Medical call center guide

Comprehensive medical call center guide. We use these steps to manage medical call centers for eye care and cardiovascular practices. See the results – you can get the same as well.

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Table of Contents

Here’s a comprehensive medical call center guide based on my experience of growing group practices of specialists and PCPs.

Medical Call Center Performance Achieved

We manage medical call centers for eyecare and cardiovascular practices. Here are the results. You can achieve the same as well.

  • 85% of daily appointments were made proactively by our call center team
  • NJ cardiovascular group booked 3x more appts per day by us handling 3x more calls per day
  • An NYC ophthalmology group grew 148% in 12 months due to the patient volume generated by our medical call center
  • Patient visit volume grew from 2,220 / month to 5,300/month in 3 months.
  • Patient work up / intake reduced by 25 mins per new patient.
  • Net new patients added via community outreach calls at a cost of $40/patient
  • Increased positive patient reviews from 22 to 1,000+ in 12 months. This led to a huge influx of inbound patient inquiries.
  • $500+ K patient dues recovered
  • 56% denials recovered in 1 quarter by staying on top of payer representatives

Summary

Leveraging a medical callcenter rather than using only a medical answering service helped me grow my group practice tremendously. We followed the following strategy.

  1. 80% of daily patient appointment volume should be from existing patients.
  2. Taking a preventive care approach with existing patients provides undeniable health benefits to patients in addition to keeping your office busy.
  3. Being proactive about appointing patients is key to this strategy.
  4. 20% of new patient volume comes from inbound patient appointment requests and your own business development activities. 
  5. Inbound patient appointment requests volume is directly related to patient reviews on Google.
  6. Your business development activities should include physician referral outreach and community outreach.

What a medical call center can do

Medical call centers that are experienced in your specialty can help you with the following.

Medical practice growth

Following are what I had my call center team do for our group practice.

  • Community outreach campaigns to get new patients
  • Referring physician outreach to get new referred patients
  • Answering all incoming queries from 
    • Google My Business
    • Facebook
    • Website chat
    • Telephone
    • Text messages
    • Emails
    • Faxes
  • Handle all appointment related activities
    • Patient recall
    • Patient referrals (incoming and outgoing)
    • Appointment scheduling / rescheduling / cancellations
    • Appointment eligibility checks
    • Appointment reminders, reactivations
    • Demographics, insurance proofs (ID card, insurance cards)
  • Handle all patient intake
    • Chief complaint
    • History of present illness
    • Social, Family, Medical history
    • Medication history and medication reconciliation 
  • Manage all faxes (incoming and outgoing) related to 
    • Referrals
    • Medical records
    • Vendors
    • Legal requests
    • Prescriptions
  • Managing prescription related calls and faxes
    • Appoint patients not seen in 6 months
    • Confirm prescriptions and if substitutes are allowed based on physician orders
    • Send prescription via fax to pharmacies if they’re not enrolled in eRX
    • Prior authorization requests for specific RX (ePAs)
  • Handled all billing related tasks 
    • Calls with billing related queries
    • Payer denials
    • Prior authorizations
    • eligibility
  • Surgery coordination 
    • Entering paper surgery orders to our surgery scheduling system
    • Prior authorizations related to surgery, laboratory, diagnostic procedures, transportation & medication orders
    • Laboratory procedure appointments, reminders, report collections on behalf of patients
    • Imaging / diagnostic procedure appointments, reminders, report collections on behalf of patients
    • Medical clearance, COVID clearance appointments, reminders, report collections on behalf of patients 
    • Medications orders, reminders, adherence confirmation on behalf of patients
    • Transportation appointments, reminders on behalf of patients
    • Patient reminders, status updates, queries
    • Surgery deposit collections, patient signatures
    • Coordination with ambulatory surgery centers and hospitals
    • Post operative documentation gathering, post op instructions
    • End to end surgery scheduling operations

Employee Wellness

  • Schedule + complete preventive screenings to reduce chances of serious illnesses
  • Triage and navigate all care requests based on clinical appropriateness, plan policy and employee choice
  • Get immediate or urgent care via virtual care
  • Reduce absenteeism for unnecessary visits
  • Save money on co-pays and deductibles
  • Medication adherence and reminders

How a medical call center gets more patients

A dedicated medical call center (whether you have it in-house or you outsource it) should do the following:

  1. Run + manage various campaigns on existing patients (example list)
    1. Reactivation campaign
    2. No shows campaign 
    3. Cancelled patients campaign
    4. No encounters campaign
    5. Patient reviews campaign
  2. Run + manage various campaigns for new patients from
    1. Existing referring partners
    2. New referring partners
    3. Community outreach
    4. Existing patient referrals

How does remote referral marketing outreach work?

