1. Telephone communication Allied health III unit 3 Allied health III unit 3

2. First impressions You are the “Director of First Impressions” The professional attitude conveyed to the caller is critical to the success of the business

3. first impressions On average, it takes about 10 seconds for a caller to pick up on your attitude from listening to the tone of your voice Developing excellent telephone customer service (tone & words) is one of the most valuable business skills you can cultivate

4. first impressions The phone call is often the first contact a patient has with the office You will want to convey empathy to your caller You must anticipate the needs of the patient & the provider

5. what your voice says about you If your tone is... Monotone

6. what your voice says about you If your tone is... Monotone It translates as... “I’m bored & have absolutely no interest in what you’re talking about”

7. What your voice says about you If your tone is... Slow speed & low pitch It translates as... “I’m depressed & want to be left alone”

8. what your voice says about you If your tone is... Slow speed & low pitch It translates as... “I’m depressed & want to be left alone”

9. What your voice says about you If your tone is... A high-pitched & emphatic voice

10. what your voice says about you If your tone is... A high-pitched & emphatic voice It translates as... “I’m enthusiastic about this subject”

11. what your voice says about you If your tone is... An abrupt speed & loud tone

12. what your voice says about you If your tone is... An abrupt speed & loud tone It translates as... “I’m angry & not open to input”

13. what your voice says about you If your tone is... High pitched combined with drawn-out speed

14. what your voice says about you If your tone is... High pitched combined with drawn-out speed It translates as... “I don’t believe what I’m hearing”

15. answering the phone Answering the call as soon as possible promotes a positive atmosphere & communicates to patients that their call is important to the practice Always answer by at least the 3rd ring Nearly all medical practices will have multiple lines & many offices will have an automated system that directs the caller & then places the call in a queue.

16. answering the phone While on hold, the automated system will often provide information such as the provider’s profiles, prescription refill policies, office hours, emergency contact information & hold times.

17. answering the phone Here is an example: “Good morning, Delaney Medical Center, this is Jennifer speaking, how may I help you?” This prompts the caller to give their name & the reason for their call.

18. answering the phone Make sure you get all the information you need & repeat back the information to the caller to make sure you have recorded the caller’s request accurately.

19. answering the phone Let the caller know when he or she may expect a response Make sure your time frame is reasonable & one you can keep If you do not have a response within the original time frame that you quoted, call the patient back & let him or her know that you are still waiting & will call back as soon as you have the information

20. answering the phone Always try to allow the patient to hang up first. If you hang up first, you might miss something that the patient wanted to add. Say: “Goodbye, Mrs. Lyons” Wait for them to respond & hear the click.

21. Handling multiple lines Sometimes, the phone rings off the hook.. It is very important to have a plan so that you know how to prioritize incoming calls

22. handling multiple lines 1st- properly place the first caller on hold 2nd- find out who is on the second line 3rd- determine whether the second call is an emergency (or a hospital or doctor calling) 4th- put the second caller through if it is an emergency or on hold if it is not Finally- finish the first call

23. to properly place someone on hold Excuse yourself & ask the patient to whom you are speaking whether you may place them on hold Answer the second call, determine whether it is an emergency, then ask if the caller can hold If it is another provider or a hospital calling, put them through immediately & do not place them on hold

24. to properly place someone on hold Then, return to the first call & thank him or her for holding Resolve the first call & return to the first

25. telephone screening An established phone screening manual should be kept near each phone for reference If you do not know how to handle a patient or if the questions have not been addressed in the manual, referring the problem to one who is more experienced is necessary & appropriate Never guess in response to a patient’s question & do not treat any question lightly

26. Telephone screening Document, in detail, all the information obtained from the patient & relay or attach the message for the doctor to review Anticipate what the doctor will need, such as relevant patient information & symptoms, lab results, consult results, date of last appointment, next appointment (if scheduled), blood pressure, & temperature & mark the message urgent if determined to be so or advised to by the patient

27. routing calls Knowing where to send a call when it comes in will save time, avoid frustration, & score service points

28. non-emergency calls If the person on the phone needs additional information, or the call is going to take a while, excuse yourself from the phone call by saying, “May I put you on hold for a moment?” Be sure to confirm the patient’s phone number before hanging up Find out a good time to call back, including later times in case the provider wants to talk with the patient When a caller is on hold, be mindful of the length of time on hold

29. transferring calls If you need to transfer a patient’s call to another department or office, first give the caller the phone number, extension, & the person’s name to whom you are transferring him or her in case there is a disconnection Signal (or page) the person for whom the patient is calling, explain who is waiting to speak to him or her, & give a brief summary of the issue

30. transferring calls Pull the chart for the provider if the patient is calling for information & have the pertinent data readily available(labs, test results, consults, chart notes) If using a public address system, be very careful with confidentiality, stating only the person’s name & that he or she has a call on a particular line

31. interpreter services Offices should have policies in place regarding the provision of language services & should not rely on patients’ friends, family, or other ad hoc interpreters. It is your responsibility to become familiar with your office policies regarding interpreter services, how to access language services, & how to work with an interpreter

