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.

Categorized as Contact Center, Guides

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

Today’s Problem: Fragmented Healthcare Experiences

Fragmented healthcare experiences are a common problem in today’s healthcare system.

Patients often have to navigate multiple healthcare organizations and providers to receive the care they need.

This can lead to a disjointed and frustrating experience for patients, who may have to repeat their medical history or undergo unnecessary tests due to a lack of communication between providers.

For patients with chronic diseases, this fragmentation can be particularly challenging, as they may require ongoing care from multiple specialists over an extended period of time.

This can lead to confusion and frustration for both patients and their families, who may struggle to keep track of appointments, medications, and test results.

One solution to these problems is the use of medical call centers.

These centers offer patients a centralized point of contact for all their healthcare needs.

By providing patients with access to trained professionals who can help them navigate the complex healthcare system, medical call centers ensure that patients receive the right care at the right time, no matter what health issues they may be facing.

Medical call centers can also help improve patient outcomes by providing timely access to care.

For example, if a patient is experiencing symptoms that require immediate attention but cannot get an appointment with their primary care physician for several days or weeks, they can call a medical call center for assistance.

The center can then direct them to an appropriate provider or facility where they can receive the care they need without delay.

In addition to improving patient outcomes and reducing frustration for patients and their families, medical call centers can also provide cost savings for healthcare organizations.

By streamlining patient access and reducing unnecessary testing and procedures due to miscommunication between providers, medical call centers help reduce overall healthcare costs while improving quality of care.

However, it is important that medical call centers are staffed by trained professionals who understand the complexities of the healthcare system.

These professionals must be able to accurately assess patient needs and direct them towards appropriate resources while maintaining patient privacy and confidentiality.

Furthermore, it is essential that medical call centers are integrated into the larger healthcare system.

This means that medical call center staff must have access to patient records and be able to communicate effectively with other providers in order to ensure continuity of care.

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.


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.

Medical call centers are an essential component of healthcare delivery, providing patients with timely and efficient contact with healthcare providers.

By serving as a centralized point of contact for patients, medical call centers can streamline the patient journey and improve the quality of care and attention patients receive.

One of the key benefits of medical call centers is their ability to reduce wait times and minimize the need for in-person visits.

This is especially beneficial for patients with mobility or transportation issues who may find it challenging to attend appointments in person.

With a medical call center, patients can access healthcare services from the comfort of their own homes, reducing stress and inconvenience.

Medical call centers also play a critical role in enhancing the patient experience by providing personalized support and guidance throughout the patient journey.

With trained professionals available to handle a wide range of inquiries and concerns, medical call centers provide patients with peace of mind knowing that they have access to expert advice when they need it most.

In addition to improving patient experience, medical call centers can also help healthcare providers optimize their operations by reducing administrative burdens associated with appointment scheduling and follow-up care.

This allows healthcare providers to focus on delivering high-quality care to their patients without being bogged down by administrative tasks.

What is a Medical Call Center?

Medical call centers are an essential part of the healthcare industry.

These specialized call centers handle incoming calls related to healthcare and medical services.

The agents who work in these call centers are trained to have knowledge of medical terminology and can provide assistance to callers with questions or concerns about their health.

Appointment Scheduling

One of the primary functions of a medical call center is appointment scheduling.

Patients can call the center to schedule appointments with their healthcare providers, including doctors, nurses, and other medical professionals.

This service is particularly helpful for patients who have busy schedules or who may have difficulty getting through on the phone lines at their doctor’s office.

Prescription refills

Another important service provided by medical call centers is prescription refills.

Patients can call the center to request refills on their medications, which can be sent directly to their pharmacy for pickup.

This helps patients avoid having to make multiple trips to the pharmacy or wait in long lines.

Urgent medical issues

Medical call centers also play a crucial role in triaging urgent medical issues.

When patients experience sudden symptoms or injuries, they may not know whether they need emergency care or if they can wait for an appointment with their regular doctor.

Medical call center agents can help assess the situation and determine whether immediate care is necessary.

Patient care navigation

In addition to these services, medical call centers can also help patients navigate the healthcare system and connect them with appropriate resources.

For example, if a patient needs assistance finding a specialist or obtaining insurance coverage for a particular procedure, they can contact a medical call center for guidance.

