There is an Ooma "bug" going on right now for certain area codes when calling out. Dialing the *99-1-xxx-xxx-xxxx is a work-around put out by Ooma for the dialing-out problem.
Some modems and routers have problems with Ooma's Mac address Spoofing, causing high bandwidth usage and poor QoS.
When the Ooma device is set to MAC Address - Automatic, it allows MAC Address Spoofing.
So you may want to select "Use-Built-In" MAC address, which shuts off MAC Address Spoofing, to rule out that possibility for poor QoS.
Running http://www.speedtest.net/ and http://speedtest.phonepower.com/ a few times, looking for high jitter, high TCP readings, and dropped or lost packets will let you know if you Internet provider, Modem, or Router is giving trouble or is starting to fail.
Placing the Ooma's Static IP address in your router's DMZ, places it on the WAN Internet side. It should rule out blocked ports.
Firmware updates are automatically pushed by Ooma. The latest Firmware update being pushed right now is "Device Status - Rev: 1.43368" You can view thay by going to "Ooma Setup" and viewing "Status".