32. documenting calls It is critical to record the date, time, name, date of birth, M/F, phone number(s) & detailed & accurate message along with your name & initials. All calls should be documented in the same manner Urgent messages should be marker “urgent” & given to the doctor immediately

33. documenting calls Pull the chart & have all information relevant to the call attached to the message (lab reports, test results, consults, prescription requests) If electronic messaging with EMR, attach the relevant information to the message to expedite care

34. documenting calls All messaged must be signed off (both paper & electronic) to confirm final action has been taken. Usually, the last person to contact the patient shall sign off & file or save the chart & notify patient of the action

35. documenting calls Confidentiality: Data regarding patients may not be given out over the phone to anyone, unless the patient has given written permission with a signature for the release of specific information This authorization is often given with a CCP

36. confidentiality When returning patient messages, confidentiality in accordance with regulations established by HIPAA is of primary concern. Data regarding patients may not be given out over the phone to anyone unless the patient has given written permission for the release of specific information with a signature

37. confidentiality Authorization to give medical information to a person other than the patient is often given with a “Confidential Communication Preference (CCP)”

38. recording messages Internal EMR messaging, lab reports, & prescription refills can be available to doctors 24/7, although replies to patients are not be expected outside normal business hours Answering machines are useful for short periods such as during lunch time; however, answering services are more likely used outside office hours

39. recording messages The answering service can relay messages to the office by email, fax, or phone or contact the doctor by cell phone or pager if the call is determined to be an emergency or the doctor is on call Messages from the answering service need to be returned in the order of importance within an appropriate & reasonable time period. Remember to check the fax machine & patient portal for other patient related messages

40. guidelines Answer the phone as promptly as possible, with a smile Keep a pad & pen next to the phone at all times Verify the caller’s name & correct spelling. If an adult calls about a child, make sure you have the correct last name & date of birth. Do not assume the child’s last name is the same as the caller’s

41. Guidelines Determine the reason for the call Handle as many phone calls as you can without disturbing the provider. Provide message & documentation, including attaching the backup & chart when needed by the provider for review

42. guidelines Whenever possible, if you cannot handle the call alone, take a message for the provider. The provider will tell you what to do or call the patient back as time allows Make a memorandum for the provider of every call. Use printed telephone memorandum pads that show the date, time of call, name of caller, telephone number, date of birth, & sex & send the message to the provider

43. Guidelines Always know where to reach the provider. If the message is urgent & the provider is not int he office, page or call at once & relay the message If the provider cannot be reached, have the message by your phone. When your employer calls to check in, you may relay the message

44. guidelines Learn from the provider how much medical information you are authorized to give over the phone. Patients often call the office because they have forgotten the provider’s instructions about treatments or medications. If this information is clearly stated in the chart, or in a preapproved triage manual, it might be acceptable to repeat it for the patient

45. guidelines When answering a second line, determine whether it is an emergency or another provider before placing the caller on hold & returning to finish the first call Always allow the caller to say goodbye & to hang up first

46. common types of phone calls Patients who are calling for appointments, prescriptions or the results of tests Referrals Emergency calls Other providers, hospitals or laboratories Personal calls & general business calls

47. appointments When scheduling appointments, be sure to positively identify the patient & confirm the last appointment date Be sure to use at least 2 identifiers of the patient, including date of birth as well as last & first names.

48. appointments If you work for a “closed practice” (one that is no longer accepting new patients), it is important to confirm that you are booking only current patients

49. appointments Assess the type of appointment needed (comprehensive physical exam, follow-up, immunization, new patient) Each type of appointment can carry a different billing code, requires a different amount of time for the visit & have different eligibility for insurance reimbursement.

50. appointments Example: a typical CPE will not be reimbursed by insurance if the appointment is less than 1 calendar year from the previous CPE appointment.

51. appointment Appointment schedule templates usually have a time slots held for patients that require same-day or urgent visits. Book these appointments first from your calls of the day. Use your screening methods to determine which patients need to be seen in the same-day & urgent time slots

52. appointments You will also want to book from any open appointment slots in order during the day Example: if you have 3 morning & 2 afternoon appointments open at the beginning of the day, fill your morning appointments first

53. appointments When a patient calls for an appointment, give them a choice of 2 appointment times. Usually, one the options will be acceptable to the patient. This prevents the patient from requesting multiple dates & times

54. appointments Always read back the scheduled time to the patient after it has been recorded in the appointment book or scheduling system for confirmation. Often, medical offices place reminder calls to patients 24-48 hours before their appointment

55. prescription refills Verify the office rules for prescription refills & follow them without exception The general rule is that a medical assistant does not give out information or call in a prescription without the express direction of the provider Write a message of the request for prescriptions in legible handwriting with detailed accuracy or document in the EMR

56. prescription refills For a patient request of a prescription refill, document the name & phone number of the pharmacy as well as the name of the medication, strength & prescription number & when the prescription was last filled Record the phone number where the patient can be reached in case the provider needs to talk with them before prescribing the medication or if the provider determines the patient might need an examination first

57. prescription refills Many prescriptions are currently sent to the office by electronic messaging, known as easyscripts or surescripts (often referred to as e-scripts) directly from the pharmacy Patients might request prescription refills through patient portals

58. test results Always observe office policy for releasing results Most providers will want to speak with the patient if the test results are abnormal, although some allow the medical assistant to give normal results over the phone Attach the result of the test, lab or consult report for the provider to review along with the message for the provider to call back.

