How to Set Up a Twilio Toll-Free Number for US & Canada in EMR

What EMR helps with

Instead of forcing you to figure out the whole compliance process alone, EMR helps structure the toll-free verification flow so the setup is much more predictable.

• The setup flow
• The compliance pages
• The opt-in flow
• Message examples
• Verification checks
• The final submission format

What you need before you start

Have the following details ready before you begin so you can move through both Twilio and EMR without stopping halfway through.

• Your agency legal business name
• Your website
• Your business email
• Your business phone number
• Your business address
• Your EIN if you are in the US, or your Business Number if you are in Canada
• A card on file in Twilio

How long this takes

The easiest path

Keep the first version simple. Start with one number, get it approved, and only make the setup more complex after the first toll-free flow is working cleanly.

• Create or log in to Twilio
• Make sure your Twilio account is paid
• Set up your Twilio business profile
• Connect Twilio to EMR
• Get one toll-free number
• Complete the guided compliance flow inside EMR
• Submit for approval
• Wait for approval, then start sending review invites

Step 1: Create or log in to Twilio

If you do not already have a Twilio account, create one first. If you already use Twilio, log in and continue with the existing account you want EMR to use.

• Create a Twilio account
• Open the Twilio Console

Step 2: Make sure your Twilio account is paid

For toll-free verification in the US and Canada, Twilio needs to be on a paid account. If the account is still on trial, EMR will not let you complete the toll-free verification step.

• Check or upgrade Twilio billing

Step 3: Set up your business profile in Twilio

Twilio may require your business profile before your toll-free number can be approved. Use your agency real business details here, not temporary details and not a client business profile.

If Twilio puts the profile into review, that is normal. It usually takes 1 to 3 business days.

• Use your own business details
• Do not use made-up details
• Do not use a client's business details

• Open Twilio business profile setup

Step 4: Connect Twilio inside EMR

Inside EMR, go to the SMS provider setup and choose Twilio. You will enter your `Account SID` and `Auth Token`, which you can find in the Twilio Console.

• Open the Twilio Console to get your Account SID and Auth Token

Step 5: Get your toll-free number

You can do this directly inside EMR, which is the easiest path because EMR guides the selection or purchase flow.

If you want to look in Twilio first, choose a toll-free number that starts with a prefix such as `800`, `888`, `877`, `866`, `855`, `844`, or `833`.

• Browse phone numbers in Twilio

Step 6: Let EMR handle the compliance flow

Once your number is selected, EMR walks you through the rest. This is where EMR saves the most time because it helps structure the submission the way Twilio expects instead of forcing you to improvise.

You mainly need to enter your real business details accurately and consistently.

• Your legal business name
• Your website
• Your business email
• Your phone number
• Your business address
• Your EIN or Business Number

Step 7: Submit and wait for approval

Once everything is complete, submit the toll-free verification inside EMR. Twilio review usually takes 3 to 5 business days.

While you wait, you can keep setting up the rest of your account. The number just cannot send live review invites until approval is complete.

What you can do while waiting

• Onboard customers
• Prepare your review request templates
• Get your workflows ready
• Make sure your website and business details stay accurate

The biggest things that improve approval odds

The cleaner and more consistent the setup is, the easier the approval process usually goes.

• Use your real business details
• Use your real website
• Use a paid Twilio account
• Make sure your business profile is set up in Twilio
• Start with one toll-free number
• Use that number only for review requests and reminders
• Let EMR handle the compliance flow instead of trying to improvise it

The most common things that cause problems

• Twilio account still on trial
• Business profile not completed yet
• Website is weak, broken, or not public
• Fake or temporary business details
• Trying to use the number for marketing instead of review requests
• Changing details so they do not match

The safest first-time setup

If this is your first time doing BYOK with Twilio, keep the first rollout intentionally boring. One paid account, one profile, one number, one approval path.

• Set up one paid Twilio account
• Complete your business profile
• Connect it to EMR
• Get one toll-free number
• Complete the EMR compliance flow
• Get that number approved first

Quick checklist

• Your Twilio account is paid
• Your business profile is set up in Twilio
• You have selected one toll-free number
• Your website is live
• Your EIN or Business Number is correct
• Your business details are real and consistent

Useful links

• Create a Twilio account
• Twilio Console
• Billing and upgrade in Twilio
• Business profile setup in Twilio
• Phone numbers in Twilio

Final thought

US and Canada toll-free compliance is one of those setups that feels harder than it should be.

The goal inside EMR is simple: make Twilio setup easier, cleaner, and less stressful so you can get approved and start sending review invites faster.

Common questions