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Can anyone share their experience with virtual PBX systems like Onebox or RingCentral?

Wayne: I've not started using either yet but I had narrowed it down to those two. Was originally leaning towards Ring Central but now am about to start with Onebox. It is the 2000 minutes that convinced me. I may need more than 4 "extensions" but it is less expensive to add one for 11.99 than to get more upfront with RingCentral but fewer minutes. I'm thinking all my calls will be channeled through this to reduce (or nearly eliminate) the receptionist time on the phone- so we need enough minutes. One area of concern I learned about today however, is that they don't have support available after hours or weekends. I would hate to have a glitch and not be able to troubleshoot it after hours.

Wayne,

I used RingCentral which also has eXtremeFax. I used it exclusively for Internet faxing and found it way too expensive. Of course, now I fax for free. I wasn't aware that RingCentral had expanded its offering to be more of a OneBox-type program. In my experience OneBox has many more offerings and functionality than RingCentral. Plus, it couples with UpDox and is much cheaper that way.

If you are planning on using it for the weekends, etc., please don't do ANYTHING without talking to Adam as he has been using OneBox not as a receptionist (there are three ways to use it) but as his answering service. He loves it and knows exactly how to use it and has spoken directly with Andrew Barbash who, of course, knows OneBox and UpDox better than anyone.

I am using GotVMail instead of answering service after work hours and on weekends.

GotVMail sounds good too. Very much like OneBox I have heard.

I think with Adam's greeting, it helps cut down on pages, because it starts off with something like "For routine matters, please leave a message, and we will get back with you promptly at 8AM." Then, "For extremely urgent matters, you may click two, and I will be paged and get back to you within an hour."

I think sometimes patients think we are actually open 24/7, so when they call with something trivial at 7PM and get the service, they sort of panic and tell them what they needed. Then it gets paged out.

Has this been your experience apricot? Has it cut down on unnecessary pages?

This is great info folks. We are hoping to eliminate most of our phone answering during the day (unless its slow). It would also run on weekends, but we dont get too many calls on weekends.

How does the 2K minutes work out? Do you see frequent overruns?

I'll definitely try to talk w/ Adam before i jump.

After reading Adam's posts about Onebox back in March, I looked into it and liked what I saw, and saved money getting rid of my answering service with Onebox in it's place. I set it up similar to how Adam described in his post...

Signed up for the Onebox "Executive" account which gives me 2000 minutes/faxes (in or out) for $30/mo.
During the day I only have my fax line being forwarded to my Onebox number, so they come in as PDFs which are then easily imported (UpDox) by my receptionist and signed off by me. I usually open each imported item "in Default Application" and write notes on it with the comment tools of Adobe Standard (came with my Fujitsu Scansnap s510)... I found that writing notations on the item itself (usually labs) in the red ink of Adobe's comments was much more easily identified and read by me and my staff when looking for my comments on the item.

When the office is closed for the night, I "turn over the phones" to Onebox... just forwarding my office number to my Onebox number. I've recorded a message similar to those mentioned... "yada yada... leave a message that will be addressed when the
office opens.... if you need to speak with me urgently, state your name and wait to be connected"... so when the patient
calls and really needs to speak with me, they are put "on hold" and Onebox will call me on my cell phone. I have the option
of connecting right to them, or I press "3" to send them to voicemail, where the message asks them to leave a message and that I'll return their call within a half hour. Most of the time I'll just connect right away, and patients appreciate not having to go through a traditional answering service where they give details about their concerns then wait around for me to call them back.

I don't use Onebox for calls during the day, as minutes spent on calls that are directed via Onebox are taken out of the 2000 minute/fax allotment, and I think they would quickly be used up. There is a price per minute after that, which could get costly. From what I can tell, GotVMail hits you the same way, but the 2K minutes cost more. So, having all calls to the office routed through a Virtual PBX may not be the most cost effective way of decreasing phone time for the receptionist.

Things I really like about Onebox include:
-the ability to check the office voicemail and faxes from any internet connection. You can also check them from your phone... and Onebox will read the email messages to you.
-the ease in changing your messages... simply uploading the message (.wav file), or having the Onebox "lady" read your typed message (though she doesn't always pronounce words in ways that are ideal)
-the "interface" with UpDox, making document management super easy.
-faxing from any computer with internet access.
-getting rid of the pager. Especially nice when going out for a long run (training for the NYC marathon), I don't have to bring the pager along on my hip... just the iPhone on my arm as my music, phone, and "pager" all in one.