59. test results Review the patient’s CCP prior to calling with any results. Confirm which number to call & authorization to leave messages or speak with other parties Generally, it is best not to leave a message with abnormal results You should leave a message for the patient to return your call, without revealing a sense of urgency in your voice

60. follow-up calls Providers often advise patients to call the next day to report their progress The medical assistant should determine whether to take the call & relay the message to the doctor ( always attach the patient’s report to the chart) or whether the provider wishes to speak directly to the patient.

61. follow up calls Make sure you have the patient’s current home & cell phone, pager or work number(s) before the patient leaves your office so you will be able to call if necessary Verify that the patient’s chart has a current phone number of a relative or friend that can be called if the patient cannot be contacted Remember, though that you need that contact to be authorized per the CCP

62. professional calls When another provider calls to speak to your employer, politely ask the caller for his or her name & inform the provider. Professional etiquette dictates that the provider does not keep a colleague waiting unless the provider is involved with an emergency or surgical procedur

63. professional calls Be sure to ask whether the call is regarding a patient & whether you should pull the chart It is wise to obtain the name & phone number if the caller in case the call is disconnected

64. professional calls Calls received regarding X-ray or laboratory results need to be recorded with precise accuracy Always record the name of the person giving the report & phone number in case your doctor wants to call back for further information Read back everything you have written down to be sure it is correct & complete before allowing the caller to leave the line Attach the message along with the patient’s chart for review by the doctor

65. business, personal, & legal calls Office policy will dictate protocol for business, personal & legal calls Calls from attorneys requesting information about a patient must be handled with great caution

66. calls from attorneys Attorneys know that patients must give written permission to divulge information to anyone regarding their health, yet lawyers call still

67. calls from attorneys Pull the patient chart & look for authorization listing the name of the attorney & the signature of the patient If you find the authorization, you may answer questions about the patient. Some providers may still want you to check with them before releasing information

68. calls from attorneys You must confirm information written on the patient’s CCP. If you do not find authorization listing the name of the attorney, you must tell the caller an authorization signed by the patient is required prior to releasing information

69. calls from attorneys It is advisable to return a call from an attorney, even if you have authorization so you can ensure to whom you are speaking Most doctors prefer to be advised of requests from attorneys

70. calls from attorneys A quality department review might be required prior to release of patient information Only information that has been authorized by the patient in writing, with the patient’s signature, may be given to another party

71. calls from attorneys Record the call & information released by telephone or copied for attorneys or other parties from patient charts. Patients have the right to know who has accessed their medical information, & their charts should reflect each & every release of information Common practice is to refer business or legal calls to the office manager. Check with the doctor or employer regarding the policy

72. long-distance calls You may be in need of calling a patient whose phone number is long distance. Be sure to check the area code for time zone to determine the appropriate time to call, avoid calling before or after business hours or during lunch breaks Be sure to know the code needed to dial for your long distance service in addition to the number of the person that you are calling

73. difficult callers Any person on the “front lines” of customer service will have to deal with difficult customers. When a caller’s demands are unreasonable &/or difficult to provide, your first reaction could be annoyance. When this happens, you should try to hold off negative judgements & do your best to accommodate the patient’s requests

74. difficult callers Patients might insult you or curse at you... If this happens, give the caller the benefit of the doubt, & say “I really want to help you, but I’m having trouble with the kind of language you are using. Can you please refrain from using that kind of language?” Give the caller a second chance & another warning if the language continues

75. difficult callers If the caller continues to curse at you, you are within your rights to let the patient know that you are “no longer the person who can help” & inform your supervisor of the problem.

76. difficult callers If a caller makes any threats, document the identity of the caller, the nature of the threat, advise them that you are no longer the person who can help, & inform your supervisor. Be sure to end the call in a professional manner.

77. telephone services Phone Menus Conference Calls Teleconferencing

78. phone menus Most business phone systems have a menu for the caller to be connected to the proper person or department. A recorded message will direct the caller to push a number corresponding to their intended recipient... (Press 1 for Ms. Lyons..) The caller should be instructed at the beginning of the message to “hang up & call 911” if the nature of their call is an emergency

79. conference calls The phone can be used to simultaneously conduct conversations with several people in various locations. Conference calling saves time, travel & money If your provider’s phone system is not equipped for multiple connections, calls can be arranged with your local phone service provider

80. teleconferencing A means of exchanging information much like a conference call, except everyone can see & hear each other at the same time. The phone company for the meeting originator will contact all other sites & network the phones. Can include several people in many locations & ideas can be presented, concerns expressed & new techniques shown

81. community resources It’s a good idea to keep an up-to-date index of your most frequently called numbers by the phone.