This is a guide for healthcare leaders looking into centralized healthcare call centers. We discuss the top FAQs, benefits, value proposition, how to build a centralized healthcare call center and more.
Top FAQs and Benefits
Centralized healthcare call centers have become increasingly popular in the medical industry.
These centralized healthcare call centers are designed to provide patients with a centralized location for all their healthcare needs. These needs include scheduling appointments, obtaining test results, and accessing medical advice.
The purpose of a centralized medical call center is to improve patient experience and increase efficiency for healthcare organizations.
By providing patients with a single point of contact for all their healthcare needs, these call centers can reduce wait times. Additionally, they can streamline communication between patients and providers.
Call center operations in a medical setting typically involve three main roles. These include healthcare call center associates, call center agents, and call center staff.
Healthcare call center associates are responsible for answering calls and directing patients to the appropriate resources.
Call center agents handle more complex issues such as scheduling appointments or providing medical advice.
Call center staff oversee the entire operation and ensure that everything runs smoothly.
There are two options: internal or outsourced.
Internal call centers are run by the hospital or provider themselves, while outsourced call centers are managed by third-party companies.
It’s important to select a qualified call center supervisor who can oversee operations effectively regardless of which option is chosen.
In addition to selecting the right supervisor, utilizing appropriate call center software is also crucial for success.
This software can help manage patient data efficiently, track patient interactions with the system. They also provide real-time feedback on performance metrics.
What is a Centralized Healthcare Call Center and How Does It Work?
A centralized medical call center is a facility that provides a single point of contact for patients to access medical advice, information, and services.
The call center operates 24/7 and is staffed by trained medical professionals. These personnel can triage calls, provide medical advice, schedule appointments, and coordinate care.
The primary function of a centralized medical call center is to improve patient access to care.
Patients can easily reach the call center at any time of day or night without having to go through the hassle of scheduling an appointment with their primary care physician or visiting the emergency department.
This helps reduce unnecessary emergency department visits and ensures that patients receive timely care for their health concerns.
Moreover, the centralized nature of the call center makes it easier for healthcare providers to coordinate care across different facilities.
Patients may need to see multiple specialists or visit different facilities for diagnostic tests or treatments.
A centralized medical call center can help ensure seamless communication between these different providers and facilities so that patients receive coordinated care.
One major benefit of a centralized medical call center is increased patient satisfaction.
Patients appreciate being able to quickly and easily access medical advice and services when they need them most.
They also appreciate the convenience of being able to speak with trained medical professionals without having to leave their homes or wait in long lines at the emergency department.
Another benefit is improved patient outcomes.
By providing timely access to medical advice and services, a centralized medical call center can help prevent minor health concerns from turning into major ones.
It can also help ensure that patients receive appropriate follow-up care after receiving treatment for acute conditions.
Finally, a centralized medical call center can help reduce healthcare costs by reducing unnecessary emergency department visits and hospitalizations.
Many patients who seek treatment at emergency departments do not actually require urgent care but are unable to access other forms of healthcare due to barriers such as transportation issues or lack of insurance coverage.
By providing an alternative source of healthcare services, a centralized medical call center can help reduce the burden on emergency departments and ensure that patients receive appropriate care in a timely manner.
Centralized healthcare call center technology
The call center uses advanced technology such as electronic health records (EHRs), telemedicine, and secure messaging to ensure seamless communication and coordination between patients, providers, and healthcare facilities.
EHRs allow medical professionals to access patient information quickly and easily, which helps them make informed decisions about patient care.
Telemedicine allows patients to receive medical advice and services remotely, which can be especially helpful for patients who live in rural areas or have mobility issues.
Secure messaging allows medical professionals to communicate with each other quickly and securely, which helps ensure coordinated care across different providers and facilities.
Example – nurse line
One example of a successful centralized medical call center is the Nurse Advice Line operated by Kaiser Permanente. The Nurse Advice Line provides 24/7 access to registered nurses who can provide medical advice over the phone or via secure messaging. Patients can also use the service to schedule appointments with their primary care physicians or get referrals to specialists if needed.
Example – telephone triage
Another example is the Veterans Health Administration’s Telephone Triage Service. This service provides veterans with 24/7 access to trained medical professionals who can triage calls, provide medical advice, schedule appointments, and coordinate care across different VA facilities.
According to a study published in the Journal of General Internal Medicine, patients who used a centralized medical call center were less likely to visit the emergency department for non-urgent health concerns than those who did not use the service.
The study also found that patients who used the call center were more likely to receive appropriate follow-up care after receiving treatment for acute conditions.
Example – Higher patient reviews
A centralized healthcare call center helps immensely with patient access thereby leading to higher patient acquisition, patient retention, patient satisfaction, better patient reviews.
These, in turn, lead to higher medical practice reputation scores, which in turn contribute to more patient appointment calls. Of course, this translates to a much easier medical marketing and patient pipeline .
MGMA had done a pretty good study on centralized call centers (read here). “Today’s healthcare consumers are seeking out care that is convenient and easily accessible at a date and time they want to be seen. If today’s patients (new or existing to the system) do not get the appointment date and time requested, they will continue to search for a provider that meets their expectations.”
That’s precisely what our medical call center team that handles inbound calls for multiple practice groups has seen as well.
