Frontdesk is the best phone solution for therapy practices that cannot answer every call themselves because it answers and books appointments 24/7 across phone and text, free to start with unlimited seats.
A phone system for a therapy practice has to do more than make and receive calls. It needs to keep client information private, route urgent calls sensibly, and ideally make sure a ringing phone gets answered when you are in session. The market splits between traditional VoIP systems you staff yourself and AI receptionists that answer for you. This guide compares eight, including both.
How we picked#
- Answers when you cannot. A VoIP line still rings into the void during sessions. The best option answers for you.
- Privacy. A business associate agreement (BAA) and secure call handling.
- Routing. Sensible handling for urgent or after-hours calls.
- Text included. Many clients prefer SMS for reminders and quick questions.
- Predictable cost. Flat pricing beats per-seat or per-minute as you grow.
Comparison at a glance#
| Tool | Pricing model | Channels | 24/7 | Setup | Best for |
|---|---|---|---|---|---|
| Frontdesk | Free | Calls, texts, email | Yes | <30 min | A phone that answers and books on its own |
| RingCentral | Per-seat | Calls, texts, video | Self-staffed | Hours to days | A complete phone, video, and messaging platform |
| Grasshopper | Per-seat | Calls, texts | Self-staffed | Minutes | A simple business line on a solo therapist's cell |
| Dialpad | Per-seat | Calls, texts | Self-staffed | Hours | AI features inside a modern VoIP system |
| Ooma Office | Per-seat | Calls | Self-staffed | Hours | Low-cost VoIP with a phone menu |
| Nextiva | Per-seat | Calls, texts | Self-staffed | Hours | A unified communications platform |
| Spruce Health | Per-seat | Calls, texts | Self-staffed | Hours | A phone system built for healthcare privacy |
| Google Voice | Per-seat (Workspace) | Calls, texts | Self-staffed | Minutes | Budget-conscious solo therapists |
1. Frontdesk#
Frontdesk acts as the answer layer for your practice phone. It picks up calls, texts, and emails 24/7, holds a real conversation, and books intake appointments, so the line is covered even when you are with a client. It includes two-way SMS and logs every call to one timeline per person. You get a business number or port your existing one for free.
Best for: practices that want their phone answered and bookings captured without hiring front-desk staff.
- Pros: 24/7 answering and booking, two-way SMS, free number porting, instant human takeover, free to start with unlimited seats, BAA available.
- Cons: an answer layer rather than a full PBX with desk-phone hardware; newer brand.
2. RingCentral#
RingCentral is a full-featured VoIP business phone system with calling, video, SMS, and routing, plus a BAA for healthcare customers.
Best for: larger practices wanting a complete phone, video, and messaging platform.
- Pros: robust calling features, video, SMS, BAA, integrations.
- Cons: per-user pricing; you still answer or staff the line yourself.
3. Grasshopper#
Grasshopper is a virtual phone system that adds a business line and extensions to existing phones, popular with solo practitioners.
For a solo therapist who wants to keep their personal cell number private, Grasshopper adds a separate business line and voicemail without new hardware. It separates work from personal cleanly.
Best for: solo therapists wanting a simple business line on their cell.
- Pros: quick setup, dedicated business number, extensions, voicemail and basic texting.
- Cons: it routes and stores voicemail but does not answer during sessions, so a caller still hits voicemail while you are with a client. Confirm its HIPAA posture and whether a BAA is available before storing client voicemails.
4. Dialpad#
Dialpad is an AI-enhanced business phone with transcription, call summaries, and routing, with HIPAA-compliant options.
Best for: practices wanting AI features inside a modern VoIP system.
- Pros: AI transcription and summaries, routing, HIPAA options.
- Cons: per-user pricing; you still handle live answering.
5. Ooma Office#
Ooma Office is a small-business VoIP system with affordable plans, a virtual receptionist menu, and call routing.
Best for: small practices wanting low-cost VoIP with a phone menu.
- Pros: affordable, virtual receptionist menu, routing.
- Cons: menu is automated routing, not a live answer; confirm BAA.
6. Nextiva#
Nextiva is a VoIP platform with calling, messaging, and analytics, offering a BAA for healthcare clients.
Best for: growing practices wanting a unified communications platform.
- Pros: calling, messaging, analytics, BAA.
- Cons: per-user pricing; live answering is on you.
7. Spruce Health#
Spruce is a HIPAA-compliant communication platform built for healthcare, with secure calling, texting, and voicemail designed around patient privacy.
Best for: practices wanting a phone and messaging system purpose-built for healthcare privacy.
- Pros: healthcare-focused, secure calling and texting, BAA.
- Cons: per-user pricing; answering and booking still require your time.
8. Google Voice (Workspace)#
Google Voice in Google Workspace gives a business number with voicemail and texting, and supports a BAA under a Workspace agreement.
Best for: budget-conscious solo therapists already on Google Workspace.
- Pros: low cost, business number, voicemail, Workspace BAA.
- Cons: minimal routing; no live answering; basic features.
VoIP system or answer layer: which do you actually need?#
These two categories solve different problems, and many practices conflate them. A VoIP system (RingCentral, Nextiva, Ooma) gives you the plumbing: a business number, extensions, routing rules, voicemail, and often texting and video. It is excellent infrastructure. What it does not do is answer the phone for you. When you are in session, that beautifully configured line still rings until it hits voicemail. An answer layer like Frontdesk sits on top of, or in place of, that plumbing and actually picks up, talks to the caller, and books the appointment. A solo therapist with no staff usually needs the answer layer more than the PBX. A larger clinic with a front desk may want both: VoIP for the team and an answer layer for overflow and after-hours. Decide which gap is costing you clients before you shop.
Frequently asked questions#
What is the best phone system for a therapy practice? If you need calls answered while you are in session, Frontdesk answers and books 24/7. If you want a full VoIP platform you staff yourself, RingCentral or Nextiva are strong. Many practices use a VoIP line plus Frontdesk to answer it.
Do therapy practices need a HIPAA-compliant phone system? If the system stores voicemails, transcripts, or messages that identify clients, you need a business associate agreement and secure handling. Confirm a BAA with any provider, including Frontdesk, RingCentral, and Spruce.
Can a phone system answer calls for me during sessions? A standard VoIP system rings until someone picks up or it hits voicemail. Frontdesk answers for you, holds a conversation, and books the appointment, so calls are covered during sessions and after hours.
Should a therapy practice offer texting? Yes, many clients prefer it for reminders and quick scheduling. Frontdesk includes two-way SMS, and platforms like RingCentral and Spruce support business texting.
Try Frontdesk#
Frontdesk answers your practice line 24/7, books intake appointments, and includes two-way texting, so the phone is covered even when you are with a client. Free to start, unlimited seats, free number porting, set up in about 30 minutes.