Patient advocates

The agents who work in medical call centers are highly trained professionals who must possess excellent communication skills as well as knowledge of medical terminology and procedures.

They must be able to remain calm under pressure and provide accurate information while dealing with potentially stressful situations.

Overall, medical call centers are an indispensable part of the healthcare industry that provides valuable services to patients across all demographics.

By offering appointment scheduling, prescription refills, urgent care triage, navigation assistance, and more, these call centers help patients receive the care they need in a timely and efficient manner.

Medical call center agents – not run of the mill

Medical call center agents are an integral part of the healthcare industry, and their work is essential to ensuring that patients receive the care they need.

These agents must possess a wide range of skills, including knowledge of medical terminology, excellent communication skills, and the ability to remain calm under pressure.

In addition to these skills, medical call center agents must also be able to handle a high volume of calls while maintaining accuracy and efficiency.

They must be able to quickly assess each caller’s needs and provide appropriate assistance or referrals as needed.

Medical call center agents have specialized training

One way that medical call centers ensure that their agents are well-equipped for their jobs is through ongoing training programs.

These programs help agents stay up-to-date on the latest medical procedures, technologies, and regulations so that they can provide accurate information to callers.

Another important aspect of working in a medical call center is maintaining patient privacy and confidentiality.

Agents must adhere to strict guidelines regarding the handling of sensitive patient information and ensure that all interactions with callers are conducted in a professional manner.

Despite these challenges, many people find working in a medical call center to be rewarding.

By helping patients navigate the complex world of healthcare and providing valuable services such as appointment scheduling and urgent care triage, medical call center agents play an important role in improving patient outcomes.

FAQs about Medical Call Center Services

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

1. Appointment scheduling

One of the primary functions of a medical call center is to schedule appointments for patients. This can include everything from routine check-ups to more complex procedures.

2. Patient screening

Medical call centers can also screen patients before they come in for an appointment. This can involve asking questions about their symptoms, medical history, and insurance coverage.

3. Prescription refills

Patients often need prescription refills between appointments, and medical call centers can handle these requests quickly and efficiently.

4. After-hours support

Many medical call centers offer after-hours support for patients who need assistance outside of regular business hours. This can be particularly helpful in emergency situations.

5. Nurse triage

Some medical call centers have nurses on staff who can provide triage services over the phone. This involves assessing a patient’s symptoms and determining whether they need immediate medical attention or if it’s safe to wait until their next appointment.

6. Billing inquiries

Patients may have questions about their bills or insurance coverage, and medical call centers can help them navigate these issues.

7. Referral management

When patients need to see a specialist, medical call centers can help manage the referral process by coordinating with other healthcare providers and ensuring that all necessary paperwork is completed.

8. Health education

Medical call centers may also provide health education resources to patients, such as information about managing chronic conditions or tips for staying healthy.

9. Medical practice growth

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

10. 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

Significance of Physician’s Call Center for Patient Experience

Quick Access to Medical Advice

A physician’s call center provides patients with quick access to medical advice, which can be crucial in emergency situations.

Patients who are experiencing symptoms or have questions about their health can call the center and speak with a trained medical professional who can provide guidance and support.

This immediate access to medical advice can help patients make informed decisions about their health and well-being.

Improved Patient Satisfaction

Patients who have access to a physician’s call center are more likely to be satisfied with their overall healthcare experience.

This is because they feel supported and cared for by the medical professionals who staff the call center.

Patients appreciate being able to reach out for assistance when they need it, especially outside of regular office hours.

Increased Patient Compliance

Patients who receive medical advice from a physician’s call center are more likely to comply with their treatment plans, leading to better health outcomes.

When patients have questions or concerns about their treatment plan, they may be hesitant to follow through on it.

However, by speaking with a medical professional at the call center, they can gain clarity and confidence in their treatment plan, leading to better adherence.

Reduced Healthcare Costs

By providing patients with access to a physician’s call center, unnecessary emergency room visits and hospitalizations can be avoided, resulting in reduced healthcare costs.

Patients who are unsure if they should seek emergency care can consult with a medical professional at the call center first.

If it is determined that emergency care is not necessary, the patient can avoid costly hospital bills.

