1. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1 Telephone Techniques Chapter 9

2. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 2 Introduction The telephone is the lifeline of the medical practice. Telephone technique can either build or destroy a physician’s office. The patient is never an interruption of the workday; instead, the patient is the reason the practice exists.

3. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 3 This chapter will examine:  How to develop a pleasing telephone voice  Correct use of the handset  How to handle callers who wish to speak to the physician  The items needed to take an accurate telephone message  How to handle difficult callers  Questions to ask during an emergency call

4. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 4 Calls in the Physician’s Office Most incoming calls are from these sources:  Established patients calling for appointments or to ask questions  New patients making a first contact with the office  Patients and medical workers reporting treatment results or emergencies  Other physicians making referrals or discussing a patient  Laboratories reporting vital patient information

5. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 5 Effective Use of the Telephone  The telephone is one of the most valuable tools used in the physician’s office.  Medical assistants must project a caring attitude when speaking to those who call the facility.

6. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 6 Effective Use of the Telephone (cont’d)

7. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 7 Active Listening  Focus attention on the call at hand.  Give the caller the same attention as would be given to a face-to-face visitor.  Listen for clues about the patient. Is he or she distressed? Agitated? Fearful?

8. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 8 Developing a Pleasing Voice  Callers should “hear a smile.”  Provide excellent customer service.  Enunciate clearly.  Use inflections.  Listen to impressions the caller is making. Is he or she worried? Frantic?

9. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 9  How something is said to a patient is just as important as what is said.  Remember, the patient may be stressed or worried about his or her condition.  Every caller should feel that the medical assistant has time to address his or her concerns. Points to Remember

10. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 10 Telephone Tips  Be alert and interested in the caller.  Give the caller full attention.  Talk naturally.  Avoid using professional jargon.  Speak distinctly.  Talk directly into the mouthpiece.  Do not eat, drink, or chew gum while on the phone.

11. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 11 Holding the Handset Correctly  Place the handset so that your voice is heard clearly and distinctly.  The mouthpiece should be about 1 inch from the lips and directly in front of the teeth.  Never hold the mouthpiece under the chin.  Speak directly into headset mouthpiece.

12. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 12 Maintaining Confidentiality  All communications in the healthcare facility are confidential.  Use discretion when using the name of the caller.  Be careful about being overheard.  Never use speakerphone to retrieve messages.

13. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 13 Thinking Ahead  Have the patient’s chart or bill at hand before dialing the phone.  Write down a list of questions or goals for the conversation.  Keep the call short to free phone lines.  Keep a list of frequently called numbers for staff use and to offer to patients.

14. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 14 Techniques for Incoming Calls Answer promptly.  Always answer by the third ring.  Place subsequent calls on hold and take care of calls in order.  Make certain the call is not an emergency.  Keep focus on the call.  Never answer by stating “please hold” without verifying that the patient is able to hold.

15. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 15 Techniques for Incoming Calls Identify the facility.  Use a telephone greeting as set forth in the policy and procedure manual.  The title “doctor” may need to be avoided, depending on the type of practice.  Salutations such as “good morning” are optional.

16. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 16 Techniques for Incoming Calls Identify the caller.  Ask who is calling.  Repeat the caller’s name often.  If the caller refuses to identify himself or herself, politely refuse to forward the call to the physician.  Refer the call to the office manager.

17. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 17 Techniques for Incoming Calls Screen incoming calls.  Put calls from other physicians through at once, unless the policy manual requires other action.  Identify the caller.  Determine who should receive the call.  Take an accurate phone message.  Cultivate a reputation for being helpful and reliable.

18. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 18 Techniques for Incoming Calls Minimizing wait time.  Ask the caller if he or she prefers to wait.  Return to the call often.  Give the caller an estimate as to the length of time he or she will have to wait.  Thank the patient for waiting.

19. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 19 Techniques for Incoming Calls Transferring a call  Ask permission to place the patient on hold.  Call the person the patient wishes to speak to, and state that the call is being transferred.  Transfer the call.  Always send the call to the person who knows the most about the situation.

20. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 20 Techniques for Incoming Calls Taking a phone message  Name of person calling  Name of person the call is for  Caller’s phone numbers  Reason for the call  Action to be taken  Date and time of the call  Initials of person taking the message

21. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 21 Techniques for Incoming Calls (cont’d)

22. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 22 Taking Action on Phone Messages  Make certain that phone messages receive follow-up.  Never trust memory alone for follow-up on messages.  Establish a follow-up procedure to ensure that messages are not missed and that follow-up is conducted on each message.

23. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 23 Ending a Call  Stick to business during the call.  Do not encourage chit-chat, but maintain a friendly attitude.  Ask if the patient has any further questions or if you can assist him or her in other ways.  Close the conversation, and let the patient hang up first.  Replace the handset on the cradle gently.

24. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 24 Retaining Records of Telephone Messages  Develop a policy for message retention.  Many offices keep messages for the same amount of time records are kept.  Phone records include telephone bills.  Keep message pads.  Use message pads that make a copy of the message.  Document the number of attempts to return calls.

25. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 25 Typical Incoming Calls  New patients scheduling appointments  Established patients scheduling appointments  Patients needing directions  Inquiries about bills and fees  Insurance provider questions  Requests for assistance with insurance  Radiology and laboratory reports  Satisfactory progress reports from patients  Routine reports from hospitals and other sources  Office administration matters  Requests for referrals  Prescription refills

26. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 26 Special Incoming Calls  Patients refusing to discuss symptoms  Unsatisfactory progress reports  Requests for test results  Requests for information from third parties  Complaints about care or fees  Calls from the physician’s family or friends  Call from staff members’ family and friends  Angry or aggressive callers  Emergency callers

27. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 27 Questions to Ask during an Emergency Call  At what telephone number can you be reached?  Where are you located?  What are the chief symptoms?  When did they start?  Has this happened before?  Are you alone?  Do you have transportation?

28. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 28 Screening Guidelines  One individual is often assigned screening duties.  A written emergency protocol should be close to each phone.  Employees must not give any advice not on the written protocol.  Emergency phone numbers should be available.  Make certain that the physician can always be reached.

29. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 29 Getting Information the Physician Needs  Listen carefully to the physician when he or she is questioning patients about their symptoms.  The medical assistant will learn to anticipate the physician’s needs.

30. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 30 Getting Information the Physician Needs

31. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 31 Outgoing Calls  Plan outgoing calls in advance.  Have all information handy when making the call.  Make a list of questions.  Be courteous and use good diction and enunciation skills.  Make all outgoing calls at once to use time to the best advantage.  Organizing calls increases office efficiency.

32. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 32 Telephones of Today Voicemail  Widely used.  Most employees have their own voicemail.  Often frustrating for patients who have to go through several voicemail menus.  Temporary greetings can be recorded for vacations and meetings.

33. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 33 Telephones of Today Answering machines  Similar to voicemail.  Machine is attached to telephone or a part of the telephone.  Some have microcassettes or regular cassette tapes.  Less common now that voicemail is popular.

34. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 34 Telephones of Today Answering services  Phones answered by operators.  Most offer round-the-clock coverage.  Operators follow physician’s instructions regarding call- backs and pages.  Operators often cover calls during lunch hours and meeting times.

35. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 35 Telephones of Today Automatic call routing  Often extremely frustrating for the patient  Especially frustrating for elderly patients  Call is answered automatically, and callers are given options: “For appointments, press 1… For insurance questions, press 2…”

36. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 36 Telephones of Today Call forwarding  Allows user to forward calls to another designated number  Keeps the user from missing important calls when on the go

37. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 37 Telephones of Today Caller ID  Allows the user to see who is calling before picking up the handset.  Caller’s name and phone number usually appear.  Lets the user decide whether to answer the call.  Call waiting caller ID identifies callers while the phone is in use.  Caller ID Blocker may need to be disabled when a patient expects an after-hours call from the physician.

38. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 38 Telephones of Today Cellular phones  Many individuals no longer have a home phone and opt to have cell phones only.  Commonplace today, although considered a luxury item as recently as 10 years ago.  Some allow Internet access and play MP3s.  Families or members of groups often can talk to one another for free.

39. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 39 Telephones of Today Pagers  Not as popular since the advent of cell phones.  Newer models allow Internet access and news broadcasts.  Text messaging is available on newer pagers.

40. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 40 Telephones of Today Fax machines  Imperative in physician’s offices.  Confidentiality is critical.  Use cover sheets that stress confidentiality.

41. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 41 Telephones of Today

42. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 42 Telephones of Today Headsets  Allow the user to use both hands.  Most are comfortable and lightweight.  Many have cords that allow for quick disconnect so that the user can walk around and still be connected to a call.

43. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 43 Long Distance Calls  Many telephone companies offer nationwide long distance for very reasonable fees on land lines and cell phones.  Be careful of directory assistance calls; look for phone numbers on the Internet and in phone directories.

44. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 44 Time Zones

45. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 45 Wrong Numbers  Always apologize when a wrong number is reached.  If a wrong number is reached long distance, call the operator and ask for credit on the phone bill.

46. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 46 Conference Calls  Can be set up through operators or through conference call services.  Can be local or long distance, or both.  Charges are added for the number of places connected, distance between parties, number of parties, and length of the call.

47. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 47 Operator-Assisted Calls and Services  Person-to-person  Billing to a third party  Collect calls  Requests for time and charges  Certain calls placed from hotels  Credit for wrong numbers  Conference calls  Some international calls

48. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 48 Telephone Directories Usually divided into three sections:  Introductory pages  White pages  Yellow pages Many directories have blue pages, which list government offices and services. Make a practice of using www.yellowpages.com!

49. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 49 Other Information in Directories  Emergency services  Service calls  Dialing instructions  Area codes  Newcomer information  Community service numbers  Prefix locations  Rates and regulations

50. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 50 Personal Phone Directory  The personal phone directory should include numbers that employees frequently call.  Establish a list of community resources that includes phone numbers and contact information.

51. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 51 Summary of Scenario  Give every call the attention that it deserves  Remain calm, no matter what is happening on the other end of the telephone line.  Treat callers as you would personally wish to be treated.

52. Copyright © 2011, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. 52 Closing Comments  Make certain that the patient hears caring and compassion in your voice.  Always try to help the patient accomplish what he or she set out to do when making the call to the office.  Make certain that follow-up on every call is completed in a timely manner.