> ## Documentation Index
> Fetch the complete documentation index at: https://docs.routiq.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# Human Escalations

> How Robyn hands a patient over to your team — call transfer, email notification, hybrid, or per-practitioner routing.

<Info>
  **Why this matters.** Robyn is good at the predictable 80%; your team
  is irreplaceable for the difficult 20%. The handoff between them is
  where most AI receptionist tools fail — too eager to escalate
  (annoying for patients), too reluctant to escalate (dangerous). Routiq's
  escalation system is designed around the actual situations clinic
  reception faces every day.
</Info>

## When Robyn escalates

By design, Robyn hands off to your team when:

* A patient asks for **clinical advice** ("should I take X", "is this normal", symptom triage)
* A patient describes a **medical emergency**
* A patient asks to **speak to a specific practitioner** by name
* A patient **expresses dissatisfaction** or wants to make a complaint
* A patient asks something **the knowledge base doesn't cover** (logged as a knowledge gap)
* A patient **explicitly asks for a human**
* A patient mentions **insurance / billing dispute** terminology
* A conversation reaches a **confidence threshold** — Robyn isn't sure of her ground

Each of these triggers is configurable in **Settings** → **Escalations** → **Triggers**.

## Escalation methods

Four ways Robyn can route a handoff:

<CardGroup cols={2}>
  <Card title="Call transfer" icon="phone-arrow-right">
    Live caller is forwarded to a team line. Robyn says "Hold on, I'll put you through" and warm-transfers.
  </Card>

  <Card title="Email notification" icon="envelope">
    Conversation summary, patient details, and suggested action emailed to your team for callback. Default for SMS/email/widget escalations.
  </Card>

  <Card title="Hybrid" icon="clock">
    Call transfer during configured business hours; email notification outside hours. Best of both.
  </Card>

  <Card title="Per-practitioner routing" icon="user-doctor">
    "I want to speak to Dr Lin" → email goes directly to Dr Lin's address, not a generic clinic inbox.
  </Card>
</CardGroup>

## What your patient sees

> **Patient (call):** Hi, I need to speak to Dr Lin about something he said at my last appointment.
>
> **Robyn:** Of course. Let me grab some details and have Dr Lin call you back. What's the best number to reach you on?
>
> **Patient:** This one — 0412 345 678.
>
> **Robyn:** Got it. And just so I can let Dr Lin know what it's about — anything you'd like to share, or would you prefer to wait and tell him directly?
>
> **Patient:** I'll tell him directly thanks.
>
> **Robyn:** No problem. Dr Lin will call you back as soon as he's free. Have a great day.

*(Behind the scenes: email lands in Dr Lin's inbox with patient name, phone, and a one-line summary "Wants callback from Dr Lin re: something from last appointment".)*

## Setup

<Steps>
  <Step title="Choose your default routing">
    **Settings** → **Escalations** → **Default Method**:

    * **Call transfer** — most clinics with reception staff during business hours
    * **Email** — solo practitioners, after-hours, smaller clinics
    * **Hybrid** — most common — transfer in business hours, email out of hours
  </Step>

  <Step title="Set the call transfer number">
    **Settings** → **Call Handling** → **Call Transfer Number**.

    <Warning>
      Don't enter the same number that's forwarded to Robyn — that creates an infinite loop. Use your team's direct line, not the public clinic number.
    </Warning>

    For hybrid mode, also tick **Only forward within office hours** so out-of-hours calls fall back to email.
  </Step>

  <Step title="Configure office hours">
    **Settings** → **Account Setup** → **Office Hours**. Define your in-hours window per day. Used for hybrid routing and outbound message timing.
  </Step>

  <Step title="Set escalation email recipients">
    **Settings** → **Account Setup** → **Notification Email**.

    Single email or multiple comma-separated. Goes to all recipients for every escalation by default.

    <Tip>
      For multi-practitioner clinics, use a shared inbox like `reception@yourclinic.com` rather than a personal email — easier to keep continuity if someone's on leave.
    </Tip>
  </Step>

  <Step title="Set per-practitioner routing">
    For requests like "I want to speak to Dr X":

    1. **Settings** → **Account & Logins** → create a login for each practitioner (so they have their own account)
    2. **Clinic Setup** → **Practitioners** → for each practitioner, set their **Notification Email** to the email address they actually monitor

    Robyn matches the practitioner name in the conversation to your configured practitioners and routes accordingly.
  </Step>

  <Step title="Customise escalation triggers">
    **Settings** → **Escalations** → **Triggers**. Each category can be on / off, and the threshold is tunable:

    * Clinical questions (recommended: always on)
    * Specific practitioner request (always on)
    * Complaint / dissatisfaction (always on)
    * Insurance / billing (recommended: on for clinics with dedicated billing staff)
    * Knowledge gap (always on)
    * Confidence threshold — slider 0-100; default 75

    <Tip>
      Lower the confidence threshold (e.g. 50) for the first month so Robyn escalates more aggressively while you build trust. Raise it later as the knowledge base gets richer.
    </Tip>
  </Step>
</Steps>

## What's in the escalation email

Every escalation email contains:

* **Patient name** (if matched in PMS) and contact info
* **Channel** the conversation came in on (call / SMS / email / WhatsApp / widget)
* **Summary** — one-line of what they wanted
* **Full transcript** of the Robyn-patient conversation
* **Suggested action** — "Call back", "Reply to thread", "Add to KB", etc.
* **Direct link to the conversation** in the dashboard (one click → take over)

## Common questions

<AccordionGroup>
  <Accordion title="Can different escalation triggers route to different teams?">
    Yes. **Settings** → **Escalations** → **Routing Rules**. E.g. "billing-related → billing\@clinic", "clinical → practitioner email", "everything else → reception\@clinic".
  </Accordion>

  <Accordion title="What if the call transfer number doesn't pick up?">
    Robyn detects the no-answer (configurable timeout, default 30 seconds) and falls back to email. Patient hears "Sorry, I couldn't reach the team — I've taken your details and they'll call you back as soon as possible."
  </Accordion>

  <Accordion title="Can Robyn escalate to a different number based on the time of day?">
    Yes — hybrid routing supports this directly. For more complex schedules (e.g. on-call rotation), use multiple notification email addresses per day in **Office Hours** settings.
  </Accordion>

  <Accordion title="Will Robyn always escalate clinical questions, even if the answer seems obvious?">
    Yes — by design. Robyn is not a clinician and Routiq does not allow her to give clinical advice, regardless of how clear the answer might seem. Keeps you AHPRA-safe.
  </Accordion>

  <Accordion title="Can a team member intervene mid-conversation?">
    For SMS, email, and widget — yes. Open the live conversation in the dashboard, click **Take over**, type your reply. Robyn won't touch the thread again unless you give it back. For calls, you can request the transfer mid-conversation if Robyn isn't already mid-handoff.
  </Accordion>
</AccordionGroup>

## Next

<CardGroup cols={2}>
  <Card title="Knowledge base" icon="book" href="/features/knowledge-base">
    Reduce escalation volume by filling knowledge gaps as they appear.
  </Card>

  <Card title="Multi-practitioner logins" icon="users" href="/features/multi-practitioner-logins">
    Set up per-practitioner accounts so per-practitioner routing works.
  </Card>
</CardGroup>