1. The First Contact: Telephone
Chapter 5:
The First Contact: Telephone
and Reception

2. Learning Outcomes Cognitive Domain
Note: AAMA/CAAHEP 2015 Standards are italicized.
1. Spell and define the key terms
2. Explain the importance of displaying a professional image to all patients
3. List six duties of the medical office receptionist
4. List four sources from which messages can be retrieved
5. Discuss various steps that can be taken to promote good ergonomics
6. Describe the basic guidelines for waiting room environments
7. Describe the proper method for maintaining infection control standards in the waiting room

3. Learning Outcomes (cont'd.)
8. Discuss the five basic guidelines for telephone use
9. Describe the types of incoming telephone calls received by the medical office
10. Discuss how to identify and handle callers with medical emergencies
11. Describe how to triage incoming calls
12. List the information that should be given to an emergency medical service dispatcher
13. Describe the types of telephone services and special features
14. Discuss applications of electronic technology in effective communication

4. Learning Outcomes (cont'd.)
Psychomotor Domain
Note: AAMA/CAAHEP 2015 Standards are italicized.
1. Demonstrate professional telephone techniques (Procedures 5-1 and 5-2)
2. Demonstrate telephone messages accurately (Procedures 5-1 and 5-2)
3. Coach patients regarding (a) office policies (Procedure 5-3)
Report relevant information to others concisely and accurately

5. Learning Outcomes (cont'd.)
Affective Domain
Note: AAMA/CAAHEP 2015 Standards are italicized.
1. Demonstrate empathy, active listening, and nonverbal communication
2. Implement time management principles to maintain effective office function
3. Show sensitivity when communicating with patients regarding third-party requirements
4. Demonstrate awareness of the consequences of not working within the legal scope of practice
5. Demonstrate sensitivity in communicating with both providers and patients

6. Learning Outcomes 6. Demonstrate sensitivity to patient rights
7. Protect the integrity of the medical record
8. Recognize the physical and emotional effects on persons involved in an emergency situation
9. Demonstrate self-awareness in responding to an emergency situation

7. Learning Outcomes (cont'd.)
ABHES Competencies
1. Use proper telephone technique
2. Receive, organize, prioritize, and transmit information expediently
3. Apply electronic technology

8. Introduction
As a medical assistant, you are the patient’s primary contact with the physician. In certain situations, the patient may spend more time with you than with the physician. Your interaction with the patient sets the tone for the visit and directly influences the patient’s perception of the office and the quality of care the patient will receive. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule affects every area of the office. You must take proper precautions to protect patient confidentiality.
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9. Professional Image Importance of a Good Attitude
Medical assistant attitude is transmitted to patients
Good attitude = positive patient response
Components of good attitude:
Patient is an individual — has right to compassion and dignity
Empathy = putting yourself in patient’s shoes
attitude: a state of mind; how a person feels about a given
subject or at a given time
Ask yourself how you would feel in a similar situation and how you would want to be treated. By demonstrating empathy, interest, and concern, you tell the patient that he or she is important to you and that you care.
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10. Professional Image (cont’d.)
The Medical Assistant as a Role Model
Good appearance creates positive role model for patient
Good health and grooming
Makeup — natural
Clothing — clean and in good repair
Personal hygiene especially important
Daily shower
Nails — short, clean, neutral, no artificial nails
Avoid fragrances and jewelry
The properly dressed medical assistant presents a professional and positive image to patients.
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11. Professional Image (cont’d.)
Courtesy and Diplomacy in the Medical Office
Must deal with variety of people and situations — apply courtesy and diplomacy to all
Courtesy — Respectful treatment based on sensitivity to needs and feelings of person
Diplomacy:
Apply same treatment to all
Set aside personal feelings — exercise self-control
diplomacy: the art of handling people with tact and genuine
concern
Courtesy and diplomacy are fundamental to successful human relations.
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12. Professional Image (cont’d.)
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13. Professional Image (cont’d.)