The Value of a Centralized Healthcare Call Center and Its Benefits
A centralized medical call center can provide numerous benefits to healthcare providers and patients alike.
One of the most significant advantages is cost reduction.
By streamlining communication and reducing the need for multiple staff members to handle calls and appointments, healthcare providers can significantly reduce their costs.
For example, a study conducted by the University of Rochester Medical Center found that implementing a centralized medical contact center resulted in a 30% reduction in staffing costs.
This reduction was achieved by consolidating multiple call centers into one central location, which allowed for more efficient use of staff resources.
Higher patient satisfaction
In addition to cost savings, a centralized medical call center can also improve patient satisfaction and retention.
By providing a single point of contact for patients, healthcare providers can ensure that patients receive consistent and high-quality care across all touchpoints.
This consistency is essential for building trust with patients, which is critical for retaining them over the long term.
According to a survey conducted by Accenture, 41% of patients cited trust as the most important factor in choosing a healthcare provider.
Moreover, improved patient satisfaction leads to increased revenue for healthcare providers.
Satisfied patients are more likely to return for future appointments and recommend their provider to friends and family members.
Another benefit of using advanced technology in a centralized medical call center is improved efficiency and accuracy in scheduling appointments, managing patient information, and providing medical advice.
For example, many centralized medical call centers use automated appointment scheduling systems that allow patients to schedule appointments online or via phone at any time of day or night.
These systems not only save time but also reduce errors associated with manual scheduling processes.
Additionally, some centralized medical contact centers offer telemedicine services that allow physicians to consult with patients remotely via video conferencing technology.
This approach not only saves time but also reduces the need for unnecessary office visits while still ensuring that patients receive high-quality care from licensed physicians.
Furthermore, a centralized medical call center can provide valuable data and insights into patient needs and preferences.
By tracking patient interactions and collecting data on patient demographics, healthcare providers can gain a better understanding of their patients’ needs and preferences.
This information can then be used to tailor services and improve overall patient care.
For example, if a significant number of patients are calling with questions about a particular medication, healthcare providers can use this information to develop educational materials or training programs for staff members.
Do you need a centralized call center?
Advisory board had published an article “Must-Have Upgrades for the Consumer-Focused Health System” that shows the current state of patient access and makes a case of why health systems, primary care and specialists need to make patient access a high priority. They go on to explain why patient consumerism is forcing providers to change the way they do business.
According to that report “Access a Major Decision Factor 6 of the top 10 decision drivers are related to access and convenience, when choosing a primary care Physician“. Also, “42% of consumers report “short travel distance” as a top-three driver when choosing a specialty care provider”
Our experience with centralized healthcare call centers
Our own healthcare call center experience has taught us that patients are simply not willing to wait.
If you’re not answering their calls within a minute, they are already calling another provider (probably, your competitor).
Our experience has been that if a patient does not get an appointment for their desired/convenient dates/times, they will seek another provider or, at the very least, be a no-show.
A centralized call center has its benefits and its pitfalls.
The first step to even begin thinking about a centralized healthcare call center is to judge what your patient access experience looks like.
Try being a patient at your own practice / health system to find out what a typical patient access experience is like.
Centralized healthcare call center KPIs
Before you get started on a centralized healthcare call center initiative (or any digital transformation initiative), you want to document the business as it is today. For our client, there were no KPIs to gather because they were never being measured.
KPIs (Key Performance Indicators)
These are essential metrics that help centralized healthcare call centers measure their performance and identify areas for improvement.
By tracking and analyzing these KPIs, healthcare call centers can optimize their operations, reduce wait times, and improve patient satisfaction.
In this section, we will discuss some of the most important KPIs for measuring healthcare call center efficiency.
Average Handle Time (AHT)
This is a crucial centralized healthcare call center KPI that measures the average time it takes for a call center agent to handle a call from start to finish.
This metric includes the time spent on hold, the time spent talking to the caller, and any after-call work that needs to be done.
A low AHT indicates that agents are efficient in handling calls while maintaining quality service.
However, it’s important to note that a very low AHT may indicate rushed or incomplete interactions with patients.
Average Speed of Answer (ASA)
ASA is another important KPI that measures the average time it takes for a call center agent to answer an incoming call.
This centralized healthcare call center metric is critical in determining how quickly patients can access care and support when they need it.
Long wait times can lead to frustration among patients and may result in negative reviews or even lost business.
First Call Resolution Rate (FCR)
FCR is another significant KPI that measures the percentage of calls resolved on the first attempt without requiring additional follow-up calls or escalations.
High centralized healthcare call center FCR rates indicate effective problem-solving skills among agents and reduced wait times for patients.
This refers to the percentage of callers who hang up before speaking with an agent or receiving assistance.
High abandonment rates suggest long wait times or poor customer service experiences.
Service Level Agreement Compliance (SLA)
SLA is another critical KPI that tracks whether agents meet specific performance goals set by management within a certain timeframe.
For example, if an SLA goal is set at 80%, then 80% of all calls should be answered within a certain timeframe, such as 30 seconds.
In addition to these KPIs, healthcare call centers may also track other metrics such as call volume, call types, and agent performance.
By analyzing this data, healthcare call centers can identify trends and patterns that can help improve their operations and patient satisfaction.