Things I'm not so fond of with Onebox:
-often will get voicemail "messages" that are just a 5-10 second button tone. I think this happens when the person hangs up midway through the process of hearing my message or waiting to be connected.
-patients are sometimes confused about the "state your name and wait to be connected" part... often they start with their message
and then they are cut off, since Onebox gave them 5 seconds to record their name. However, the more clearly I spell out the instructions in the voicemail message, the less this happens.

So, overall I'd give Onebox a thumbs-up and recommend you at least check it out. They used to give a 30 day trial, but I don't see that offered on their site at the moment... but there are neither setup fees nor cancellation fees. UpDox used to have a deal with Onebox that you could get a discount, but not sure that's still available. BTW, I also recommend UpDox. It has lots of cool features (see links at the bottom of this site: http://updox.com/blog/demossharing/) and makes document management very easy. Andy Barbash is a tremendous help, and he'll walk you through any steps necessary to have your program running smoothly.

Hope this helps

CJ,

Thanks for the very organized and detailed overview. That's my understanding as well. You should do reviews for a magazine.

But, if you do talk to Dr. Barbash, make sure you've had at least three cups of coffee first.

ok-dumb question....does one NEED to use Updox? What is the advantage/disadvantage? I currently scan everything in and back up the data with the AC on-line back up every day. Is there a better way? Please-prey tell!

No, you don't need to use UpDox, but depending on your office setup, it likely has many features that may make workflow more efficient. My office is 99% paperless (Family Medicine, opened the office in May after a separating from another FP). All faxes come in as PDFs, all mail correspondence and intake forms/insurance cards scanned in via the Scansnap.

For me, UpDox acts as a type of email client (similar to how one would use Outlook or Thunderbird) for the practice. Most of the content of my Inbox is the faxes that come in as PDFs via Onebox, and with a few clicks of the mouse each page of the fax can be assigned to one or more patients and imported to their chart. In fact, anything you see on your screen or printed can be "captured" and imported into a patient's chart: emails, diagrams, pictures, etc. Communicating with patients via email is made easier with UpDox as it allows for templated text and a form of secure transmission. You can use UpDox to record a .wav file to embed into the emails... in fact I used this to create the voicemail messages that I upload to my Onebox greetings. You can also bring any files on your computer (scanned items, etc) into the UpDox workspace and import them into AC from there.

But, if your current workflow has you scanning in your progress notes and importing them into the chart, UpDox probably doesn't save much time/energy compared to just using the importing process from within AC. However, if you do have faxes coming in digitally, UpDox is a useful tool.

Apparently, UpDox is in the process of converting to a "web centric workflow model". I'm not sure how this will change things in my office yet. You might consider being a beta user if you find UpDox interesting.

Advantages: detailed above, I think. Additionally, there is a feature that allows you to write comments/signatures on the PDFs, however I use the features of Adobe Standard to do this.

Disadvantages: there is a cost to using UpDox... again, not sure how it'll change with the web-centric model, but currently I pay
$90 a year for support and "license" to use the program on any and all computers in the office. There is also an interface fee ($20/mo)paid to AC. "This effectively keeps active the patient list view within updox and the filing of documents and messages directly into AC. If you use UpDox with AC, do not subscribe to a Onebox or any other new fax/mail/voice service and just use your current inbound fax process, then there are no added fees for the fax workflow." (pasted from the UpDox FAQ). I guess this means that Onebox is out unless you are using features of Onebox other than the fax/messaging... so if I weren't using Onebox for my "answering service", I'd likely be using something like pFax for incoming faxes ($4/mo unlimited inbound), and UpDox for the outbound.

So far, I've found UpDox worth the price. Again, I'd check out the demos (link in last post) to see UpDox in action.

-chris

Thank you Chris- your posts are very helpful. I DO want the option of having onebox or some other option as a system to reduce the receptionist time on the phone. I may paint myself into a corner sometime soon and not even have a receptionist.

