Make sure urgent calls reach a doctor
Start a 14-day free trial of Lydoh After Hours, add your on-call providers, and test the cascade on your own phone.
For physicians and practices with a call schedule
When an after-hours caller says it can't wait, Lydoh works out who is on call from your schedule, phones that provider until they accept, moves to the backups if they don't, and keeps a timestamped record of every attempt.
Lydoh After Hours: $99/mo with 300 minutes included · on-call escalation included
Illustrative. Names and times are examples.
The short answer
Three things: page the right provider, keep trying until a person takes the call, and be able to show afterwards who was reached and when. A message relayed to a pager does the first, sometimes. Lydoh is built around all three. This page covers the on-call step; for the rest of the night (911 first, routine requests for the morning) see the after-hours answering service.
Lydoh never decides how urgent a call is. It asks the caller whether they need the on-call provider tonight or whether it can wait, and takes the answer. It never assesses a symptom or gives medical advice, and anyone describing a life-threatening emergency is told to hang up and dial 911. Assessment stays with your clinicians, as telephone triage rules expect.
Step one
Lydoh reads your schedule at the moment each urgent call arrives, in your practice's timezone, so a rotation changes at your midnight, not a server's. The order is fixed:
Everyone else on your list, in the order you set, is the backup chain. Draft the rotation with the free on-call schedule builder, which runs the same resolver Lydoh uses on live calls, and print it or export a CSV.
Step two
A provider who declines has answered, so they are not rung again. One who didn't pick up can be rung a second time if your escalation policy asks for it. Only one cascade runs at a time: if a second urgent call comes in while the first is still ringing doctors, its details go to the whole chain by text instead, so two patients never compete for the same phone.
If nobody accepts, you can also have Lydoh text the patient, from your practice number. The text is written to leave the reason out:
Cedar Grove Family Medicine: we haven't reached Dr. Patel yet. Dr. Patel has your message and will call you back as soon as possible. If your symptoms get worse, call 911 or go to the nearest emergency room. Reply STOP to opt out.
Practice and provider names are examples. The patient text is off unless the practice turns it on, and needs patient texting set up.
Optional
By default the patient hangs up and the provider who accepts is connected back to them. Some practices would rather the patient never hang up. With Keep urgent callers on the line turned on in Settings:
Live connect is off by default and is being rolled out to practices now. It needs live transfers, which switch on once the free trial ends. Talk time is not yet recorded for live-connect calls, so practices that bill from the export may prefer the call-back path for now.
The audit log
Every urgent call becomes an escalation record: each provider dialed, the outcome of each ring, and the timestamps, written as they happen and visible in your dashboard. "We paged the doctor" is a claim; a timestamped record of each attempt is evidence.
Talk time for billing
When a provider accepts, Lydoh records how long they talked with the patient. The CSV export lists the date and time in your practice's timezone, the patient, the outcome, the provider reached and the talk time in minutes, which is what time-based coding asks for. See the telephone E/M billing guide for the codes.
Which plan
After Hours, $99/mo. For a practice with one on-call provider and backups in order. After Hours answers the calls you forward when you're closed, runs the cascade above, and includes live connect as an option. It includes 300 minutes a month, then $0.25 a minute.
Group, $249 per location. For several providers sharing call: weekly and day-of-week rotations, plus everything in Frontdesk. It includes 1,200 minutes and 3 providers per location, and each provider past 3 is $79/mo. Compare all plans.
Specialties with heavy night call have their own pages: see the OB-GYN answering service for labor and postpartum calls. Comparing on-call services? Read the MedXCom alternative comparison, and what after-hours coverage costs across the options.
FAQ
An on-call answering service answers a practice's phone when the office is closed and gets urgent calls to the clinician on call that night. Most services page or text the doctor a message. Lydoh phones the on-call provider, asks them to accept, connects them to the patient, moves to the next provider if they don't, and records every attempt.
From your schedule, at the moment the call arrives, in your practice's timezone. A date override (a holiday, a vacation, a swap) wins first; then your weekly rotation or day-of-week assignment; then your first provider. Everyone else on your list, in order, is the backup chain.
The caller. Lydoh asks whether they need the on-call provider tonight or whether it can wait until you open, and takes their answer. It never judges how serious a symptom sounds, never gives medical advice, and tells anyone describing a life-threatening emergency to hang up and dial 911.
Lydoh moves to the next provider in your chain. A provider who declines is not rung again; one who didn't pick up can be rung a second time if your policy asks for it. Up to four providers are phoned per urgent call, and if nobody accepts, every provider on the chain and the practice owner get a text with the patient's name, callback number and reason, and the call is logged as an urgent request.
Yes, as an option. With live connect turned on in Settings, the patient holds while the on-call provider's phone rings from your practice's Lydoh number; the provider hears who is holding and why, says accept, and is put straight through. A decline, voicemail or no answer brings the patient back, and the ordinary call-back cascade carries on. It is off by default and is being rolled out to practices now.
Each urgent call is an escalation record in your dashboard: every provider dialed, whether they accepted, and when. When a provider accepts on the call-back path, Lydoh records the provider-to-patient talk time, and the CSV export gives the date and time in your practice's timezone plus talk time in minutes for time-based telephone E/M coding. Talk time is not yet recorded for live-connect calls.
The on-call part is the piece that reaches a clinician. An after-hours answering service also handles everything routine: messages, appointment and refill requests for the morning. Lydoh does both on the same call; this page covers the on-call step.
Lydoh After Hours is $99/mo with 300 minutes included, with on-call escalation included and extra minutes at $0.25. For weekly or day-of-week rotations across several providers, Lydoh Group is $249 per location with 1,200 minutes and 3 providers, plus $79/mo for each provider past 3. Both have a 14-day free trial.
Keep reading
Start a 14-day free trial of Lydoh After Hours, add your on-call providers, and test the cascade on your own phone.