Office Communications: Phone, Scheduling, and Mail CHAPTER 4 Office Communications: Phone, Scheduling, and Mail

Learning Outcomes After studying this chapter, you will be able to: 4.1 Explain how proper triage of patients during a phone conversation can assist the office environment. 4.2 Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. 4.3 Recall the steps in processing incoming mail and discuss related safety recommendations.

Key Terms annotate emergency Bound Printed Matter Certificate of Mailing Certified Mail chief complaint (CC) cluster scheduling Collect on Delivery Delivery Confirmation double-booking appointments emergency established patient (EP) Express Mail First-Class Mail Insured Mail Media Mail new patient (NP) no-show open/fixed office hours Teaching Notes: Review the chapter terms; define, spell, and pronounce the terms out loud if necessary. As an administrative medical assistant, you must know the meaning of each key term. Knowing the definition of these terms promotes confidence in communication with patients and coworkers.

Key Terms (cont.) optical character reader (OCR) Parcel Post POSTNET Priority Mail Registered Mail Restricted Delivery Return Receipt screening calls shared medical appointments Signature Confirmation Special Handling telephone etiquette triage urgent wave scheduling ZIP ZIP+4 Teaching Notes: Review the chapter terms; define, spell, and pronounce the terms out loud if necessary. As an administrative medical assistant, you must know the meaning of each key term. Knowing the definition of these terms promotes confidence in communication with patients and coworkers.

4.1 Telephone Skills Administrative medical assistants must: Follow proper telephone etiquette (conduct) Screen calls according to the office’s policy Take complete and accurate messages Learning Outcome 4.1: Explain how proper triage of patients during a phone conversation can assist the office environment. Teaching Notes: Telephone Etiquette. When answering the telephone, the administrative medical assistant presents an image of the physician and the office; therefore, you should present a positive image to the caller through the tone of your voice. Remember, the first impression is what stays with the caller. Remember to speak clearly and distinctly; do not run words together or mumble. Always address the patient by “Mr.”, “Mrs.”, or “Miss” (last name); this demonstrates professionalism and respect. If you must place the patient on hold, always ask the patient for permission, let them know why you are putting them on hold, and allow the patient to reply to you. Also remember to use “please” and “thank you”. Screening Calls. Evaluating calls to decide on the appropriate action is an important task of the administrative medical assistant. This aspect of the job should be discussed with the physician or supervisor at the very beginning to ascertain what calls the physician will take while seeing patients in the office or what information should be given out. You should know when messages should be taken, and when the patient should be told that the physician or nurse will return the call. Taking Messages. When taking a message over the telephone, always verify the information you just wrote down by repeating everything back to the caller. Be sure to ask the caller to spell their name if you do not understand their pronunciation. Other important pieces of information that must be verified are the date of birth and the reason for the call.

4.1 Telephone Skills (cont.) Telephone Etiquette Use a pleasant tone that conveys self-assurance, along with a genuine desire to be understanding and helpful Promptness: courtesy begins with promptness in answering the call Greeting and identifying Learning Outcome 4.1: Explain how proper triage of patients during a phone conversation can assist the office environment. Teaching Notes: Telephone Etiquette. As mentioned earlier, your voice conveys attitude, assurance, empathy and a desire to understand and help the caller.

4.1 Telephone Skills (cont.) Screening calls Message-taking situations Transferring calls Emergency calls Nonmedical screening situations Taking messages Message slips Verifying information Using speakerphones Answering services Learning Outcome 4.1: Explain how proper triage of patients during a phone conversation can assist the office environment. Teaching Notes: Good telephone etiquette also consists of knowing how to listen to the caller and to determine how the call is going to be handled, at the time of the call. By listening to the caller, the administrative medical assistant should be able to handle the call promptly and know how to direct and or evaluate the call immediately.