So- the 2000 minute allotment for onebox is better than ringcentral's lower allotment. But it may not be large enough. So now, I'm looking at Costco's digital phone system for small businesses... if you go to costco.com and search "smartphone" you will find it. may not be available everywhere.

It appears the digital phone system could replace my current phone package which costs me $200/month for 3 lines and phones I purchase on my own. My current system has one voice mail box- no forwarding etc. The digital system can have an automated attendant added on for $20/month that looks like it can provide informational extensions such as directions, hours and fax numbers/email. Each phone extension has voice mail. And with an executive membership, one gets a free web-based fax line that will import as pdf files (or other file types). Looks like the first year price for 5 very nice phones and two lines of service (VM for each of the 5 extensions, web mail box and an extra VM box) would run about $108/mo- then the second year, the phones are paid off and the two lines run $50/mo. I would add an automated attendant for $20/mo and a directory listing for $2/mo. At that price, I could be redundent and add the onebox system and STILL pay less than I do now for my current phone setup. The second year the price would be even lower. And I would have MUCH more functionality including 1500 minutes of long distance per line. Sounds too good to be true?

I think most of the features Chris really likes would be addressed with this setup- except no checking voicemail from an internet connection.

My only question is how good is digital phone service? It would be dependent on my broadband connection but could be forwarded to a cell or other phone in an emergency. Might be worth keeping just one line of the "traditional" system for that purpose. Does anyone have experience with digital phone service? And last question, isn't onebox simply a digital phone system with add-ons?

Wayne- I am PMing you to ask about your experience with appointment quest.

Carla Gibson

Carla,

I have researched this much tonight, but I did look extensively at what is related when I opened my practice. Even if what I say is off base, hopefully I can help you by at least saying, "Be careful."

First, I believe most business phones are digital. Try taking your home phone and plugging it into your office jack. I doubt it will work and vice versa. Your phone system in your office runs back to a rather expensive converter for lack of a better term.

What you are referring to runs over the Internet. It is VoIP, not just a digital phone system. The digital phone system in your office is something like Verizon or AT&T or whatever. As my phone vendor said to me, "When was the last time you picked up your receiver and didn't hear a dial tone?" Correct. Almost never.

From what I read on Costco.com, it sounds more like what you would have at home like Vonage. It would just simply be using a device to change your voice (analog) to packets (digital).

Voice over Internet Protocol or IP which is just over your broadband connection depends on several things. It depends mainly on bandwidth. You must have a lot of bandwidth down, but you ALSO must have a ton of bandwidth UP. Your patients will be very unhappy with anything less than around 754 up and down. Since, you are sending packets, they will drop, get lost, be sniffed, etc. If something happens, who will be there for support?

With business VoIP, the cost as always is much higher. Each "seat" which is a phone costs, say, $40 per month depending on the features. So, you add an employee and need another phone, it's $40 more per month. So, two phones = 80 but 10 phones = $400. But, you only need one cable line. A very good VoIP would use a T1 to the main trunk of the Internet. But, to give an example, even though I never purchased the main piece of equipment for VoIP (I forget the term), I did know I needed a VoIP ready switch. Most switches like Linksys or NetGear for an office LAN can be bought for $60 to $150. My swithc was over $1,000. Works great, but I didn't need it. I ended up not going with VoIP.

If you go with business VoIP, which is highly recommended, you can either go with your own VoIP setup in your office, cheaper in the long run, but you have to maintain it or pay someone to do it for you or you go with Hosted VoIP. This is where a third party company hosts it for you and has all of the extremely expensive equipment such as switching, etc. Think of a small phone company -- actually smaller.

Now, with real VoIP, not Vonage, you can do amazing things. Everyone will eventually go VoIP, I want to. I can't even explain the amazing things you can do with VoIP and your computer. Just to give an example, say you have four phones in your office. These are VoIP phones, mind you. And, your phone number is 207-555-1111. You can pick up a phone, take it to Branson, MO or Japan, plug it into any Internet jack and people can call you at 555-1111. It's like an office call. Your secretary could talk to you like you were two offices over.

I don't want to burst your bubble. And, again, maybe this is something worth looking into. But, I will give you a website to look over which has lots of information on this stuff. Maybe it is what you are looking for. But, at least you can compare it to the Costco phone system.