For example, if a healthcare call center notices an increase in calls related to a specific issue or condition, they may need to allocate more resources or training to agents who handle those calls.
Similarly, if an agent consistently performs poorly on certain metrics, additional coaching or training may be necessary.
Social proofs suggest that tracking KPIs can lead to significant improvements in healthcare call center efficiency.
For instance, a study conducted by the Medical Group Management Association found that tracking AHT and ASA helped one medical practice reduce wait times by 50% while increasing patient satisfaction scores.
If you can, try to gather at least the following metrics / business intelligence
- Scheduling correct appointment
- Average speed to answer
- Duration of call
- Call hold times
- Total or % abandoned calls
- Call volumes per week/month
- Call volume trends by day of week (for this medical group, Monday-Wednesday had the highest call volumes)
- Patient satisfaction (if you have a patient reviews or patient satisfaction survey initiative, it will be reflected there)
- No show rates of appointments that were scheduled more than 2–3 weeks before appointment date
Key personnel for a centralized healthcare call center initiative
This is a disruptive and transformative change in your medical practice. Make sure you identify a steering committee that will take on this initiative and will guide/coach the team.
This could include your office manager, site supervisors, patient access director (if you have one), front desk/receptionists and a lead from your medical billing department.
For our client, this included the receptionists from each office location and the office manager.
We had excluded the medical billing department and found out that they have a LOT of inputs into what the receptionist must do / the information that the front desk must gather from patients to avoid downstream issues in the medical billing process.
Patient Access Director
The Patient Access Director oversees the entire patient access experience, ensuring that every aspect of it meets or exceeds expectations.
They work closely with healthcare providers and organizations to develop policies and procedures that promote high-quality care for all patients.
The director also ensures that all staff members are adequately trained in handling complex issues related to patient care, including patient service and communication.
This approach helps reduce the likelihood of errors or miscommunications that can negatively impact the patient experience.
Patient liaisons are skilled advocates who work closely with patients to ensure that they receive high-quality care and support throughout their journey.
These advocates are trained in handling complex issues related to patient care, including communication, referrals, and access to information.
They work closely with healthcare providers and organizations to develop personalized solutions that meet each patient’s unique needs effectively.
Patients can trust these advocates to provide timely assistance when they need it most while also protecting their personal information through strict privacy regulations.
Healthcare providers play a crucial role in delivering high-quality care to patients.
They are responsible for diagnosing illnesses, providing treatment options, and ensuring that patients receive accurate test results and other critical information about their health status.
By using a centralized medical call center, healthcare providers can streamline patient calls and referrals, reducing wait times for appointments or tests while also ensuring that patients receive accurate information about their health status.
This approach helps improve the overall patient experience while also promoting better health outcomes for all patients.
Centralized healthcare call center – locations, providers
You could take one of these approaches to the centralized call center roll out.
All practice locations and all doctors
– in this approach you decide on a cut over date and transition your entire practice and all its providers to your centralized healthcare call center. There are several pros and cons to this approach.
Planning tends to be very thorough in this case and the committee tends to view this a lot more seriously (as there’s no rolling back).
Standards are made quite stringent due to the same reason.
Participation is a lot more active from all stakeholders as they realize that all functions are being transitioned over the call center.
Various scheduling gaps are identified in this process because all locations come together towards the same goal.
A centralized scheduling workflow is developed that is consistent with best practices and does not allow for variations based on doctors’ personal preferences
This is a big bang approach and investments are made up front, in one shot.
The risks are higher in this approach as this could lead to larger disruptions, should the roll out not work perfectly from the get-go.
Providers are hesitant because of their perception of loss of control over their own schedules.
Planning requires more time — hence, executive management tends to view this as analysis-paralysis.
Opt–in of doctors
– in this approach, your providers / doctors make the decision whether they want to participate / open up their schedules to a centralized call center or not. For the providers that do accept to participate, all their locations are made available for scheduling.
This has the biggest provider buy in from the get go. It is a lot easier to handle as the staff has to manage only those providers’ preferences.
It also allows patients to “follow” a doctor / provider of their choice.
This allows us to test the waters and iron out the kinks in the transition process before bringing other providers onboard.
This is only a stop gap solution.
If the end goal is to transition to a full fledged centralized healthcare call center, then this does add a bit to the confusions during the interim.
Staff typically get confused about which schedules are available to the centralized call center vs which ones are not.
There are also several dependencies between provider schedules (based on visit types) that are not accounted for in this approach.
Opt–in of locations
– in this approach, you start a trial / pilot with only a few locations (or even a single location).
This allows you to start with locations that have a lower call volume.
This also allows you to start this “trial”, iron out the issues in call handling/scheduling before transitioning the entire practice / health system to using the centralized call center.
These are very similar to the issues you will face with the option above (opt in providers)
We ended up taking approach #1.
Centralized call center location growth plan
We knew that once the centralized call center started providing tangible benefits to the practice, this would increase the volumes of patient calls and would increase the volume of patients seen.
This in turn would also improve the practice reputation, which will contribute to increased patient visits and appointment calls.
We needed to be ready for the growth of this practice — which in turn would grow the call center staffing and the team size as well.