Make sure to assign several medical call center agents as referring physician liaisons to make calls throughout the week.

These referring physician liaisons work to establish rapport & educate via the phone. They also determine who the key decision makers at the referring partners are.

The physician referral marketing team can also set up appointments for meetings between staff from your office with decision makers at the potential referring office.

medical call center - physician referral marketing
medical call center – physician referral marketing

How long does it take to generate new physician referrals?

It takes at least 3 months to start seeing results. Over these 3 months, the potential referring physician should be contacted at least 6 times. As you are well aware of, it takes time to build rapport and credibility with referral sources. In some highly competitive towns/cities in California, Florida, New York this might take longer.

Want our patient access team to help? Reach out.

    How to run healthcare campaigns with a medical call center

    1. Decide on the return of investment you expect from each campaign
    2. Identify the people, processes and technologies for your campaign
    3. Define your health campaign
    4. Prepare your campaign’s data
    5. Execute your campaign
    6. Monitor your campaign and improve

    Callcenter return on investment

    Here’s a simple way to calculate your expected return on investment on the medical call center (in-house or outsourced).

    1. Let’s say that each day, a single agent can dial about 200 patient phone numbers. They could dial a lot more if they are using the right call center software.
    2. Out of all patients called per day per agent, I found that about 20% (i.e. 40) patients pick up the call. So, each agent is going to talk to 40 patients a day.
    3. In my experience, out of the patients that agents talk to, about 50-70% agree to be re-appointed. So, each agent can re-appoint about 25 patients a day.
    4. Net-net, out of 200 patient calls per day per agent, you win 25 patients back, lose 15. This means that your agent is left with 160 patients per day to add to the next day’s calling workload / queue.
    5. So, conversion is 25 / 200 = 12.5%. In other words, you can add 40 more contacts to your agent’s list.
    6. If each patient gets exactly 1 call per week, this means that your agent would need 200 * 5  = 1,000 numbers to contact.
    7. Each day, 40 numbers are removed from their calling list. In 5 days, you can add 40*5 = 200 more numbers. So, you might want to start with approximately 2000 numbers per agent, per month (there will be many wrong numbers as well).
    8. Using this math, you can decide how many agents you need to hire. e.g. if you have 4,000 patients, you would need a minimum of 2 callcenter representatives handling ONLY outbound calls.

    Revenues per patient

    You should know the average collections per patient being re-appointed. Assume this to be $100/- per follow up appointment per patient.

    If you are adding 5*25 = 125 patient appointments from a campaign and only 70% of them show up, you have 88 * $100 = $ 8,800/- in additional revenues per week.

    If you hire our team (minimum 10 for inbound + outbound) your cost will be $1,760/- per agent per month. You will profit about $33K per month per agent.

    Based on this calculation, How many return patients do you need from this campaign to break even?

    Do not start without defining this. 

    That’s how much one agent is contributing to your top line per week. In a month, you are looking at approximately $35K new revenues per agent you have.

    Medical call center people, processes and technologies needed

    All of this is great on paper but will not work unless you have the right people, processes and technologies to support your initiative.

    Call center technologies to use

    • I highly recommend not running these campaigns straight out of your EMR. Instead, you should use a HIPAA compliant patient CRM that ties into your EMR.
    medical call center software
    medical call center software
    • Your medical call center staff can certainly use their desk phones to do all the calling, but my recommendation is to use a healthcare call center software for this purpose. The productivity gains are tremendous
    • For SMS, I recommend using a medical CRM software for SMS texting. It gets impossible to manage the volume of SMS sent if you are using staff cell phones to send SMS. According to the Pew Research Center, 31% of Americans prefer text messages to phone calls. Gallup reports Texting is the most frequently used form of communication among Americans younger than 50.
    medical call center - text messaging
    medical call center – text messaging

    Medical call center people / staffing

    Hiring the right call center supervisor and call center agents is crucial. Make sure you hire someone with medical call center experience.