With consumer VoIP, you have the converter from analog to digital much like a modem. With commercial, it is Ethernet based. Keep in mind again that your call quality is based heavily on your bandwidth. With commercial VoIP, your system has a component which protects your phones, so if you set it at 700 and your employee starts to download those MP3s, it will not let all of your bandwidth go to the download.

Anyway, check out:

http://www.voipreview.org/Business_Telephone_Systems/BusinessArticles.aspx

The one line you would keep would be your fax line. You could use it if your VoIP went down or if you power went down. I wouldn't really call OneBox a phone system. It is a very powerful phone attendant with many options as you say.

Bert-

I will carefully review the link you sent. I REALLY appreciate your thoughts. I know nothing about VoIP. I spoke with the AccessLine rep today- per his report my 700 kbps download and 380 kbps upload speed would support up to 4 lines- I need 2. But that is the salesperson talking.

I will review your link and come back to this thread if I "discover" anything new or decide to give it a trial.

Thanks again!
carla

Thanks. Yes it is very difficult with the biases from sales people. You could probably get by with 380 up, but that would be the bare minimum, and you would need it all the time. With two on the phone at the same time, you couldn't have anyone uploading something taking up bandwidth. The hosted versions and the non-hosted PBX systems have QOS or quality of service which helps with that.

What I would recommend is Googling hosted VoIP in your area and trying to talk with one. They can explain it to you much easier. You could ask them about the one you are talking about. Of course, my guess is they will say horrible things about it, but if they don't, then you may be OK.

The independent salesperson who got me interested in VoIP probably had to answer somewhere in the neighborhood of over 100 questions. VoIP, especially commercial, is SOOOO different than regular POTS. Plain Old Telephone Service. I would love to do hosted VoIP. It is simply awesome. The two companies I talked with for references had around 1,000 phones. That is $40,000 per month just for the leases on the seats. (Phones). But, that is another great place for VoIP. You can have multiple offices with the same phone lines.

NEWBEE here
Just happen to find this discussion on virtual PBX.
I have installed on and old server a demo version of 3CX
A VOIP-PBX for your own lan hosting.
I used an old PC as a server, and Grandstrem IP phones.
The total cost was about 1200$s.
www.3CX.com
clearly the cheapest and very versatile, and easy to configure.
Ajay Ajmani, MD

Ajay:

Tell us more. How long have your been using it? How old is the PC? Is it XP? Are you using it for faxes? What is an SIP phone? What VoIP provider did you go with?

Carla Gibson FNP

Did you go with the "free" version or the one of the business versions?

Actually more to the point as I thought it over, approx what is the breakdown of the $1200.

I have considered VOIP and yet am somewhat concerned it may not be as reliable.

Do you have to completely overhall your current telephone system or is there a way to connect POTS (plain old telephone system) to the network?

Wendell,

I researched this extensively as I really wanted to go with VoIP as the options on configuring it daily via the web were incredible. I am not sure what each hosted provider would charge, but we had to have Power over Ethernet (PoE) switch $1,000, there is a VoIP-type control that I can't recall the name that is around $2500 or more. That is the brains. You can't use POTS. You MUST use VoIP capable phones. Cisco, Toshiba etc. make these. They run around $150 to $350. The real cost is each phone seat. It is completely different than a PBX phone system.

With a "normal" phone system, you decide how many lines you need. Say each line cost $25 monthly, and you had four lines. That is, of course, $100 monthly. Now, you could add 100 phones with extensions to those four lines, and it would not cost you anymore. Each seat (VoIP phone) runs between $35 to $75 or so depending on what features you want (Outlook contacts availability and so on). So, say you went with level 2, which would be $50 per seat. 100 phones would run you $5,000 per month.

Now, of course, you won't have 100 phones, but we have six. We pay ~ $30 a month for two lines or $60 plus a fax line for another $20. So = $80. If we used VoIP phones, we would pay ~ $300 a month plus our $20 fax line, which is also a backup line if your Internet goes down or power is out.