Based on the latest increase in minimum wages in the USA, our first approach was to have this call center location in USA states where the minimum wage was not as high as that of NYC.
However, after a lot of budgetary discussions and calculations, this option turned out to not be sustainable moving forward with the growth plans of the practice.
Next option was to locate the call center in Asia (India or philippines). Considering the fact that a large part of the patient population spoke South asian languages, our call center location needed to be based in India.
Centralized scheduling system
Our client was using CareCloud’s EPM for scheduling.
Each location had receptionists and front desk staff that would book appointments.
There were several scheduling rules based on provider timings per day as well.
On top of this, some specialists wanted to see specific visit types (e.g. RETINA, GLAUCOMA etc) while some ODs could very easily do other consults.
In addition to this, not all providers were at par with various payers, hence not all patients could be easily assigned to / appointed with all doctors.
Some patients had personal histories with specific providers as well — all added to the complexities of scheduling.
Most health systems’ front desk / receptionists have to deal with this situation wherein it is nearly impossible to translate such “localized knowledge” to a systemized process.
This almost always also leads to longer training and onboarding time needed to get a new hire started / productive.
When patients called for appointments, it took almost 10 minutes to get the patient an appropriate appointment that would work both for the patient and the practice.
The idea was to have the “system” do most of the work by processing these rules and presenting appropriate available appointment dates/times to the patient.
The longer term goal that we kept in mind was that the same functionality would also be made available on our client’s website — so that patients can self schedule their appointments.
Based on our goals, we connected our custom scheduling software to Carecloud, pulled in all the providers, schedules, block-outs, appointment templates etc and used a business rules engine in our custom software to achieve this.
The intent was to reduce scheduling times to less than 1 minute
Integrate practice management software with your call center software
However, none of the call center software is really integrated with your practice management software.
That’s where most of the challenges crop up.
For a call center customer service representative to be effective, they need to have easy access to your EMR / EPM and their access needs to be up-to-date in real time, as changes to your appointment calendar occurs, as patients flow in and out of the system.
This step is crucial for success and should not be overlooked.
You can try to get by with assembling spreadsheets to get the job done.
However, keep in mind that as soon as you export data from your practice management software into a spreadsheet, that data is, effectively, stale and out of date.
Our call center software integrates with most, if not all leading practice management software.
For this particular client, we needed to connect with Carecloud and our team was able to connect with Carecloud using its APIs.
We also have the option to connect via HL7 — should we choose to.
But, typically, integrating with HL7 is associated with added costs, hence we opted to not take that route and stuck with APIs instead.
Hiring the right call center supervisor and call center agents
The talent pool for call center customer service representatives is large and in many call centers, you can get away with having remote agents working from home.
However, healthcare call centers face a challenge wherein they need to handle HIPAA and SOC2 compliance very seriously.
Hiring a call center supervisor is crucial and depending on the size of your call center team, you might have to hire more than 1 team leads as well.
Our general recommendation is that one manager should have no more than 10 direct reports. So, if you have 30 call center agents, you are going to need 3 managers (at a minimum).
Our recommendation is not to skimp on hiring a call center supervisor. Call centers have a work culture of their own and unless you have led a call center before, you are in for a rude shock.
The industry behaves in a certain way and agent burnout + attrition is very high.
You need to constantly be hiring and maintaining a bench of call center customer service representatives to be good at this game.
You also need to be very careful of the agents you hire for your centralized healthcare call center.
Keep in mind that these are patients you are dealing with and patients need to be handled in a slightly different fashion than any other traditional call center customer.
You need to hire call center agents with empathy.. That’s quite possibly the biggest job requirement.
You also need to hire bilingual agents. In our case, we hire customer service representatives that speak English, South asian languages and Spanish.
We have noticed that only about 10% of callers truly do need Spanish support (we had thought otherwise).
Staffing and Scheduling a centralized healthcare call center
Efficient scheduling practices can have a significant impact on reducing staff burnout and turnover rates, leading to better patient engagement and satisfaction.
When staff members feel overworked or overwhelmed due to poor scheduling practices, it can lead to decreased job satisfaction, increased stress levels, and ultimately higher rates of turnover.
This not only affects the morale of the remaining staff members but also negatively impacts patient care.
Training and education
Proper training and support for administrative and front desk staff in appointment scheduling can improve workflows and handle time more effectively.
By providing education on best practices for appointment scheduling, such as how to prioritize appointments based on urgency or how to manage last-minute cancellations or no-shows, staff members are better equipped to handle their workload efficiently.
This leads to less stress and burnout among employees while also improving the overall patient experience.
Effective leadership and supervision can help manage staff schedules and ensure that clinical roles are properly staffed, reducing the workload on individual employees.
When leaders take an active role in managing schedules, they can identify potential issues before they become major problems.
They can also work with employees to create schedules that balance workload with employee needs for rest and recovery time.
Implementing improvements in scheduling and management practices can benefit the entire practice, from reducing wait times to improving overall patient experience.
For example, by implementing online appointment scheduling systems or automated reminder systems for patients, practices can reduce administrative burdens while also improving communication with patients.
This not only improves efficiency but also increases patient satisfaction.
In addition to these benefits for patients and staff members alike, there is a financial incentive for medical practices to invest in effective staffing and scheduling practices.