Enhanced Continuity of Care

A physician’s call center can help ensure that patients receive consistent and coordinated care, even outside of regular office hours.

By having access to a trained medical professional at all times, patients can receive guidance on how best to manage their symptoms or concerns until they are able to see their primary care provider again.

Examples of Successful Physician Call Centers

One example of successful physician’s call centers is provided by Kaiser Permanente, a large healthcare organization that offers call center services to its patients.

The call center is staffed by registered nurses who are trained to provide medical advice and support to patients.

Patients can reach the call center 24/7 and receive assistance with everything from medication questions to emergency care.

Another example is provided by the Cleveland Clinic, which operates a nurse triage line for its patients.

This service allows patients to speak with a registered nurse who can provide guidance on how best to manage their symptoms or concerns until they are able to see their primary care provider again.

Social Proofs of Successful Physician Call Centers

Studies have shown that physician’s call centers can be highly effective in improving patient outcomes and reducing healthcare costs.

One study published in the Journal of Medical Internet Research found that patients who had access to a physician’s call center were more likely to adhere to their treatment plans and experience better health outcomes overall.

Another study published in the Journal of General Internal Medicine found that providing patients with access to a nurse-led telephone triage system resulted in reduced emergency department visits and hospitalizations, leading to significant cost savings for both patients and healthcare organizations.

How can a medical call center benefit healthcare providers and patients?

There are many benefits to using a medical answering service or call center for both healthcare providers and patients:

1. Improved patient satisfaction

By providing prompt and efficient service, medical call centers can improve patient satisfaction levels. Patients appreciate being able to schedule appointments easily and get their questions answered quickly.

2. Increased efficiency

Medical call centers can help healthcare providers streamline their operations by handling administrative tasks like appointment scheduling and prescription refills. This frees up staff to focus on providing high-quality care to patients.

3. Cost savings

Outsourcing certain tasks to a medical call center can be more cost-effective than hiring additional staff or investing in expensive technology.

4. Better patient outcomes

By providing nurse triage services, medical call centers can help ensure that patients receive the appropriate level of care for their symptoms. This can lead to better health outcomes and fewer unnecessary emergency room visits.

5. 24/7 support

Many medical call centers offer after-hours support, which can be especially valuable in emergency situations when patients need immediate assistance.

6. Improved communication

Medical call centers provide a centralized point of contact for patients, making it easier for them to get the information they need and reducing the likelihood of miscommunication between healthcare providers.

Inbound and Outbound Medical Call Center Service: Unparalleled Capability

Inbound and outbound medical call center services offer an unparalleled ability to manage high volumes of calls, ensuring that patients receive the attention they need promptly.

Outsourcing medical call center services to a reliable provider can help healthcare organizations prioritize patient care while freeing up internal resources for other critical tasks.

Medical call center service providers have the necessary resources and expertise to handle complex medical inquiries, providing patients with accurate information and guidance.

The ability to connect with patients in real-time through inbound and outbound medical call center services can significantly improve patient satisfaction and loyalty.

Investing in inbound and outbound medical call center services can help healthcare organizations streamline their operations, reduce costs, and improve overall efficiency.

With the priority on patient care, inbound and outbound medical call center services can provide a seamless experience for patients, ensuring that their needs are met with compassion and professionalism.

Outsourcing Medical Call Center Services

Outsourcing medical call center services is becoming increasingly popular among healthcare providers as it allows them to focus on providing quality care while leaving non-medical tasks such as answering phone calls to experts in the field.

By outsourcing these tasks, healthcare providers can ensure that their patients are receiving prompt attention without sacrificing quality or accuracy.

In addition, outsourcing allows for greater flexibility in staffing levels. Healthcare providers may not always have enough staff available to handle high volumes of calls during peak times or emergencies.

Outsourcing ensures that there is always someone available to answer calls promptly regardless of the time of day or volume of calls.

The Ability to Manage High Volumes of Calls

One of the most significant advantages of inbound and outbound medical call centers is their ability to manage high volumes of calls efficiently.

During peak times or emergencies, it’s crucial that patients receive prompt attention from trained professionals who can provide accurate information and guidance.

Medical call centers have access to advanced technology systems that allow them to manage large volumes of calls quickly while maintaining excellent customer service standards.