First Impressions
Patient perception of whole office is based on the impression given by medical assistant
Can lose business if patient leaves practice
Expect excellent customer service
The patient’s perception of the medical office is based in part on the impression you make.
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14. Checkpoint Question
What are four ways that you can demonstrate a professional image to patients?
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15. You can demonstrate a professional image by:
Checkpoint Answer
You can demonstrate a professional image by:
Transmitting a positive attitude
Acting as a role model
Using courtesy and diplomacy
Making a positive first impression
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16. Reception The Role of the Receptionist
Receptionist may be nonmedically trained or may be a medical assistant who also serves as receptionist
receptionist: a person who greets patients as they arrive
at a medical office and performs various administrative
tasks
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17. Reception (cont’d.) Duties and Responsibilities of the Receptionist
Prepare the office for patient arrivals
Ensure confidentiality at all times
Close privacy window
Take patient information at private area
Keep voice down when discussing patients
Make referral calls away from reception desk
Keep computer screens, printed appointment lists, appointment books, patient charts, etc. out of view
Maintain sign-in sheet to protect patient’s privacy
Be mindful of patients’ right to privacy as conduct daily duties
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18. Reception (cont’d.) Duties and Responsibilities of the Receptionist
Preparing the office
Office:
Unlock door
Disengage alarm system
Turn on lights
Turn on office equipment
Ensure specimens have been taken from collection box
Prepare new patient sign-in sheet for the day
Systematic check of office —medical records put away; tidy; forms restocked
Check exam rooms if needed
The office should be left in a professional manner.
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19. Reception (cont’d.) Retrieving Messages Check messages frequently
Forward retrieved messages to recipient
Messages retrieved from:
Answering service
Voice mail system
Electronic mail
Facsimile machine
No matter how a message has been sent, however, all information must be treated confidentially and handled according to HIPAA regulations.
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20. Reception (cont’d.)
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21. Reception (cont’d.) Answering Service
Receive calls from patients, hospital staff, and other physicians and communicate to physician via beeper
Left for office staff to retrieve next morning:
Patients calling the office for a sick appointment (not an emergency, such as an earache or flulike symptoms)
Calls from hospitals or skilled nursing facilities about changes in patient status (new wounds or bed sores or patient falls without injury)
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22. Reception (cont’d.) Voice Mail Systems
After retrieving, delete unless otherwise instructed
May include:
Patients wishing to change or cancel their appointments
Patients requesting prescription refills
Family members or patients calling to ask for additional information or clarification about their medical care or test results
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23. Reception (cont’d.) Electronic Mail
messages are sent from other physicians, professional organizations, and hospital personnel (sometimes patients)
May include:
Memos from professional organizations
Pharmaceutical representatives’ updates or announcements
Medical staff meeting minutes, announcements from hospital administration
Upcoming continuing education courses for physicians
Insurance representatives regarding billing issues
Patient inquiries
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24. Reception (cont’d.) Facsimile Machines May include: Patient referrals
Consultation reports
Laboratory and radiology reports
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25. What four locations should you retrieve messages from?
Checkpoint Question
What four locations should you retrieve messages from?
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26. Messages can be retrieved from: Answering services Voice mail
Checkpoint Answer
Messages can be retrieved from:
Answering services
Voice mail
Electronic mail
Facsimile machines
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27. Reception (cont’d.) Prepare the Charts
Collect charts of all patients scheduled to be seen
Put in order of appointment
Ensure each is complete and up-to-date
Include necessary blank forms
Welcoming Patients and Visitors
Try to greet every patient personally
Be cheerful and friendly
If it is your responsibility to greet patients, you should make this a top priority.
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28. Reception (cont’d.) Register and Orient Patients and Visitors
New patients should complete information sheet
Explain policies
Tell patient location of drinking fountain, bathroom
Manage Waiting Time
If appointment will be more than 30 minutes late, offer patient option to reschedule
Be honest with waiting patients.
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29. Reception (cont’d.) Ergonomic Concerns for the Receptionist
Lift items at waist level
Keep lifted items close to body
Have deliveries placed so they won’t required bending to lift
Lift small loads, make more trips
Place frequently used items within easy reach
Use telephone head sets to keep head upright
ergonomic: describes a workstation designed to prevent work-related injuries and to promote work efficiency
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30. Reception (cont’d.)