High levels of employee turnover are costly for any business due to recruitment costs associated with hiring new employees as well as lost productivity during periods of transition.
By reducing turnover rates through effective staffing strategies such as proper training programs or flexible work arrangements like telecommuting options when possible; medical practices stand a chance at saving money long-term.
HIPAA Compliance: Why Centralized Healthcare Call Centers Must Comply and Ensure Data Security
HIPAA compliance is mandatory for all healthcare providers, including hospital call centers that handle sensitive patient data.
The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 to protect the privacy and security of patients’ health information.
HIPAA regulations apply to all healthcare providers, including hospitals, clinics, pharmacies, insurance companies, and their business associates.
Failure to comply with HIPAA regulations can result in severe penalties and legal consequences for hospitals and their call centers.
Hospitals can face fines of up to $1.5 million per year for each violation of HIPAA regulations.
Loss of reputation
In addition to financial penalties, hospitals may also face damage to their reputation and loss of patients’ trust.
Hospital call centers must implement strict data security measures to protect patient information from unauthorized access, theft or misuse.
Patient data includes any information related to a patient’s past or present health condition, treatment history, medications, lab results, or insurance information.
Regular risk assessments
HIPAA requires hospitals to conduct regular risk assessments and implement appropriate safeguards to ensure the confidentiality, integrity, and availability of patient data.
This means that hospital call centers must identify potential risks to patient data such as unauthorized access by employees or third-party vendors; physical theft or loss of devices containing patient data; hacking attempts by cybercriminals; or natural disasters that could disrupt access to patient records.
Once potential risks are identified through a risk assessment process, hospital call centers must implement appropriate safeguards such as encryption of electronic communications containing patient data; secure storage of physical records containing patient data; access controls limiting who can view or modify patient records; logging and monitoring of user activity on systems containing patient data; disaster recovery plans ensuring timely restoration of critical systems after an outage.
HIPAA training for centralized healthcare call center
Hospital call centers must train their staff on HIPAA regulations and data security best practices to prevent accidental or intentional breaches of patient information.
Staff training should cover topics such as the importance of patient privacy; how to identify and report potential security incidents; how to use secure communication channels when transmitting patient data; how to properly dispose of physical records containing patient data.
HIPAA compliance is not only a legal requirement but also a moral obligation for hospital call centers to protect patients’ privacy and trust in the healthcare system.
Patients expect that their personal health information will be kept confidential and secure by healthcare providers.
Hospital call centers play a critical role in maintaining patients’ trust by ensuring that their sensitive information is protected from unauthorized access, theft or misuse.
One of the primary items in getting your call center to be SOC 2 compliant is the integration between your patient relationship management software / tool and your existing systems (EMR, EPM etc).
You need to follow a SOC 2 compliance checklist that guides you through these processes and includes measures like firewalls and malware protection.
You need to be able to demonstrate SOC2 compliance thus:
- Security protocols around how patient data is handled, how patient data access is tracked, time of access etc.
- Demonstrate training of employees to ensure that each customer service representative, supervisor, MIS personnel involved know security risks, procedures, and protocols
- Prove your compliance via extensive real-time and historical auditing of adherence to procedures and processes.
- HIPAA compliance is not very far away from SOC2 compliance in the sense that access, transmittal, mode of transmittal of ePHI is to be managed, monitored, audited and reported on. There are some excellent guidelines for enabling HIPAA compliance in your call center (e.g. read here).
Determine the right staffing for your call center
For this, you really do need to understand and implement the call center industry standard — Erlang C model.
There are several handy calculators you can use to determine your staffing need based on the Erlang C calculator. (e.g. here’s one).
Before you determine the right amount of staff you need, make sure that you know the total number of inbound calls handled per week/month and also understand the seasonality of call volumes.
You need to understand (from the steps above) which days a week call volumes are highest and staff accordingly.
Take care to understand what the typical call duration is and also find out which call types have what durations. E.g. your inbound appointment requests might need more time on call to go towards resolution while you pharmacy related calls might immediately be forwarded to your healthcare technicians (or otherwise).
Once you have figured out how many agents you need on the floor at all times, take some time to adjust for call center attrition, training, leaves etc.
We typically adjust the right staff size needed by 20% to account for bench and having the same staff sizing on the floor at all times.
Existing scheduling coordinators
Our recommendation is to hire someone with at least 2–3 years of scheduling experience in your practice as being a critical part of your team and being a mentor for new agents.
Healthcare practices typically do have high attrition rates in front desk/ receptionist staff.
Your mileage may vary on this one as you might not have folks with 3 years experience in scheduling your providers.
In that case, any of your existing scheduling coordinators would suffice — as they are required to train the centralized call center agents on the ins and outs or idiosyncrasies in scheduling for your practice.
Before you get started, ensure that you have an entire standard operating procedure written up by the scheduling coordinator(s) that are going to be doing the training / knowledge transfer.
This helps because new agents should have material for self-help and training before they spend 1–1 time on scheduling training.
Centralized healthcare call center training
Accuracy of appointments scheduled ends up being a sticking point for most of these transitions.
While the ability to handle more patient calls is great (and that’s why you started the call center in the first place), patient experience and appropriate / accurate appointment scheduling takes priority over volume of calls.