    Call center agents

    You can get away with having remote agents working from home (know how to handle HIPAA and SOC2 compliance).

    Hire call center representatives with empathy. Do not hire staff that prefer volume work over work with empathy.’

    Hire career call center representatives – i.e. people that have been agents for a majority of their careers. The remaining talent is typically using your call center job as a “stop-gap” in their careers.

    The industry 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. 

    Medical call center supervisor

    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.

    My 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). 

    Do not skimp on hiring a call center supervisor.

    In addition, do not underestimate the importance of a training program for your call center. I cannot state this strongly enough. Your supervisor will be responsible in defining the training as well.

    Director of patient access

    Initially, this might not seem as very important, but having a single medical call center coordinator / director of all patient access challenges is crucial.

    This person is directly responsible for patient access, satisfaction, maintaining KPIs related to patient AND provider satisfaction.

    Steering committee

    This is a disruptive and transformative change in your small business or 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.

    Try to include the receptionists from each office location and the office manager.

    Include someone from the medical billing department. They have a LOT of inputs into what the receptionist must do / the information that the front desk must gather from patients. This helps them avoid downstream issues in the medical billing process.

    Want our patient access team to help? Reach out.

      Callcenter processes

      Define the daily process that your staff must follow. You can do it anyway you prefer. Here’s our recommendation.

      1. Start of campaign – prepare the backlog of patients to be called. I recommend using a medical CRM to handle the following automatically, but you can also use spreadsheets.
      2. Start of the month, give the next 2 weeks’ data to the agents. This way, each agent will have 250 calls (target) per day * 10 days = 2,500 patient records to call.
      3. End of each day, each agent should hand over their daily updates to the staff member dealing with data and reports.
      4. At the start of the next day, the data person should take the previous day’s agent spreadsheets and update the EMR + the baseline spreadsheet with the agents’ dispositions.
      5. At this time, the data person would also pull all updates from the EMR (for these patients that are being called on) and rework each agents’ spreadsheets if needed.
      6. At the end of 2 weeks, the data person would hand over a new spreadsheet to each agent. This will contain the patients to call over the next 2 weeks. This spreadsheet will be prepared by shuffling the patient phone numbers randomly between all calling agents so that each agent doesn’t get into a rut of calling the same patient. This also helps because the patient sees a different phone number dialing in.
      Call dispositions

      We use the following (you can have your own). To avoid handling these headaches, use a medical CRM.

      • DONE – this means that the patient was re-appointed
      • NOANS – this means that the patient did not answer the phone. I recommend that your team calls them back next week (i.e. it goes into next week’s backlog)
      • LVM – this means that the agent left your patient a voicemail. This is a bit tricky because if the patient calls back and books an appointment, usually another agent answers the call. You need to ensure that this agent also updates the spreadsheet with the fact that the patient now has an appointment hence should be removed from your no-shows campaign.
      • WNUM – this means wrong number. Yes, it happens ALL the time.
      • CBACK – this means that the patient has asked for a call back at a certain date/time or both. The agent needs to be able to set a reminder for themselves to call the patient back.
      • LOST – this means that the patient has either found another doctor or has decided that they do not want to come in for an appointment (i.e their need has been met). Usually, I put these patients in another campaign to try and win them back.
      • DCONN – this means that the patient’s phone number is disconnected. The patient population that my clients work with tends to have this happen to them (obamaphones).
      • UNAVLBL – this means that for whatever reason the patient is not available, but the phone number is correct (e.g. someone from their family picked up the phone but your agents are not allowed to book appointments unless they speak to the patient directly)
      • HUNG UP – this also happens wherein a patient simply hangs up. Don’t call them back immediately but try reaching out to them the week after.
      • DNC – this happens (for whatever reason) when the patient does not want to be called any longer. They tell your agent to not call back again – these are a separate category of patients that are lost. DNC is something that I consider as non-recoverable, where as LOST patients is something that I consider as LOST for now, but will try to win back later.
      • RECONFIRMED – sometimes due to data errors, the agent runs into situations where the patient has already called in and made an appointment to come back, but the agent’s spreadsheet does not reflect this new appointment. In that case, the agent simply confirms the new appointment date/time.
      • DUPLICATE – happens all the time where the patient record is a duplicate in the spreadsheet they are working off of.
      Max attempts per patient

      I have typically defined this as five(5) – ie our BPO team should call the patient at least five times before they give up on that patient.