Using correct ergonomics when working on the computer to avoid injury.
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31. What is the purpose of having an ergonomic workstation?
Checkpoint Question
What is the purpose of having an ergonomic workstation?
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32. Checkpoint Answer
The purpose of an ergonomic workstation is to prevent injuries to employees and to increase employee satisfaction and work efficiency.
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33. Reception (cont’d.) The Waiting Room Environment General Guidelines
Entrance, hallways, stairs must be well maintained
Furniture:
Arranged to allow easy walking
Comfortable and attractive
Durable
Have different chair designs to accommodate all
The reception area should be designed for the comfort, safety, and enjoyment of all patients.
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34. Reception (cont’d.) Color Low-key, muted pastel
Bright primary colors for pediatrics
An example of an office waiting area that sees pediatric patients.
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35. Reception (cont’d.) Bright, not glaring light
Ventilation and good temperature control
Keep plants in good condition
Keep magazines current and relevant to patients — no medical journals
Television
Policies vary among offices
Closed captioning option for hearing impaired
Can be made into teaching tool for patients
closed captioning: printed words displayed on a television screen to help people with hearing disabilities or
impairments
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36. Checkpoint Question
What option should you offer hearing-impaired patients if they wish to watch television?
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37. Checkpoint Answer
Patients who are hearing impaired should be offered closed captioning if they are requesting to watch television.
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38. Reception (cont’d.) Guidelines for Pediatric Waiting Rooms
Many have two areas — sick and well child areas
Place patients with communicable diseases in exam room promptly
Monitor play area closely
Keep toys clean, repaired
No noisy battery-powered toys
Choking hazards — ensure all toys are larger in diameter than a toilet paper tube
Keep clean, intact books on hand for parents to read to their children
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39. Reception (cont’d.) Americans with Disabilities (ADA) Act Requirements
Ensure accessibility:
Paths, walking areas
Doors
Reception desk
Restroom
The ADA Title III act requires that all public accommodations be accessible to everyone.
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40. Reception (cont’d.)
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41. What act prohibits discrimination of patients with disabilities?
Checkpoint Question
What act prohibits discrimination of patients with disabilities?
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42. Checkpoint Answer
The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities.
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43. Reception (cont’d.) Infection Control Issues
Aseptic technique must be used for infection control in the office
Always follow standard precautions
Handwashing
Can use alcohol-based antiseptic hand cleanser
Never touch a specimen container with bare hands
Handwashing is the most important practice for preventing the transmission of diseases.
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44. Reception (cont’d.)
Good hand washing skills are essential to prevent disease transmission.
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45. Reception (cont’d.) Ill patients in waiting room Sneezing, coughing
Give patient tissues
Ask patient to cover nose and mouth if coughing or sneezing
May provide disposable face mask while sitting in waiting room
Put patient in examination room promptly
If vomiting, bleeding, or discharging other body fluids must not be left in waiting room
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46. Reception (cont’d.) Biohazard Waste
All body fluids must be considered infectious and be managed appropriately, including:
Dressing supplies with bloodstains from cuts or wounds
Tissues from patients with acute nosebleeds
Urine-saturated diapers left in the restroom
Vomit
Saturated tissues with sputum
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47. Reception (cont’d.) Communicable Diseases
Good communication between clinical and administrative staff essential to manage patients with communicable diseases
Not all communicable diseases are easily transmitted to others (HIV, AIDS, hepatitis)
Need to be able to recognize possible contagious diseases and not let these patients sit in the waiting room
Patients with impaired immune systems or taking medications that hinder their immune system may require immediate placement in examination room
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48. Reception (cont’d)
Back to Learning Outcome

49. Checkpoint Question
What is the most antiseptic technique for preventing the transmission of diseases?
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50. Checkpoint Answer
The most antiseptic technique for preventing the transmission of diseases is handwashing.