There are several items to check before we consider a scheduled appointment to be accurate. E.g.
- Correct patient name spelling,
- 1 or more patient phone numbers (mobile preferred),
- Correct DOB of patient,
- Whether doctor’s “desired” schedule was matched or not,
- Was the right doctor selected for the visit type,
- Was the appointment selected as per Nature Of Visit,
- Was the appointment booked as Per call notes,
- Was the call documented correctly (chief complaint, reason for visit etc)
- Referring provider / PCP info — was that collected or not
- Did we collect the source of patient appt (e.g. “where did they hear about us”)
- Was the correct payer name, plan name, member ID collected or not
- Was the patient advised on whether we accept that insurance or not
There should be a training / orientation program for call center agents so they clearly understand the importance of gathering each info and do actually gather all the information requested by management.
Most call center software have the ability to record all calls. Some of them face challenges because of where those call recordings are stored.
Medical call recordings have to be stored in a HIPAA compliant manner and therefore many of the industry leading call center software cannot be used.
We use Amazon Connect and it is very easy for us to record all calls in a HIPAA secure manner, and quite cheaply as well (AWS S3 storage is quite cheap).
Call recordings are a must have — you are going to need them for quality audit purposes and you are also going to need it for training purposes.
While there is a lot of value in training your call center agents via live 1–1 or a group training session, nothing beats the kind of training an agent can get if they listen to representative call recordings for the workflow they would be handling.
Auditing call recordings for supervisory purposes is mandatory. While it is never going to be possible for your supervisor to audit all call recordings, a random sampling of 10% of call recordings every day is more than enough.
There are several factors to audit recordings on — here are the ones we use.. E.g.
- Call opening
- Call probing
- Empathy displayed during the call
- Call resolution
- Script adherence
- Call closing
- Call compliance
These are just guidelines and your medical call center, along with your existing scheduling staff should develop their own metrics.
Sometimes it is better to not have all calls scripted — but we recommend preparing scripts for agents as you begin this journey.
While we do not force call center agents to follow the script religiously, we do expect the call center agents to follow the general guidelines of the script.
Having these scripts created also helps immensely with training and onboarding of call center agents.
At a minimum, you need to have scripts for the following workflows:
- – inbound calls for appointments scheduling, rescheduling, cancellations
- – inbound calls for surgical coordinations
- – inbound calls for pharmacy / medication related issues
- – inbound calls for billing related issues
- – inbound calls for insurance / eligibility related issues
- – inbound calls for patient balances
- – outbound calls for patient reminders
- – outbound calls for no show patients
- – outbound calls for reactivation of patients that have fallen out of care
- – outbound calls for patients that made an appointment and never showed up (no-encounter patients)
- – outbound calls for community outreach
- – outbound calls for patient balance reminders and collections
- – getting new patient referrals from existing patients
Do keep in mind that if you are calling on behalf of your own medical practice, you are a first party collector and do not have to handle Miranda rights to the extent that a third party collector has to.
Single number for the entire practice
We have dealt with situations where each location has its own phone number and patients have to remember each number.
However, our recommendation is that if you are creating a centralized healthcare call center, you should get a single, well branded number to represent your entire practice and all its locations.
Purchase toll free numbers
For our client, we purchased the numbers from http://www.tollfreenumber.com/ — this process was really easy and we received the Toll Free Birth Certificate very quickly as well. The next step was for us to port this toll free number to Amazon Connect.
Port numbers and Update IVR
Of course, the existing local phone numbers for each practice location also had to be ported into Amazon Connect.
After that, we simply ensured that we updated our client’s IVR to announce the new phone number to all our callers so they could update their own records.
Meanwhile, we also ensured the the call flow for each one of the older inbound phone numbers were the same as that of the new, main phone number we acquired for our client.
This call flow would be routed to our inbound call center agents, so callers/patients never really knew the difference in which number is actually being answered.
Each one of these individual offices had their phones hosted using freePBX.org and there were extensions for each staff.
New numbers for internal transfers
To resolve this challenge, we purchased a few more local numbers that were never to be published to the outside world and associated those phone extensions to the staff / doctors.
Whenever the call center received a phone call that needed to be routed to a particular staff, they would simply dial the “secret” phone number of the practice and dial the required extension.
Voicemail set up
Amazon connect does have a challenge wherein it does not allow for voicemails very easily.
This issue was resolved quite well by having a general voicemail box on one of these local phone numbers that would collect all the incoming voicemails for the call center agents.
The call center agents had access to the voicemail box and could return calls as needed/appropriate.
While this transition was being planned and prepared for, we also had all the marketing materials of our client updated (including the website).
Our client had ongoing PPC campaigns and these campaigns did use call tracking numbers.
This became a challenge because these call tracking numbers were allocated to each practice location.
That was the only hiccup we faced during this entire transition.
Centralized healthcare call center testing
Before we rolled out the centralized call center, we took the time to test things out first.
The existing inbound numbers remained as they were.
- Our call center agents took mock calls on the inbound phone number that we purchased.
- Our agents responded to various scenarios that inbound calls typically come in for.
- We also tested the call volumes that are expected on Mondays- Wednesdays for our client.
As expected, the call center IVR, call center agent response times, call drops etc went well — however we still had to tweak the appointment scheduler a bit.