      Medical call center - call tracker
      Medical call center – call tracker

      Define your campaign

      I recommend that you start only one campaign at a time until you get good at operations. You can run any of the following campaigns (one or more).

      1. Reactivation campaign
      2. No shows campaign 
      3. Cancelled patients campaign
      4. No encounters campaign
      5. Patient reviews campaign
      6. Existing referring partners
      7. New referring partners
      8. Community outreach
      9. Existing patient referrals

      Prepare your campaign’s data

      1. Export data as spreadsheets or CSV file – keep in mind that as soon as you download the data, it is obsolete because within 5 mins, your staff could update the EMR and one or more of the records you downloaded, would be stale. This is usually free.
      2. Connect via APIs – as per CMS mandata, each EMR is expected to have API connectivity into their data for ONC certification (typically this is free as well). Keep in mind that when you connect via APIs, you pull data as and when needed. As soon as you pull data, that data might be obsolete as well, since 5 mins after pulling the data from your EMR via APIs, someone from your staff might have updated the EMR with changes.
      3. HL7 integration – this is true, real time integration. As soon as a change happens in your EMR, the data is pushed via secure FTP as a new record so your application can act on it. This means that you always get the latest and greatest changes pushed to you. 

      Almost every EMR allows you to get data from it. Here are a few ways:

      Execute your campaign 

      You can decide to set aside a few hours each day, start dialing, dispose the call with an outcome, notes and follow up if any required.

      Keep adding to the list, keep working the list (never ending process). Understand the basic math as mentioned above.

      In one week, the backlog of calls to be made adds up significantly.

      Do not let patient data get stale. If you need more people to add to this team, do so and you will reap the rewards.

      Monitor your campaign

      Monitor the performance of your efforts and fine tune calling times if needed.

      Calling times

      I have noticed that certain cohorts of patients tend to pick up the phone early in the morning, around lunch time and then again around 4 PM onwards. Another set of patient demographics seems to pick up the calls throughout the day. 

      Number of calls

      I have also experienced that the conversion rate seems to decrease as the total number of calls to the same patient increases. This means that if the patient picks up the phone in the first try, the chances of reappointing them are close to 100%, if they pick up at the second try, the chances go down a bit to around 70% or so, if they pick up on the 3rd try, it reduces further etc. 

      Fine tune the number of calls to be made before you give up on that patient.

      Medical call center – call list

      Want our patient access team to help? Reach out.

        KPIs for your contact center

        Before you get started, try to gather at least the following metrics / business intelligence (current state). These would be the same KPIs you would measure once you start your medical contact center as well.

        1. Scheduling correct appointment
        2. Average speed to answer
        3. Duration of call
        4. Call hold times
        5. Total or % abandoned calls
        6. Call volumes per week/month
        7. Call volume trends by day of week
        8. Customer satisfaction
        9. No show rates of appointments that were scheduled more than 2-3 weeks before appointment date

        Reporting

        I recommend using a medical CRM instead of dealing with these headaches.

        COLUMNDESCRIPTION
        DISPOSITIONThe outcomes as we discussed
        APPT DATEThe appt date (if the patient was re-appointed)
        REMARKSAny call notes/ remarks / patient insurance updates etc
        CALL DATEThe day of today’s call
        LAST CALL DATEThis is important for other agents to understand how many more calls have been made to the same patient phone number
        REQUIREDTHESE COLUMNS ARE REQUIRED TO DO A GOOD JOB
        LAST ENCOUNTER DATEThe last encounter date of the patient. This helps drive the campaign.
        LAST APPT DATEThe last date when the agent had an appointment – doesn’t matter if they cancelled it or were a no-show. Hopefully this is the same as the last encounter date.
        NEXT APPT DATEThis is very important to know because you don’t want to be trying to re-appoint a patient that already has an appointment within the upcoming 3-4 weeks
        medical call center reporting needed
        medical call center reporting
        medical call center reporting

        I tend to include columns like these (yours can be different to suit your needs).

        • Assigned Date – the date this patient account was assigned to the agent. I want to monitor if they are actively working the accounts given or not.
        • Disposition – outcome of the call
        • Call date – 1st call date
        • 2nd call date – self explanatory
        • 3rd call date – self explanatory
        • 4th call date – self explanatory
        • 5th call date – self explanatory
        • Notes in your EMR – whatever be the outcome of the call, the agent puts this in EMR as an “after call work”.