4.1 Telephone Skills (cont.) Remember the following procedures for taking efficient, informative telephone messages: Always have pen and message pad on hand or have the electronic message center on the computer screen Make notes as information is being given Ask politely to have important information repeated Verify information such as names, spellings, numbers, and dates for accuracy Make inquiries tactfully Use medical office abbreviations to save time when recording a message Learning Outcome 4.1: Explain how proper triage of patients during a phone conversation can assist the office environment. Teaching Notes: The administrative medical assistant should remember to always follow these steps to take an efficient and informative telephone message: Always have a pen and pad handy Make notes while the caller is speaking Ask politely for the caller to repeat any information you’re not understanding Always verify back to the caller names, DOB, and especially telephone number – this is very important information in order for you to relay the correct information to the physician

4.1 Telephone Skills (cont.) Outgoing Calls Planning the call Using resources Telephone directories Other automated features Placing the call Identify yourself and the physician’s office State the reason for the call Provide the necessary information Learning Outcome 4.1: Explain how proper triage of patients during a phone conversation can assist the office environment. Teaching Notes: Placing an outgoing call is just as important as receiving incoming calls. A personal directory with frequently called numbers should be kept near the phone for easy access. When you have the proper information and are prepared to place a call, state the reason for your call and provide only the necessary information – remember to follow confidentiality guidelines.

4.1 Telephone Skills (cont.) Placing the call (cont.) Ask tactfully for information Listen carefully and make notes as needed Verify information If the person you are trying to reach is unavailable, leave a message for that person to call you back; remember to follow the confidentiality guidelines of the office Learning Outcome 4.1: Explain how proper triage of patients during a phone conversation can assist the office environment. Teaching Notes: When you have the proper information and are prepared to place a call, use the following procedures: • Identify yourself and the physician’s office. If you are calling for the physician, identify the physician. • State the reason for the call. • Provide the necessary information. • Ask tactfully for information. • Listen carefully and make notes as needed. • Verify information. • If the person you are trying to reach is unavailable, leave a message for that person to call you back. Remember to follow confidentiality guidelines.

4.1 Telephone Skills (cont.) Using the fax machine Contact the receiver before transmitting the information Send a release of information with a facsimile cover letter File the original cover letter in the chart Request a signed return of the faxed information Photocopy documents received on thermal fax paper before placing them in a patient’s chart because thermal fax paper deteriorates over time Learning Outcome 4.1: Explain how proper triage of patients during a phone conversation can assist the office environment. Teaching Notes: A facsimile (fax) machine may be used to send or receive information about patients immediately, but patients’ confidentiality must be protected.

4.2 Scheduling Following through on calls Following the physician’s policy Office hours: the administrative medical assistant must know the basic schedule of the physician’s office Length of time required for appointments Other policies, preferences, and obligations of the physician Learning Outcome 4.2: Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. Teaching Notes: Proper handling of telephone calls does not end after the phone is hung up. The administrative medical assistant must follow through on all requests made and instructions provided in the conversation.

4.2 Scheduling (cont.) Types of scheduling Scheduled appointments: a system in which each patient is given a set appointment time – an approximate time the patient will be seen by the physician Open/fixed office hours: a combination of open and fixed office hours Wave scheduling: also known as cluster scheduling Shared medical appointments: many appointments are made for the chief complaint of follow-up or routine care; these are also called group appointments or visits and are voluntary for patients Learning Outcome 4.2: Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. Teaching Notes: Scheduling appointments is one of the principal duties of the administrative medical assistant. Appointments are entered into a book or a computer for scheduling. The assistant is responsible for collecting all the correct and necessary data for the appointment, such as patient’s name, phone number, and the reason for the appointment. The physician’s policy for seeing and treating patients is the initial guideline in scheduling. Every facility has its own policy on how the patients are seen and may use a variety of scheduling systems.

4.2 Scheduling (cont.) Types of scheduling (cont.) Patient online scheduling: allows patients to search for and schedule appointments with physicians Double-booking Computer scheduling Screening patients’ illnesses: the administrative medical assistant must use good judgment to determine how soon a patient needs to be seen; this process is called screening or triage Learning Outcome 4.2: Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. Teaching Notes: Other types of scheduling include allowing patients to schedule their appointments online, using the computer scheduling method. Sometimes physicians see their patients according to the patients’ needs and how soon the patient must be seen; this method is screening the patient over the phone. The administrative medical assistant must use good judgment in triaging the patient over the telephone. Also, be very careful that you do not give the same time slot to two different patients when scheduling – this is referred to as double-booking.

4.2 Scheduling (cont.) Considering patients’ preferences Necessary data Patient’s first and last names Telephone number E-mail address for electronic communications Address and date of birth (DOB) Reason for the appointment Patient status: new patient (NP) or established patient (EP) Referring physician Insurance provider Notations regarding any laboratory tests or x-rays required before the examination Learning Outcome 4.2: Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. Teaching Notes: When patients’ appointments are scheduled, all necessary data should be collected and recorded. A practice may have patients with duplicate names; therefore, careful attention must be used to be sure the correct patient is scheduled.