The business rules that were powering the appointment scheduler database were not enough and the agents had to spend more than necessary time on scheduling an appointment.
We spent some more time on the appointment scheduler logic that reduced the time spent by a call center agent on scheduling an appointment.
On top of this, it also reduced the amount of auditing work that needed to be done that appointments were being scheduled correctly.
Only after a test run of 1 week, did we actually transition all the existing local numbers to Amazon Connect.
Do note that this porting process takes 1–2 weeks so we kicked off the porting process before we started our trial.
On the day of the actual porting activity (handled by amazon connect support entirely), it barely took 1–2 hours before wrap up. However, our systems were thoroughly tested already.
During our planning and design phase, we created a plan to address patient, provider, and staff issues/concerns.
As noted above, we designated a patient access director that greatly helped ease these challenges/complaints.
We had the patient access director be a liaison between the call center supervisor and the practice staff + providers.
Centralized healthcare call center metrics
We had already established the call center metrics that we were going to monitor moving forward.
A brief list of those metrics that were planned for are below. Note that Amazon connect does give us a few of these metrics in its daily reports.
The only challenge with Amazon’s reports are that they are limited to 3K rows of data (and we had a lot more than 3000 calls per day).
- Inbound calls handled per agent
- Inbound calls response time
- Abandoned calls per day
- Longest call hold times
- Peak hour traffic (for us, this is early during the day Mon-Wednesdays)
- No shows reappointed per agent
- Patients reactivated per agent
- Patient balances collected per agent
- Average call handle time
- After call work time per agent
- % calls answered within the first 20 seconds.
- Calls resolved on first contact
- Appointment reminders made successfully per agent
- New patients acquired per agent via community outreach
- New patients acquired per agent via patient referrals
- New referrals received per agent via inbound calls
- New referrals processed per agent via outbound calls
- New patients acquired per agent
- Call source (“where did you hear about us”) per agent
- Agent utilization per day
Efficiency Optimization Procedures for Centralized Medical Call Centers
Lower Total Operating Expenses through Answering Efficiency
By streamlining processes and utilizing technology such as automated call routing, these call centers can optimize their answering efficiency, which can lead to significant cost savings.
For example, by reducing wait times and improving first-call resolution rates, centralized medical call centers can reduce the number of calls that need to be escalated or transferred to other departments.
This not only improves patient satisfaction but also reduces the workload for staff members who handle escalations and transfers.
In addition, by automating certain tasks such as appointment scheduling or prescription refills, centralized medical call centers can free up staff time for more complex tasks that require human intervention.
This can improve overall productivity while reducing labor costs.
Large Surgical Practices Benefit from Centralized Call Centers
Centralized medical call centers are particularly beneficial for large surgical practices that receive a high volume of calls.
Rather than having individual offices manage their own call volume, a centralized call center can efficiently handle all incoming calls and route them to the appropriate department or specialist.
This not only reduces the workload for individual offices but also ensures that patients receive consistent and timely service regardless of which office they contact.
It also allows for better coordination between departments and specialists, which can improve patient outcomes.
Reducing Average Call Transfer Rate with a Pro Tip
One effective way to optimize answering efficiency in centralized medical call centers is by reducing the average call transfer rate.
When callers are transferred multiple times before reaching the appropriate department or specialist, it not only leads to frustration but also increases handling time and reduces overall efficiency.
To reduce average transfer rates, one pro tip is to implement a process where calls are routed directly to the appropriate department or specialist based on caller input or pre-determined criteria.
For example, if a caller selects an option indicating they need assistance with billing questions, they could be automatically routed to the billing department rather than being transferred multiple times.
This not only reduces transfer rates but also improves first-call resolution rates and overall efficiency.
It also provides a better experience for patients, who are more likely to be satisfied when their calls are handled quickly and efficiently.
Process Optimization for Total Operating Expenses
Another way to optimize efficiency in centralized medical call centers is through process optimization.
By analyzing current processes and identifying areas for improvement, call centers can reduce waste, improve productivity, and lower total operating expenses.
For example, by implementing standardized scripts or templates for common inquiries, staff members can handle calls more efficiently while ensuring consistent service quality.
By automating certain tasks such as appointment reminders or prescription refill requests, staff time can be freed up for more complex tasks that require human intervention.
In addition, by monitoring key performance indicators such as average handling time or first-call resolution rate, call centers can identify areas where further optimization is needed.
This allows them to continuously improve processes over time and achieve greater efficiency and cost savings.
Developing Standard Operating Procedures for centralized healthcare call centers
Developing standard operating procedures (SOPs) is the first step towards ensuring compliance with regulations and standards in a centralized medical call center.
SOPs should be based on best practices and industry standards to ensure that all practices are aligned with the goal of providing high-quality medical support to patients.
In this section, we will discuss the importance of developing SOPs, how to develop them, and how to ensure compliance with relevant regulations.
The Importance of Developing SOPs
Standard operating procedures are essential for any organization that aims to provide consistent service quality.
They are a set of instructions that guide employees on how to perform their daily tasks in a standardized manner.
Developing SOPs ensures that all staff members follow the same process when performing specific tasks, which helps eliminate confusion and errors.