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51. Reception (cont’d.) The End of the Patient Visit May include:
Discharging patients
Collecting fees or copayments
Scheduling follow-up appointments
Saying goodbye in a warm, friendly way
As patients leave the office, they should feel they have been well cared for by a competent and courteous staff.
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52. Telephone Importance of the Telephone in the Medical Office
Telephone — one of the most important pieces of medical office equipment
Convey competence and caring
You must be able to use the tone and quality of your voice and speech to project a competent and caring attitude over the telephone.
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53. Telephone (cont’d.) Basic Guidelines for Telephone Use
Effective communication
Over various obstacles
Cordless head sets
Diction
Enunciate words
Speak clearly and distinctly at a moderate pace
Speak directly into mouthpiece
Do not prop mouthpiece between chin and shoulder
Do not eat or chew gum
diction: the style of speaking and enunciating words
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54. Telephone (cont’d.) Pronunciation
Pronounce words correctly to avoid misunderstanding
Avoid slang and idioms
Use common terminology — avoid medical jargon
Expression
Put “smile” in voice — sit up straight, smile while speaking
Avoid monotonous style
Modulate pitch and volume
Listening
Listen actively
Do not interrupt
Verify message by repeating
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55. Telephone (cont’d.) Courtesy Speak politely
Address caller by title and last name
Do not let voice betray impatience or irritation
Never put caller immediately on hold — could be emergency
Check back with caller after 90 seconds
Do not exceed hold time of 3 minutes — offer to return call
Patients in waiting room might hear conversation — be cautious
While speaking on the telephone, be courteous and professional.
Remember that you are there to help the patient.
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56. What are the five basic guidelines for telephone use?
Checkpoint Question
What are the five basic guidelines for telephone use?
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57. The five basic guidelines for proper telephone use are: Good diction
Checkpoint Answer
The five basic guidelines for proper telephone use are:
Good diction
Pronunciation
Expression
Listening
Courtesy
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58. Telephone (cont’d.) Routine Incoming Calls Appointments
Always obtain a new patient’s telephone number and verify an established patient’s number
Billing Inquiries
Do not give out specific pricing
Do not give out information to third party
Diagnostic Test Reports
Called in from lab or hospital before sent
Routine and Satisfactory Progress Reports
Record in chart
Make note for physician
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59. Telephone (cont’d.) Test Results Always document the call
Use office policy
Illegal to give out information to anyone but patient without consent
Unsatisfactory Progress Reports and Test Results
Physician usually handles
Charting example.
Never discuss unsatisfactory test results with a patient unless the doctor directs you to do so.
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60. Telephone (cont’d.) Prescription Refills
Many offices allow MAs to refill maintenance prescriptions
Other Calls
May include:
Requests for referrals to other physicians
Clarifying instructions for patients
Routine administrative matters
Ask physician for preferences about which to handle right away and which to save for later
If there is any doubt, tell the pharmacy or the patient that you will check with the doctor and call back.
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61. Telephone (cont’d.) Challenging Incoming Calls Unidentified Callers
May be sales people
Be firm — take message
Irate Patients
Reassure patient you want to help
Listen carefully and take notes
Tell physician about fee or care complaints
When a caller is angry, you must be careful to keep your own temper in check.
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62. Telephone (cont’d.) Medical Emergencies
Calm patient and get necessary information:
Severe pain?
Profuse bleeding?
Severe vomiting/diarrhea?
Temperature above 102°F?
Ask physician for list of what constitutes an emergency in that particular practice
Specific instructions to give patients in particular situations
As a medical assistant, you must be able to differentiate between routine calls and emergencies.
Determine the patient’s name, location, and telephone number as quickly as possible in case you are disconnected or the patient is unable to continue the
conversation.
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63. Telephone (cont’d.) Triaging Incoming Calls
Urgency can be medical or administrative
Patients with potentially life-threatening problems are taken first
Irate patients should be handled promptly
Do not leave any messages unresolved
triage: sorting of patients into categories based on their level of sickness or injury to ensure that life-threatening medical conditions are treated immediately
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64. Telephone (cont’d)
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65. Telephone (cont’d.) Taking Messages Use notepad
Tell caller when to expect return call
Document all calls
The minimum information needed for a telephone message includes the name of the caller, date and time of the call, telephone number where the caller can be reached, a short description of the caller’s concern, and the person to whom the message is routed.