        Total costs of ownership of a medical contact center

        Operating costs of a contact center would generally break down into a few well known categories. You’re going to have the following (for each location of your business):

        1. Real estate costs
        2. Infrastructure costs
        3. Utilities costs
        4. Hiring costs
        5. Training costs
        6. Payroll expenses 
        7. Technology expenses

        Technology related items

        At a minimum, you are going to need to plan for:

        • Inbound phone numbers that you provision via your carrier or a VOIP provider.
        • Extension set ups or direct inward dial (DID) numbers for each team member.
        • Computers.
        • Headsets.
        • Physical phones if that’s how your call center will operate.
        • Voicemail set up if you need it
        • Web based chat software if you support that channel at your call center
        • Software to enable customers to text your call center
        • Soft phones (not all soft phones are alike)
        • A reliable, reputable call center software
        • Automated call distribution capabilities
        • Skill based routing capabilities
        • Call queues and routing profiles capabilities
        • Medical CRM
        • Call recordings – Audio file storage facility
        • IVR set up
        • Reporting and analytics software
        • WhatsApp support software
        • Facebook chat if you support that channel
        • iMessage software if your call center supports it as a channel
        • HIPAA controls and audit software
        • SOC2 compliance controls and audit software

        Centralized medical call centers

        A centralized medical call center essentially just centralizes call center functions to a single team, at a single location.

        Centralized call centers are typically off-site.

        The team in itself doesn’t necessarily have to be co-located. It is, however, important that the same processes and medical call center workflows are followed by the entire centralized contact center team.

        In a centralized medical contact center, you are centralizing

        1. Medical contact center technology and infrastructure into one
        2. Medical contact center management, training, security management into a single location
        3. Inbound and outbound contact types that your Medical contact center will handle
        4. Centralizing telecom costs

        When centralized medical contact center makes sense

        A centralized contact center brings in economies of scale and all the benefits from achieving economies of scale.

        If your contact center is going to be staffed with only a handful of staff, there would be no economies of scale to achieve. You don’t need scale as much and won’t need to centralize your contact center.

        However, a decentralized contact enter model allows you to leverage several benefits as well.

        • Labor arbitrage across locations wherein certain locations might be significantly cheaper than other locations. 
        • Real estate costs across locations might also vary significantly.
        • Having multiple locations allows you to have a backup site in case of natural disasters in one of your other call center sites.
        • In certain businesses, customers might simply prefer being served in their local languages.

        Want our patient access team to help? Reach out.

          How to start a centralized medical contact center

          You could take one of these approaches

          1. All locations and all doctors / service providers in one shot
          2. Opted-in doctors / service providers only
          3. Opted-in locations only

          All practice locations and all service providers

          In this approach you decide on a cut over date and transition your entire practice and all its service providers to your centralized contact center. There are several pros and cons to this approach.

          Pros
          • 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 service providers’ personal preferences
          Cons
          • 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.

          Opted-in doctors / service providers only

          In this approach, your service providers 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. 

          Pros
          • 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 customer to “follow” a service provider of their choice. This allows you to test the waters and iron out the kinks in the transition process before bringing other providers onboard.
          Cons
          • This is only a stop gap solution.
          • If the end goal is to transition to a full fledged centralized 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 service provider schedules (based on visit types) that are not accounted for in this approach. 

          Opted-in locations only

          In this approach, you start a trial / pilot with only a few locations (or even a single location). 

          Pros
          • 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.
          Cons

          These are very similar to the issues you will face with the opt in providers option.

          HIPAA security and SOC-2 compliance of medical call centers

          One of the primary items in getting your call center to be SOC 2 compliant is the integration between your customer 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).

          Medical call center scripts

          If your staff is experienced in recalling and reappointing patients – you might not need scripts. However, if you are hiring brand new staff to run medical campaigns, you should prepare calling scripts.

          At a minimum, you need to have scripts for the following workflows:

          • Inbound calls related
          • Outbound calls related
          • Appointments scheduling, rescheduling, cancellations
          • Surgical coordination
          • Pharmacy / medication related issues
          • Customer balances collections
          • Insurance / eligibility related issues
          • Billing related issues
          • Customer appointment reminders
          • Reactivating no-show customers
          • Reactivating customers that have fallen out of care
          • Appointing no-encounter customers
          • Community outreach
          • Customer balance reminders and collections
          • Getting new customer referrals from existing customers
          • Past due collections. Here, do keep in mind that if you are calling on behalf of your own 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 handle.

