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Reimbursement and Practice Management

Phone Finesse

The telephone is a key communication channel for customers to reach you. Unlike the flow of patients in your office, the telephone is a process that you don’t see. Out of sight, however, should definitely not mean out of mind.

In this article, you will learn how to:

  • Determine metrics to measure the success of your telephone operations
  • Describe strategies to handle peak telephone demand
  • Develop effective scripts for employees who answer telephones
  • Implement work processes that improve relations with patients and referring physicians

View related pearls

While it’s easy to view ringing telephones as a nuisance, it pays for you to focus attention on this key workflow in your medical practice; it can be the launching pad for everything from making good first impressions with patients and referring physicians to improved practice efficiency.

Take these steps to help finesse answering the phone at your office.

Choose phone systems wisely. Everyone’s talking about which electronic health record system to choose, but a different management system – your telephone system – touches more patients each day. Be sure to identify all of the functionality needed before purchasing.

System features frequently sought out are the ability to make ‘warm’ transfers (the operator remains on the line to make sure the call is handled by staff, not voice mail); automatic call distribution; reporting on call volume, service levels and other performance metrics; and prioritization of calls (such as a direct line for referring physicians).

Use the phone for marketing. Considering the hundreds – if not thousands – of minutes each day you have the attention of callers, telephone hold and auto-answer messaging can be a prime marketing opportunity. Install on-hold messages that relay basic information about your practice or its new services; but be careful to keep the messages concise, as most callers will only be listening for seconds, not minutes.

Differentiate among referrals. It can be annoying for patients to hear “if you are a doctor’s office or hospital, press 1...” when calling your practice. Why give the impression that patients are your second or even third priority? Of course, your top referring physicians are of primary significance, but it pays to keep them and your patients both feeling happy (and needed) by giving them routes to avoid your telephone tree entirely.

Create a “hotline” for referring physicians (222-PAIN, for example) or encourage them to use secure email. Or, launch a marketing campaign targeting the referring physicians who frequently call your practice; for example, ask them to “dial 9 to save time,” in order to route their calls directly to the front office supervisor or nurse. In sum, determine the best process that helps patients – and your other key customers, referring physicians – to communicate smoothly and quickly with you.

Script it. Responding to patients’ telephone calls should be a no-brainer, right? Unfortunately, there’s no book or course that can teach basic common sense. You must take the time to outline your expectations for how you want staff to greet callers. Start with the four key components that every greeting should have: salutation (“good morning”), practice’s name, staff member’s name and query (“how may I help you?”).

Be sure to specify how you want your practice’s name stated; otherwise, “Pain Management Specialists” will – unfortunately – become “Pain Specialists” or, worse, “PMS.” Instruct staff to end every call with the magic question: “Is there anything else that I can do to assist you?” This simple query has proven its value many times over because encouraging patients to ask questions now, rather than calling back later, avoids communication delays and reduces future work.

The voice counts. It’s not uncommon for physicians to place employees with the poorest customer service skills on the telephone. While this may remove the employee from face-to-face encounters with patients, the fact is that telephone operators actually need the same, if not better, service skills than their colleagues working at the front office. Callers can perceive a smile in a person’s voice, even over the telephone.

All of the positive body language tips that support good service on a face-to-face basis must be integrated into the employee’s telephone voice, too. Try hanging mirrors at the workstations of employees who handle telephone calls; it will remind them of the importance of smiling while on the telephone.

Measure success. The old instructions – be sure to pick up the telephone within three rings – simply are not good enough to ensure that your telephone operations are optimized. It’s important to measure several key metrics, including abandonment rate and service levels. Aim to have three percent or less of calls abandoned by callers, and for 80 percent of calls to be answered within 30 seconds.

Plan for peaks. Sometimes, Monday mornings for example, the telephone seems to ring off the hook. Instead of pressuring the employee assigned to answer the phones, create a back-up plan to avoid abandoned calls, which average a remarkable (and depressing) 10 percent for medical practices. Assign other employees to answer the phones during known busy times (if you don’t make specific assignments, you’ll get the “it’s not my job” attitude). Make it everyone’s job – even yours – to answer the telephone if it rings more than five times.