In a centralized medical call center, where patient lives may be at stake, having well-defined SOPs is crucial.
The procedures should cover every aspect of the call center’s operations, from handling calls to dispatching emergency services.
By following established procedures, staff members can provide timely and accurate medical assistance while minimizing errors.
How to Develop SOPs
Developing effective SOPs requires careful planning and execution. Here are some steps you can take:
- Identify the processes: Start by identifying all processes involved in running the call center. This includes everything from answering calls to managing patient information.
- Analyze current practices: Analyze current practices to identify areas where improvements can be made or inefficiencies eliminated.
- Research best practices: Research industry best practices and standards related to each process identified earlier.
- Draft the procedures: Based on your research, draft detailed procedures for each process identified earlier.
- Review and refine: Review each procedure with relevant stakeholders such as managers, supervisors, or team leaders for feedback before finalizing them.
- Train staff members: Train all staff members on the newly developed SOPs to ensure that they understand and can follow them.
Ensuring Compliance with Relevant Regulations
Compliance with regulations and standards should be an ongoing process, with regular reviews and updates to procedures as needed to ensure that the call center continues to provide the best possible medical support.
One such regulation is SOC2 compliance, which ensures that organizations have adequate controls in place for data security, availability, processing integrity, confidentiality, and privacy.
Regular training and practice sessions should be conducted to ensure that all staff members follow the established SOPs and comply with relevant regulations.
Staff members should also be made aware of any changes in regulations or standards that affect their work.
In addition to training staff members on SOPs and regulations, it is essential to monitor compliance regularly.
This can be done through internal audits or external assessments by third-party auditors.
The results of these audits should be used to identify areas where improvements can be made or inefficiencies eliminated.
Conclusion: The Benefits of a Centralized Medical Call Center
A centralized medical call center can provide numerous benefits to both patients and healthcare providers. In this section, we will explore some of the key advantages of utilizing a centralized call center in a healthcare organization.
Improved Patient Outcomes and Satisfaction
One major benefit of a centralized medical call center is that patients receive timely and accurate information about their health concerns. This can lead to improved patient outcomes and satisfaction. By having a single point of contact for all medical inquiries, patients are less likely to experience confusion or frustration when seeking information about their health.
Streamlined Communication Between Healthcare Providers
Another advantage of a centralized call center is that it streamlines communication between healthcare providers. This can reduce errors and delays in treatment, leading to better overall success rates. When all members of a healthcare team have access to the same information, they are better equipped to make informed decisions about patient care.
Advanced Technology for Efficient Triage
The use of advanced technology in a centralized call center can enable more efficient triage of patients, ensuring that those with urgent needs receive prompt attention. For example, automated systems can help identify high-risk patients who require immediate medical attention. This allows healthcare providers to prioritize care based on the severity of each patient’s condition.
Reduced Healthcare Costs
A centralized call center can also help to reduce healthcare costs by minimizing unnecessary emergency room visits and hospital admissions. By providing patients with timely access to medical advice and resources, they may be able to avoid costly trips to the emergency room or hospital stays. This not only saves money but also reduces strain on the healthcare system as a whole.
Improved Data Tracking for Quality Improvement
With a centralized call center, healthcare providers can more easily track patient data and outcomes, allowing for continuous quality improvement and increased success rates over time. By analyzing data from calls made to the central call center, organizations can identify areas where improvements are needed and implement changes accordingly.
Enhanced Reputation for Quality Care
Finally, a centralized call center can improve the overall success of a healthcare organization by enhancing its reputation for quality care and patient-centered service. Patients who have positive experiences with a centralized call center are more likely to recommend the organization to others, leading to increased referrals and growth.
Final Thoughts on Centralized Healthcare Call Centers
In conclusion, a centralized medical call center is an essential component of any healthcare organization. It provides patients with access to skilled advocates who can assist them in navigating the complex world of healthcare. By optimizing efficiency and ensuring compliance with regulations and standards, these centers can help reduce costs while improving patient outcomes.
One of the key benefits of a centralized medical contact center is its ability to measure healthcare call center metrics and KPIs for efficiency optimization. By monitoring average handle time, first-call resolution rate, abandonment rate, and other metrics, these centers can identify areas for improvement and implement procedures to increase efficiency.
Efficiency optimization procedures are critical for centralized medical call centers. These procedures include developing standard operating procedures (SOPs) that ensure compliance with regulations and standards. SOPs should be regularly updated to reflect changes in regulations or best practices.
Patient access center services are another important aspect of centralized medical call centers. These services address specific patient needs by providing skilled advocates who can assist patients in scheduling appointments, obtaining referrals, and accessing other healthcare resources.
HIPAA compliance is also crucial for hospital call centers. HIPAA regulations require that all patient data be kept secure and confidential at all times. Hospital call centers must comply with these regulations to ensure that patient data remains safe from unauthorized access or disclosure.
Real-time eligibility verification and preauthorization tracking are two additional features that can help optimize call center efficiency for patient management and follow-up. By verifying eligibility in real-time and tracking preauthorizations, these systems can help reduce denials while improving revenue cycle management.
Staffing and scheduling are also critical components of successful centralized medical call centers. Reducing turnover and burnout among staff members is essential for maintaining high levels of patient engagement over the long term.