4.2 Scheduling (cont.) Keeping to the schedule Irregular appointments: when a patient walks in without an appointment Late patients Telephone number Extended appointments Out-of-office emergencies Registering arrivals Cancelling and rescheduling appointments No-shows Next appointment Learning Outcome 4.2: Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. Teaching Notes: Even though it is important to stick to the schedule, occasionally a patient walks in without an appointment or with an urgent situation. In those cases, the assistant must adjust the schedule for any emergencies that arise, as well as set up next appointments for patients currently in the office who need a follow-up encounter with the physician. The physician will decide what action to take if a patient repeatedly makes appointments but does not keep them.

4.2 Scheduling (cont.) Out-of-office appointments: follow basic scheduling procedures, obtaining the necessary patient data required for each type of appointment Hospital admissions Surgical and diagnosic procedures Other considerations for scheduling Learning Outcome 4.2: Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. Teaching Notes: Appointments that may be scheduled outside the office include hospital admissions, surgery, and diagnostic or other special procedures.

4.3 Processing Incoming Mail and Preparing Outgoing Mail General categories of mail: Important items, such as those sent by Express or Priority Mail, or mail that is registered or certified (or sent via overnight services, such as Federal Express) Regular first-class mail The physician’s personal mail Periodicals and newspapers Advertising materials Samples Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: Every physician receives an enormous amount of mail every day, so the efficient handling of correspondence is vital. As an assistant, you must learn to distinguish quickly among the types of mail most often received. You must use sound judgment to sort mail according to its importance.

4.3 Processing Incoming Mail and Preparing Outgoing Mail (cont.) Processing guidelines for incoming mail: Open all letters except those marked “Personal” or “Confidential,” unless you are authorized to open all mail Check the contents of each envelope carefully Stamp the date on each item to show when it was received Attach enclosures to each item Carefully put aside checks from patients to be recorded and deposited later Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: In some offices, the administrative medical assistant is required to sort the items by category, depending on their importance. Carefully put aside checks from patients to be recorded and deposited later. Verify whose bill is being paid; the name on the check may not be the same as the patient’s name. Also check to be sure the envelope is empty and is not needed before discarding it.

4.3 Processing Incoming Mail and Preparing Outgoing Mail (cont.) Processing guidelines for incoming mail (cont.): Check to be sure the envelope is empty and is not needed before discarding it Write a reminder on the calendar or in the follow-up (tickler) file about material that is being sent separately Attach the patient’s chart to correspondences regarding the patient If a business letter responds to a request, pull the relevant file and attach the letter to it Set aside correspondence that can be answered without the physician’s seeing it Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: It may save time if the items that require the physician’s attention are placed on the desk in the order of importance. Set aside correspondence that can be answered without the physician’s seeing it, such as payments needing receipts, insurance forms or questions, bills, and other routine business matters.

4.3 Processing Incoming Mail and Preparing Outgoing Mail (cont.) Best practices for safe mail handling: Centralize mail handling Wear personal protective equipment Maintain a list of suspicious indicators for handlers Develop isolation/emergency procedures Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: Since the anthrax mailings in 2001 and subsequent suspicious mailings since then, businesses have realized they may be at risk for mail threats and the U.S. Department of Homeland Security has implemented Best Practices for Safe Mail Handling to protect the mail handlers and the business.

4.3 Processing Incoming Mail and Preparing Outgoing Mail (cont.) Preparation of outgoing mail: Professional correspondence concerns patients, clinical matters, and research Business correspondence relates to the management of the office and may concern insurance companies, lawyers, supply houses, and bills to patients Personal correspondence pertains to the physician’s personal rather professional life Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: Outgoing mail consists of professional, business, and personal correspondence. Professional correspondence concerns patients, clinical matters, and research. Business correspondence relates to the management of the office and may concern insurance companies or lawyers and other items. You may also be responsible for the physician’s personal correspondence.

4.3 Processing Incoming Mail and Preparing Outgoing Mail (cont.) Classifications of mail specified by the USPS: First-Class Mail Priority Mail Express Mail Parcel Post Media Mail Bound Printed Matter Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: For mail to be handled in the most efficient and cost-effective way, the assistant must know the various classifications of mail and services offered by the U.S. Postal Service.