          The following scripts are recommended to be used after introducing yourself and the usual niceties

          Script to reappoint cancelled patients

          “Well, I’m calling because we had to cancel your appt recently and upon reviewing your chart, our doctor recommended that we set up a video call with you and our doctor. This will help our doctor determine your care plan.”

          OR, if the patient had cancelled the appointment themselves.

          “Our clinical team looked at why you had needed the appointment in the first place. They feel that you should definitely have our doctor look at it further. This will help us possibly figure out the underlying cause. We don’t want to let that recur later on. Have you seen a doctor for this yet?”

          Script to reappoint no-show patients

          “Our clinical team noticed that you had missed your appointment on <date/time>. Are you OK? What happened?”

          Many patients are no-shows or cancel due to work reasons. Being able to do a televisit allows them to not have to travel and not have to take time off of work.

          This way, you at least retain the patient.

          Of course, if the patient wants to come in to the office, you don’t decline the appointment. The most important thing to keep in mind is that the next appointment should be ASAP – not 2 weeks away. If that requires a televisit appointment, so be it.

          “Our clinical team looked at why you had needed the appointment in the first place. They feel that you should definitely have us look at it further. This will help us possibly figure out the underlying cause. We don’t want to let that recur later on. Is a video call easier for you?”

          Script to convert follow up appointments to tele visit

          “Well, I’m calling because you have an upcoming appt on < date time > and upon reviewing your chart, our doctor recommended that we set up a video call with you and our doctor. This will help us determine your care plan and next steps..”

          Script to request referrals from patients

          1. When the agent speaks with a patient to confirm their appointment, the agent asks the patient something as simple as “As you know, we are a young practice. Can you think of anyone that you would recommend our doctors to?”.
          2. If the patient mentions names/numbers – the agent takes that information down, calls the referred patient and introduces themselves as “Hi, I am calling from <your practice name>. I was talking to <the actual patient name> about their upcoming appointment. They wanted to recommend doctor <provider name> to you. Hence, I am calling”.. 

          Script for community outreach

          I am calling people in our neighborhood to let them know how we can be of service. 

          Remember, you are just introducing yourself and don’t expect an appointment.

          “Just wanted to let you know that help people that are facing issues with their <add some chief complaints here>. Our doctors are available to see patients via video calls as well. If you know of someone that needs help related to <your specialty>, could you please let me know?”

          … answer questions etc.. 

          The goal here is NOT to have the patient make an appointment with your provider, but rather, to be aware of your service offering.

          So, while the patient is on the call with your agent, use this script to get the cell phone number of the patient.

          Why don’t I send you an SMS with our locations and phone numbers so you can forward it to friends and family?”

          OR

          Sure, I can set you up with a video call appt with one of our doctors”

          Want our patient access team to help? Reach out.

            Medical call center training

            Establish a training program – do not skip this.

            • Medical contact center agents need to understand the importance of security, how you want your brand represented, data crucial for smooth back office operations etc.
            • Accuracy of appointments scheduled ends up being a sticking point for most of these transitions. While the ability to handle more customer calls is great , customer experience and appropriate / accurate appointment scheduling takes priority over volume of calls.
            • There are several items to train on. These are also the same measures that your quality assurance staff would monitor. Some examples are below
              • Correct spelling of caller’s name
              • 1 or more customer phone numbers (mobile preferred)
              • Correct DOB of patient / customer
              • 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 they collect the source of patient appt (e.g. “where did they hear about us”)
              • Was the correct payer name, plan name, member ID collected
              • Was the patient advised on whether you accept that insurance

            Try to have agents participate in mock calls before they take live calls from callers.

            Call recordings for supervision and training

            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.

            Most medical call center software have the ability to record all calls. Keep in mind that medical call recordings have to be stored in a HIPAA compliant manner. 

            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 suggestions.

            • Call opening
            • Call probing
            • Empathy displayed during the call
            • Call resolution
            • Script adherence
            • Call closing
            • Call compliance

            Want our patient access team to help? Reach out.