The "brains" has to be a decent one as you want QoS (Quality of Service) if I have the acronym correct. This measures your bandwidth constantly. Again, as in a previous post, you need around 512Mb both ways. If someone downloads a large file, you could lose 300Mbs for five minutes, thus having low quality reception but still good output. Having large bandwidth gets around that problem, but most people don't think about the upload speed. The QoS makes sure that the VoIP phones take complete precedence over the Internet usage.

To be fair, I have not looked at or researched some of the VoIP recommendations on here. But, my recommendation would be at least strongly check out an actual hosted VoIP solution. While someone who works for that company has an agenda, they could at least explain the differences. For a business solution, where you completely rely on your phone system for communication, there is a reason for business-quality VoIP.

Hope this helps.

Thanks a lot Bert,

That is exactly what I needed to know. I will continue look into it. I did browse about VoIP at one time but I never saw anything about the PoE. This plus the cost of each seat changes the equation.

yw. And, of course, this is referring to what I would consider business class. And, pricing was two years ago.

I had an area rep come by. He worked on commission. He explained everything and brought the phone with him. When I installed our "regular" phone system, I had five questions. For VoIP, I had over 100 questions easily. It is just that different. But, very cool!

Bert I have had VOIP for a year now using cisco 7940s and our own IP and I love it POE not necessary but with one you don’t need individual power supplies and those hassles. We kept our land lines for the fax machines but we may convert to virtual fax in the future.
The biggest benefit has been a savings. It costs less than half the monthly costs of our old wired system and we get three outside lines per phone and we have 25 phones so we have the equivalent of 75 lines over 12 lines wired. We currently have three remote offices and some of our practitioners have them at home. I really enjoy being able to transfer a call or a message directly to their house. Because of our security systems it takes a little configuring to take one off-site but those phones can be moved anywhere in the world and it's like it's in the next office. By the way these phones only use 16kbs each.

Thanks Beau,

Things may have changed. I don't really understand how you can make phone calls with 16kbs. I thought our first modems were around 33.6 and most faxes are 14,400.

But, it sounds really good, and maybe you should share the specifics with others. Would also be good to have a hosted company come in and compare.

Good info.

I was referring to the bandwidth or requirements of the phones being 16 kB I understand some of the earlier phones required massive amounts.

A lot more I believe. I was referring to bandwidth as well -- just comparing to modem and fax speeds.

I need someone to point me in the right direction or tell me what to do, soon! Our POT's are on their last legs. We have bought up several used phones from our vendor as they have changed systems for other customers, but they tell us we are the absolute last with the system we have. (It seems like we only paid it off about a week ago!) I am afraid of starting out on VOIP and finding out that it is twice what I first thought, or doesn't work because our internet is too slow or whatever.

Martin,

I just spoke with an expert friend of mine who is a reseller for Speakeasy. http://www.speakeasy.net. It can get confusing depending on your choice of host and who supplies your Internet service now. Beau does seem to be correct in that prices are coming down significantly. My friend did think you would need more like close to 1MB of broadband.

Sometimes you need a special router such as an Edgemarc, which is close to the industry standard. Some of these can run in the thousands while some can be in the low hundreds. I am not even sure if they are even required in some setups. You do not always need a switch with PoE, but it would be nice. The two things you DO want is QoS and redundancy. I believe Speakeasy will switch the service to your cell phones in case the system is down, which is not very often. For the best quality, they recommend a T1 connection to the Internet backbone, which can be much pricier than cable or DSL, but you don't have to go with that. I think you can get a hosted server and T1 at no charge if you have enough of a need to go with their plan.

My friend on the inside has suggested you go to the net at the URL above. You can plug in your zip code to see if you have service. Definitely worth checking out, if only to learn more about it.

Beau,

So are you not using a host?

Martin,

With a hosted solution, you may choose to use a complete router/VoIP management solution. You could also send a request to Edgemarc for information on VoIP.

http://www.edgewaternetworks.com/index.html

Thanks Bert, I will be doing some diligence on this in the future and getting an idea on how to proceed.

We use the Linksys SPA-9000, and connect to a SIP Provider trough our DSL

Hi George,

How much does the Linksys SPA-9000 run?

$285.00 Each Phone is $149.00

http://www.ipphone-warehouse.com/Se...h=spa+9000&Search.x=0&Search.y=0