This ensures that no patient is left waiting for extended periods, which can be detrimental to their health and well-being.

Expertise in Handling Complex Medical Inquiries

Medical call center service providers have the necessary resources and expertise to handle complex medical inquiries accurately.

They are staffed with trained professionals who are knowledgeable about medical terminology, procedures, and medications.

This expertise ensures that patients receive accurate information and guidance when they need it most.

Medical call centers also have access to a vast network of healthcare professionals who can provide additional support if needed.

Real-time Connection with Patients

Inbound and outbound medical call center services offer real-time connection with patients, allowing them to receive prompt attention from trained professionals.

This connection can significantly improve patient satisfaction and loyalty as patients feel heard and valued.

Real-time connections also allow for immediate response during emergencies or critical situations, ensuring that patients receive the care they need promptly.

Streamlining Operations and Reducing Costs

Investing in inbound and outbound medical call center services can help healthcare organizations streamline their operations while reducing costs.

By outsourcing non-medical tasks such as answering phone calls, healthcare providers can save time and resources that can be allocated towards providing quality care.

Medical call centers also use advanced technology systems that allow them to manage large volumes of calls quickly while maintaining excellent customer service standards.

This efficiency ensures that healthcare providers are getting the most out of their investment in medical call center services.

Seamless Patient Experience

With the priority on patient care, inbound and outbound medical call center services provide a seamless experience for patients.

Trained professionals ensure that patients’ needs are met with compassion and professionalism while providing accurate information and guidance.

This seamless experience builds trust between patients and healthcare providers, leading to increased patient satisfaction and loyalty.

It also allows healthcare providers to focus on providing quality care without worrying about non-medical tasks such as answering phone calls.

Keep Costs Low with Medical Call Center Services

Medical call center services can be an excellent way for healthcare providers to keep costs low while still providing high-quality care.

By outsourcing tasks such as phone calls and appointment scheduling to a medical call center, healthcare providers can reduce the need for in-house staff, which can save money on salaries, benefits, and other associated costs.

Cheaper than inhouse medical call center

One of the primary benefits of using a medical call center is that it can help reduce overhead costs associated with maintaining an in-house call center.

For example, healthcare providers may need to invest in expensive equipment and software to support their internal call center operations.

By outsourcing these tasks to a medical call center, they can avoid these expenses altogether.

24/7 support

Another significant advantage of using a medical call center is that it can provide 24/7 support.

This means that healthcare providers can offer extended hours without needing additional staff members on hand to handle phone calls and appointments.

As a result, patients will have access to care when they need it most, which can improve patient satisfaction and retention rates.

In addition to improving patient satisfaction through extended hours of operation, medical call centers also help by providing prompt and efficient service.

When patients have questions or concerns about their health or appointments, they want answers quickly.

Access to pre-trained staff

Medical call centers are equipped with trained professionals who are knowledgeable about various aspects of healthcare.

They are well-versed in handling patient inquiries promptly and efficiently.

By offering this level of service, healthcare providers can improve patient retention rates significantly.

Patients who feel valued by their healthcare provider are more likely to return for future visits and recommend the practice to others.

Access to sophisticated call center technology

Moreover, medical call centers often use sophisticated technology systems that enable them to manage large volumes of calls efficiently.

These systems allow them to route calls based on specific criteria such as language preference or urgency levels so that patients receive appropriate assistance quickly.

As part of their services offered by medical call centers include appointment scheduling which is crucial for any healthcare provider’s office operations.

Medical Call Centers typically use scheduling software that integrates with the healthcare provider’s electronic health record (EHR) system.

This integration ensures that appointments are scheduled accurately and efficiently, reducing the risk of errors or double bookings.

Manage patient panel easily

Medical call centers can also help healthcare providers manage their patient populations more effectively.

By tracking patient data such as appointment history, medication lists, and other relevant information, medical call centers can provide valuable insights into patient behavior and needs.

This information can be used to improve care delivery by identifying areas where additional support may be necessary.

Reduced marketing spend

Finally, medical call centers can help healthcare providers save money on marketing and advertising costs by providing a platform for patient outreach.

For example, they may offer automated reminders for upcoming appointments or follow-up calls after visits to ensure that patients are satisfied with their care.