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66. What is the minimum information needed for taking messages?
Checkpoint Question
What is the minimum information needed for taking messages?
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67. Checkpoint Answer
The minimum information needed for a telephone message includes:
Name of the caller
Date and time of the call
Telephone number where the caller can be reached
A short description of the caller’s concern
The person to whom the message is routed
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68. Telephone (cont’d.) Outgoing Calls
General Guidelines for Outgoing Calls
Patient:
If rescheduling appointment, explain why
Be ready with new appointment time suggestions
Long-Distance:
Document long-distance calls
Be mindful of time zones
Conference:
Three or more people
Notify participants ahead of time of time and number to call
You should prepare for your calls carefully; have all information gathered and know what you want to say before you dial the number.
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69. Telephone (cont’d.) Calling Emergency Medical Services
Obtain patient’s name, age, sex
Nature of medical problem –
Type of service requested by physician
Emergency medical service (EMS): a group of health care providers working as a team to care for sick or injured patients before they arrive at the hospital
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70. Telephone (cont’d.) Specific instructions or requests from physician
Location of emergency
Speak slowly and calmly to dispatcher
Ask dispatcher approximate arrival time
Do not hang up until dispatcher instructs you to do so
No matter what role you play, an office emergency requires all employees to be prepared.
Reassure other patients in the waiting room. If the patient has any family members present, offer them assistance and reassurance.
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71. Checkpoint Question
What patient information should you know before calling emergency medical services?
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72. Before calling EMS, you should know:
Checkpoint Answer
Before calling EMS, you should know:
The name, age, and sex of the patient
Nature of the medical problem
Type of service the physician is requesting
Any special instructions the physician may have
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73. Telephone (cont’d.) Services and Special Features Lines
Number of incoming lines depends on size of practice
Unpublished private lines for family and staff
Direct line to hospital
Features
Recall
Volume control
Intercom
Call forwarding
Caller identification
Cordless headset — helps prevent neck injuries
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74. Telephone (cont’d.) Cell phones and pagers Don’t give out number
Typing messages is timesaver
Internet access
Text messaging
Pager to send quick messages
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75. What is text messaging, and when might it be used?
Checkpoint Question
What is text messaging, and when might it be used?
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76. Checkpoint Answer
Text messaging is done with the keypad of a cellular phone and sends a readable message to the recipient. It might be used when it is not necessary to speak with the person or a ringtone would be inappropriate.
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77. Telephone (cont’d.) Telecommunication Relay Systems
Telecommunications relay systems for hearing or speech impairments
Teletypewriter (TTY) — user types messages into phone and receives text replies
Standards:
Receptionist is most visible and accessible representative of medical office
Demonstrate tact and diplomacy in all interactions
Proper telephone etiquette and manners are essential
Excellent customer service is crucial to successful medical practice
Teletypewriter (TTY): a special machine that allows communication on a telephone with a hearing-impaired person
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78. Online Services Web Sites
Personalized Web site with information about practice
Online services
Contact information
Practice policies
Patient education
Ask questions
Request copies of medical records
Protection of privacy with personal log-in and passwords
Medical assistant responsible for accessing, distributing, and responding
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79. Online Services (cont’d)
Video Conferencing
Convenient to talk with other physicians face-to-face
Can provide medical care remotely
Must be HIPAA complaint to maintain privacy
May require you to log in to service and alert physician to patients waiting
May need to respond to s
Telemedicine:
the use of electronic telecommunication technology for the delivery of health care
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80. Checkpoint Question
What are some of the duties that may be required of the medical assistant working in a practice that utilizes telemedicine?
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81. Checkpoint Answer
Working in a medical office utilizing telemedicine services may require you to log in to the service throughout the day and alert the physician to patients waiting to be seen online or to respond to patient s through this service.
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