be disabled for the app on Android — this is a common cause of missed calls on Android devices
The app must be kept up to date — outdated versions cause missed notifications and call failures
Each staff member must be logged into their own individual user account — not a shared login
Multi-location note: If a staff member is part of multiple Aesthetix CRM accounts, they will only receive inbound calls from the last account they actively switched to in the app. If they switch to an account that does not have inbound calling enabled, they will stop receiving calls from any account until they switch back.
Best for: Providers, remote staff, or any team member who needs to be reachable when away from a desk.
The Aesthetix CRM desktop app is a standalone application for Mac and Windows that runs independently of the browser. It behaves similarly to the web app but does not require a browser tab to be open — the app just needs to be running in the background.
What the desktop app offers:
All the same calling and messaging functionality as the web app
Runs in the background without needing a browser open
Useful for staff who prefer a dedicated app rather than a browser tab
Best for: Staff who find managing browser tabs cumbersome but prefer a computer over a mobile device.
Role Recommended option Why
Front desk coordinator | Web app or desktop app | At a computer all day, needs access to full inbox and contact records |
Provider / injector | Mobile app | Needs to be reachable away from a desk, especially for patient callbacks |
Office manager | Mobile app + web app | Flexibility to monitor on the go and work at a desk |
Remote staff | Mobile app | Not in the practice, needs full call and messaging access |
Multi-location staff | Mobile app | Can switch between accounts as needed |
When staff make outbound calls from Aesthetix CRM, the patient sees the Aesthetix CRM number configured as the default outbound number for the account. Staff personal numbers are never shown.
If a user has a specific number assigned to their account and their data access is set to "only assigned data," outbound calls automatically dial from their assigned number. If a user has access to all records, they can choose which number to dial from in the dialer's "Calling From" dropdown.
Call Connect is strongly recommended for any number that forwards to an external phone. When enabled, the answering staff member hears a prompt before the call connects and must press any key to accept it. This ensures the system correctly identifies the call as answered by a human — without it, voicemail recordings can be falsely marked as connected calls and missed-call text-back will not fire.
To enable:
Go to Settings → Phone Numbers → Edit Configuration
Enable Call Connect
Set a Whisper Message — for example: "Aesthetix CRM call, press any key to connect"
Note: Whisper messages only play when calls are forwarded to an external phone number. They do not play when calls are answered through the web app, desktop app, or mobile app — this is expected behavior.
Call recording must be enabled per phone number — it is off by default.
Go to Settings → Phone Numbers → Edit Configuration
Enable Call Recording
Enable Play Call Recording Message and enter a disclosure — for example: "This call may be recorded for quality purposes"
Once enabled, recordings are saved to the contact's conversation thread and accessible in Reporting → Call Reporting.
If your practice uses number pools for website call tracking, those pools must forward to an external business line. Number pools cannot ring to the web app, desktop app, or mobile app directly — a forwarding number is always required. This means any call through a number pool routes to your forwarding destination, not the native app experience.
Feature Supported
Answer calls via web or mobile app | Yes |
Answer calls via desktop app | Yes |
Answer calls via physical desk phone (SIP) | Yes — see VOIP Desk Phone Integration article |
Call recording | Yes |
Mute during a call | Yes — web app and desktop app |
Hold during a call | Yes — web app and desktop app |
Warm transfer | Yes — web app and desktop app |
Blind transfer | Yes — web app, desktop app, and SIP desk phone |
Missed-call text-back | Yes — requires voicemail and no call tree on forwarding number |
Hold with music | No |
Conference calling (3-way) | No |
Call queuing / queue management | No |
Auto-attendant / IVR | No |
Extensions between staff | No |
Call parking | No |
Before relying on Aesthetix CRM for phone calls, make sure these are in place:
Account-level voice settings configured — go to Settings → Phone Numbers → Advanced Settings → Voice Calls and confirm which routing rules are active
Voicemail recorded and uploaded — to both Business Profile and each user who handles calls. Without it, missed-call text-back may not trigger reliably
Call recording enabled with a disclosure message — off by default, must be enabled per number
Call Connect turned on — so the system correctly identifies answered vs. missed calls
Incoming call timeout set to 20 seconds — the maximum before the carrier voicemail answers first
Mobile app notifications enabled on every staff device — at the device level in phone Settings, not just inside the app. Android users must also disable battery optimization for the app
Browser microphone permissions enabled — for any staff using the web app or desktop app dialer
Staff logged into their own individual user accounts — call routing, contact assignment, and reporting all depend on this
Forwarding numbers tested end-to-end — call the number from an external phone, let it go to voicemail, and confirm the missed-call text-back fires
Main published number (website, Google Business Profile, ads)
Ring All to front desk staff — OR — forward to front desk landline
Call Connect enabled with whisper message
Call recording enabled with recording notice
Voicemail uploaded
Missed-call text-back workflow active
Provider / consultation number (optional)
Assigned to a specific provider user
Rings to their mobile app
Call recording enabled
Separate voicemail with provider's greeting
Marketing tracking numbers (Google Ads, Facebook, print)
Individual static numbers per source
All forward to the main number or ring front desk staff
Call tracking workflow to tag lead source on every call
Will patients know they're calling a tracking number? No. Most patients Google your number and click to call — they never save it. Number changes cause far less disruption than practices expect.
What happens if staff don't answer? The call times out, the CRM voicemail plays, and the missed-call text-back fires immediately — sending the patient a text letting them know you'll be in touch.
Can two staff members answer the same number? Yes — use Ring All to ring up to 6 staff simultaneously. The first to answer gets the call.
Does the app need to be open to receive calls? No — but it must be allowed to run in the background and notifications must be fully enabled at the device level.
Can a staff member receive calls on multiple devices? Yes — one user account can receive inbound calls simultaneously on up to 10 devices. The first device to answer connects; the others stop ringing.
What if a staff member leaves the practice? Remove them from My Staff and reassign any contacts or numbers associated with their account. Their call history remains in the contact records.
Can we keep our existing phone number? In most cases yes — number porting to Aesthetix CRM is available on request. Contact your account manager to initiate the process.
Phone voice settings — complete reference (add URL once published)
How to set up voicemail in Aesthetix CRM (add URL once published)