Reduce Daily Stresses of Office Environment with Medical Call Center Services

Medical call center services have become an essential component of medical office environments.

The daily stresses of a medical office environment can be overwhelming, and it is often challenging for care teams and administrative staff to manage the workload effectively.

However, by utilizing medical call center services, organizations can streamline their systems, improve efficiency, and reduce stress levels.

Support for care teams and staff

One of the primary benefits of medical call center services is that they provide support to care teams and administrative staff.

By handling phones, triage, appointment management, and other administrative tasks, call center agents can free up staff to focus on providing quality care to patients.

This support allows care teams to work more efficiently and effectively without being bogged down by time-consuming administrative tasks.

After hours support

Moreover, these services can also improve access to care for the community by providing after-hours support and ensuring that patients are connected with the appropriate care teams.

Patients who require urgent or emergency assistance outside regular business hours may not know where to turn for help.

Medical call centers offer a solution by providing 24/7 support that connects patients with the appropriate resources.

Streamlined operations

Organizations that utilize medical call center services can benefit from improved efficiency and streamlined systems leading to better overall practice management.

Call center agents are trained professionals who understand how to handle patient inquiries quickly and efficiently while maintaining high levels of customer service.

They ensure that calls are routed correctly so that patients receive prompt attention from the right person.

Beyond phone triage

Medical call centers also provide a range of other services beyond phone triage.

For example, they may offer appointment scheduling or reminder calls which help reduce missed appointments or late cancellations.

These reminders ensure that patients receive timely reminders about upcoming appointments so they can plan accordingly.

In addition to improving patient outcomes through better access to care and more efficient practice management processes, medical call centers also play a critical role in reducing stress levels among staff members in medical offices.

Reduced administrative tasks

Administrative tasks such as answering phones or managing appointments can be tedious and time-consuming for staff members, leading to burnout and high turnover rates.

By outsourcing these tasks to medical call centers, organizations can reduce the workload of their staff members and free up time for them to focus on higher-value activities such as patient care.

This approach not only improves job satisfaction among staff members but also reduces stress levels, leading to a healthier work environment.

Highly customizable

Medical call center services are also highly customizable, which means that organizations can tailor their services to meet their specific needs.

For example, some organizations may require after-hours support while others may need assistance with appointment scheduling or phone triage during regular business hours.

Medical call centers can provide a range of services that are tailored to the unique needs of each organization.

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.

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
Nisos Technologies 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


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

      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
      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

      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.

        • 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
        • 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. 

        • 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.
        • 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). 

        • 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 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.

        SOC2 compliance requirements

        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?”


        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

          Enhancing Patient Experience with Medical Call Center Services

          In conclusion, medical call center services play a crucial role in enhancing the patient experience.

          With quality call centers providing excellent customer service, patients can easily access healthcare services and engage with their physicians and providers.

          This results in higher patient satisfaction rates and improved health outcomes.

          One of the significant advantages of medical call center services is that they provide patients with 24/7 access to healthcare professionals.

          Patients can quickly get answers to their questions, schedule appointments, and receive guidance on care plans from nurses and agents.

          This level of engagement ensures that patients feel supported throughout their treatment journey.

          Medical call center services also help reduce the daily stresses of office environments for physicians and staff.

          By outsourcing phone calls to trained agents, medical practices can focus on delivering high-quality care while keeping costs low.

          The result is a more efficient practice that delivers better outcomes for patients.

          Moreover, fragmented healthcare experiences have become a significant problem today.

          Patients often struggle to navigate complex healthcare systems, leading to frustration and dissatisfaction.

          Medical call center services offer a solution by providing personalized support that addresses individual patient needs.

          This leads to improved patient engagement and ultimately better health outcomes.

          Inbound and outbound medical call center services provide unparalleled capability for medical practices looking to improve patient access to care.

          Inbound services ensure that patients can reach out at any time for support while outbound services enable practices to follow up with patients after appointments or procedures.

          Finally, it’s worth noting that excellent customer service is key when it comes to enhancing the patient experience.

          Patients who feel heard and valued are more likely to comply with treatment plans and report higher levels of satisfaction overall.

          Want our patient access team to help? Reach out.

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