Quo vs Spruce (2026): which should you pick?

Pick Quo if

• Fits if you want a work number on your own phone, apart from your personal one
• Works for a few people sharing one sales or support line who need the same history

Look elsewhere if

• Tight if you're on Starter and want a phone menu or call transfers, as those need Business
• Not for you if you call abroad a lot, since calls outside the US and Canada are billed per minute
• Pricey if Sona answers lots of calls, as each one past the plan's credits costs $0.45 to $1.00
• Watch out: US texting needs carrier registration, $19.50 once plus $1.50 to $3 a month
• Pricey if you pay monthly, at $19 for Starter and $33 for Business, or need extra numbers at $5 each

Pick Spruce if

• Fits if you want one shared inbox for calls, texts and faxes
• Works for a practice that already has an EHR and needs the phone side

Look elsewhere if

• Not for you if you want scheduling, charting or billing, as it needs a separate EHR
• Watch out: business text sending needs a one-time A2P 10DLC fee of $19.50 per organization
• Pricey if you want call flows, integrations or the API, all on Communicator at $49
• Watch out: desk phone hardware for VoIP is extra

Quo

• Texting US numbers requires carrier registration (TCR): a one-time $19.50 review fee plus $1.50 to $3 a month.
• On Starter, calls are recorded manually only, and phone menus, transfers and CRM integrations need Business or Scale.
• Each extra number costs $5 a month; calls and texts outside the US and Canada are billed per minute or per message.
• Sona calls beyond the plan's credits cost $0.45 to $1.00 each, depending on the credit tier.

Spruce

• It does not do scheduling, charting or insurance billing; a practice still needs a separate EHR.
• Sending business SMS requires a one-time A2P 10DLC registration fee of $19.50 per organization.
• Integrations and API access are limited to the $49 Communicator plan, and VoIP desk phone hardware is an extra.
• The free trial includes Basic features but not SMS sending, which needs the registration process first.

Quo

Shared phone numbers

Several teammates can share one number with a common call and text history, internal threads and shared contacts. Starter allows up to 10 users per shared number.

Calling and texting

Unlimited calls and texts to US and Canadian numbers under a fair use policy, with snippets, scheduled messages, auto-replies and group messages.

Sona AI agent

An AI agent that answers calls at any hour. Every plan includes 1,000 credits a month, enough for 10 calls; credit packs run from $25 to $199 a month.

AI call summaries and transcripts

Business and Scale transcribe and summarize every call. On Starter, summaries cover only calls Sona handles; voicemails are transcribed on all plans.

Phone menus and routing

Business adds phone menus, call transfers, group calls and ring orders that ring teammates in batches, plus business-hours forwarding.

Integrations and API

HubSpot and Salesforce need Business or Scale. Pipedrive, Slack, Zapier, Make, Google Contacts and the Quo API are also listed, plus an MCP server for ChatGPT and Claude.

Spruce

Phone, text and fax in one inbox

Calls, SMS, e-fax, app-based secure messages and video visits arrive in a customizable shared inbox, with new or ported phone and fax numbers.

Secure messaging and team chat

Staff can message patients inside the Spruce app, share files, and talk to each other in internal chat on the same plan.

Automations for common replies

Auto-replies, saved and scheduled messages and bulk text broadcasts cut down repeat typing.

Call routing

Phone trees and extensions come with Spruce's phone system. Self-service call flows, urgent escalation and after-hours triage are on Communicator.

AI transcription

Voicemails are transcribed on both plans. Communicator also transcribes and summarizes call recordings and audio messages.

BAA and security claims

Spruce says every eligible organization gets a HIPAA BAA at signup with no extra fee, and describes the platform as SOC 2 Type II audited.

Quo

• Starter$15

  per user / month, billed annually ($19 billed monthly)

  One local or toll-free number per user, unlimited US and Canada calls and texts, voicemail transcripts, the Sona AI agent and the Quo API.

• Business$23

  per user / month, billed annually ($33 billed monthly)

  Adds AI summaries and transcripts for all calls, phone menus, group calls, transfers, ring orders, auto recording, reports and HubSpot and Salesforce.

• Scale$35

  per user / month, billed annually ($47 billed monthly)

  Adds AI call tags, dedicated onboarding, priority chat and email support, and inbound phone support.

Spruce

• Basic$24

  per user / month, billed monthly

  Phone, text, video, fax and team chat, a shared inbox, auto-replies and AI voicemail transcription.

• Communicator$49

  per user / month, billed monthly

  Adds call flows (IVR), urgent escalation and after-hours triage, integrations and API access, VoIP phone service and AI call summaries.

Quo

• Annual discount

  Lower prices with yearly billing

  Quo's pricing page shows yearly billing saving $48 a year per user on Starter, $120 on Business and $144 on Scale.

Spruce

No public discounts listed.