Your employees may need to see you answering a ringing telephone a few times before they get the point. Instead of just diffusing the work, consider hiring an extra employee for 10 to 15 hours a week to cover the peak times (perhaps, 10 hours on Mondays, and four hours on Tuesday mornings). This is a relatively low-cost option (a part-timer won’t require benefits) and it’s an effective way to ensure that the job gets done. Because the telephones represent your practice’s lifeline to business – patients and referring physicians – answering them must be a priority.

Avoid voicemail. Our reliance on voicemail is at an extreme; many employees use the function as a secretary so as to avoid taking calls. While the paper record may have legitimately required employees to be away from the telephone to locate a patient’s record in the file room, today’s electronic environment removes that justification. Voicemail is not only frustrating to callers, but it’s inefficient for the practice as those messages must be retrieved, reviewed and returned. Some practices have banned voicemail altogether.

Make first-call resolution the goal: staff must be held accountable to respond to incoming calls by addressing those patients’ needs, or finding someone who can. Strive to develop and deploy a process in which voicemail becomes an afterthought because all calls are addressed as they are received.

Consider alternatives. While honing your telephone skills, it’s important to embrace technology – it may help you to avoid the telephone altogether. Consider deploying a patient portal. Patients will appreciate it. It also will help you to meet the Stage 2 Meaningful Use requirements to provide patients a way to view, download or transmit their health information, as well as send you secure electronic messages.

Push routine test results to patients through the portal instead of the telephone, and encourage them to submit electronic requests for appointments, as well as prescription renewals. Technology will never replace the phones, but it may offer alternatives that are a win/win for your patients and your practice.

Engage employees. Being on the telephone all day is not easy. Operators may respond to hundreds of calls each day. It’s important that they do not start thinking of callers as numbers or production units. Think of ways to remind staff that each call represents a person and a potential patient of the practice.

Some practices ask their patients for approval to be photographed and hang those photos in the employee break room. Other successful solutions are to invite a patient to speak at a staff meeting; it’s an effective and powerful way for staff to truly hear and understand the voice of the customer.

Maybe you can’t significantly reduce the volume of incoming calls, but you do not have to tolerate poor telephone service from your staff or because of your technology. Appropriate telephone call handling tactics should become part of your practice’s essential staff training and expectations. It will improve the service your practice delivers – and ultimately, its bottom line.


Pearl 5/22/13

Hip About PHI

HIPAA allows parents, guardians, and adult caretakers to receive protected health information (PHI) about a patient. The exceptions to this allowed release of PHI include preventing serious harm. For example, a physician or clinical staff member can decide not to release PHI about a patient to a parent, spouse or caretaker if they suspect abuse, domestic violence, or neglect.


Pearl 5/15/13

Level Headed

“Service level” is the most common industry metric for call management, and it pays to measure and monitor it for the telephones in your practice. The measure of service level is the percentage of calls that are answered within a pre-defined wait threshold, typically stated as X percent of calls answered in Y seconds or less. This factor can be reported as a simple, cumulative average over the day, a weighted average based on the actual calls per half-hour increment, or the percentage of half-hours in which the service level is met.

While service level is perhaps the most widely used indicator of quality by call centers, there are no industry averages. However, a minimum service level goal of 80 percent of calls answered within 30 seconds is recommended, with a stretch goal of 80 percent of calls answered within 20 seconds. Prompt service will lead to a positive experience for your patients, families, referral sources, payers, and other partners in patient care.


Pearl 5/8/13

Impromptu Prompts

Keep writing tablets near all telephones. As soon as a caller states his or her name, write it down and use it during the conversation – it will help you remember his or her name. It also eliminates the need to ask for the caller’s name at the end of the conversation, which may make them wonder what other information was missed. Addressing callers by name helps them to connect with you, and it demonstrates that you are listening and attentive to their needs.


Pearl 5/1/13

MA We Take Your Call

Increasingly, medical practices are hiring medical assistants (MAs) to answer telephones. They won’t replace triage nurses, but with protocols, scripts, and directions on how to take messages, medical assistants can prove their value as efficient screeners of incoming calls. Written protocols may allow your practice to take further advantage of these clinical support staff.

Because MAs can complete many telephone-related tasks within their scope of practice – even if it’s only to take complete messages and forward them to the right person – the result will be fewer time-consuming tasks and voicemail requests for other staff to handle.


United States