4.3 Processing Incoming Mail and Preparing Outgoing Mail (cont.) Mail services available through the USPS: Certified Mail Insured Mail Registered Mail Collect on Delivery Delivery Confirmation Special Handling Return Receipt Certificate of Mailing Signature Confirmation Restricted Delivery Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: The United States Postal Service (USPS) provides excellent information in easy-to-use formats. The USPS Web site (www.usps.com) has a complete listing and description of services and rates.

4.3 Processing Incoming Mail and Preparing Outgoing Mail (cont.) ZIP codes Before sending any outgoing mail, the ZIP Code or the ZIP+4 should be placed as the last item in the mailing address Learning Outcome 4.3: Recall the steps in processing incoming mail and discuss related safety recommendations. Teaching Notes: The USPS Web site is an easy reference for ZIP codes and correct state abbreviations. The assistant must always be aware of current postal rates, requirements, and services.

Chapter 4 Summary Learning Outcomes Key Concepts 4.1 Explain how proper triage of patients during a phone conversation can assist the office environment. When patients call the medical office, they must be properly assessed in order to meet their needs. By asking a predetermined sequence of questions (triage), the assistant can determine if the situation is an emergency. By having the information available, the patient can be given proper instruction. Assessing/triaging better uses office resources by determining the time, equipment, and personnel needed to assist and properly direct the patient.

Chapter 4 Summary (cont.) Learning Outcomes Key Concepts 4.2 Recall and explain two different types of scheduling options and provide examples of practices that would be most suited to each of the schedules. Two methods of scheduling appointments are open/fixed and wave hours. Open/fixed scheduling: The physician sees patients during nonscheduled times, such as noon to 2 P.M. Patients are seen in the order in which they arrive. During the remaining hours, the physician sees patients by appointment. Outreach clinics are well suited for open/fixed hour scheduling.

Chapter 4 Summary (cont.) Learning Outcomes Key Concepts Wave scheduling: Groups of patients are asked to arrive usually on the hour. For example, 10 patients are asked to arrive at 9 A.M., and another group of 10 are asked to arrive at 11 A.M. Larger clinics with multiple physicians may use this method of scheduling.

Chapter 4 Summary (cont.) Learning Outcomes Key Concepts 4.3 Recall the steps in processing incoming mail and discuss related safety recommendations. When processing incoming mail, the assistant should follow the practice’s policies and procedures for handling incoming mail. Examples of the procedures are: Opening all incoming mail, except those marked “Personal” or “Confidential,” and carefully removing all contents. Date-stamping each item and attaching any enclosures to the items.

Chapter 4 Summary (cont.) Learning Outcomes Key Concepts Double-checking the envelope for any missed content. Setting aside checks to be processed in a central, secure location. Attaching the patient’s chart or other office record to correspondence.

Chapter 4 Summary (cont.) Learning Outcomes Key Concepts Many best practice procedures for handling incoming mail have been implemented by Homeland Security: Protective equipment, such as gloves and masks, should be worn by individuals processing incoming mail to provide for personal protection. Centralizing receipt and processing of incoming mail will reduce the threat risk to the practice by localizing the possible effect.

Chapter 4 Summary (cont.) Learning Outcomes Key Concepts Providing a list of suspicious indicators to mail handlers can reduce the possibility of a threat being carried out. Providing a listing of all emergency contact information and procedures will reduce the employee’s response time.

Chapter 4 Review: True/False Questions 4-33 Chapter 4 Review: True/False Questions State whether the statement is true (T) or false (F). If the statement is false, tell why it is false. 1. (LO 4.1) “How long have you been unable to move your right arm?” is an example of a question that may be used during triage. 2. (LO 4.2) The double-booking method of scheduling should never be used. 3. (LO 4.3) It is not necessary to date stamp a referral letter from a physician requesting a patient be evaluated. 4. (LO 4.3) During a suspected anthrax attack, valuable time can be saved by referring to a previously-posted list of emergency contact numbers such as the local Homeland Security contact information. ANSWERS: 1. T 2. F: Double booking appointments can be used but only when appointments do not overlap the same location and service at the same time. 3. F: All correspondence should be date stamped as evidence of when it was received. 4. T