Tag Archives: medical answering service articles

Utilizing Peer Review to Minimize Risk in a Medical Call Center

LVM Systems

By Mark Dwyer

peer reviewPeer review is a method of examining the quality of nursing care in terms of structure, process, and outcome. The American Nurses Association (ANA) describes peer review as the process by which practicing registered nurses systematically assess, monitor, make judgments, and provide feedback to peers by comparing actual practice to established standards. The expected outcomes of this process, in the context of a professional nursing practice model, include increased professionalism, accountability, autonomy, retention, improved communication skills, and quality outcomes.

Let’s look at how this applies specifically to assessing nurse triage calls in a medical call center. The process begins with selecting triage call records from a date range for peer review based on various triage data elements. Data points such as the triage date, triage nurse, guideline used, and disposition level are some of the standard selection criteria.

Once the appropriate records are selected for review, they are typically assigned to a queue for an immediate review or later when time permits. (Note: when conducting the peer review, the nurse reviewer must have access to both the written and, if available, audio call record.)

As the nurse conducting the peer review begins the process, she accesses the original triage call record to identify the nurse who handled the call, the patient’s birthdate and age, the date and time of the call, and the guideline used. This is also when the nurse reviews the original triage details, specifies the review type, and may indicate if the call is part of a quality improvement (QI) project.

Having reviewed the triage details, the nurse reviewer identifies the disposition selected during the original triage call. If the reviewer believes the disposition was under-referred or over-referred, the call is passed to QI management for the QI manager to determine the reason for the inappropriate referral. Some of the standard reasons resulting in an under or over-referral are:Following a nurse review process enables the medical call center to minimize its overall risk. Click To Tweet

  • Incomplete assessment or not enough objective data
  • Nurse did not recognize a serious symptom
  • Wrong guideline used
  • Nurse did not adhere to the guideline
  • Inadequate interventions tried at home

If the call included an audio recording, a separate set of questions is used to evaluate the triage assessment. These include, did the nurse:

  • Use two patient identifiers
  • Review the patient’s health history
  • Identify the main or most serious complaint
  • Assess the severity of all symptoms
  • Evaluate the guideline questions sequentially until reaching a positive response
  • Ask the caller if they understand the instructions

A thorough peer review of the audio recording must also include questions to assess the nurse’s level of communication and customer service, time management, and written documentation.

Assessing the nurse’s level of communication and customer service is done using a 3-point scale (3 = excellent, 2 = good, and 1 = room for improvement). The nurse should:

  • Develop a rapport with the caller
  • Demonstrate advocacy for the patient and family
  • Use open-ended questions through most of the interview

Additional considerations evaluate time management. These include:

  • Time progression of the call
  • Maintained control of the call
  • Redirected the caller as needed

The nurse reviewer then assesses the written documentation to determine if it aligns with the audio recording and is complete, and whether, in the reviewer’s opinion, the triage nurse selected the most appropriate guideline and disposition. Again, if the reviewer believes the disposition was under-referred or over-referred, the call is passed to QI management for the QI manager to determine the reason for the inappropriate referral.

Finally, to assess the outcome of any emergency department (ED) or urgent care center (UCC) referral, if the referral, in the opinion of the reviewer, was an under or over-referral, a unique set of questions enable a QI review by the medical director. For example:

  • Did the patient’s overall clinical picture suggest the need for an urgent visit to rule out serious differentials?
  • Was the patient seen within the appropriate time frame?
  • Did the patient receive interventions that couldn’t have been done at home?
  • What was the patient’s most significant diagnosis?

If the medical director agrees that the call resulted in an under or over-referral to the ED or UCC, she tracks the appropriate disposition and indicates the reason for the incorrect disposition.

Once the assessments are completed, monthly results are shared with the reviewed nurses providing feedback on ways to offer better telephone triage services. The manager also runs reports to quantify departmental results. Using this information enables the manager to conduct remedial training as appropriate.

An effective peer review program allows for a formal approach to the analysis of performance and to the systematic and continuous actions that lead to measurable improvement. Following a nurse review process like this one enables the medical call center to minimize its overall risk.

LVM SystemsMark Dwyer is a 32-year veteran of the healthcare call center industry. Mark is in his sixteenth year at LVM Systems, where he serves as COO. LVM Systems provides healthcare call center software. For more information or a demonstration of LVM’s call center solutions contact Carol Zeek, regional VP, sales, at 480-633-8200 x279 or Leann Delaney, regional VP, sales at 480-633-8200 x286.

Is BPO a Key Enabler in the Push for Better Patient Outcomes?

By Anand Natampalli

In the emerging value-based world, healthcare providers and payers increasingly align incentives to drive improved patient health outcomes, more patient-centric services, and reduced medical cost for individuals. BPO (business processing outsourcer) service providers can bring a neutral consultative perspective, with design thinking and innovation, to meet the provider’s complex challenges.

To solve individual provider’s specific needs, BPO organizations bring customized solutions using a service incubation approach. It incorporates the following:

  • A new breed of patient engagement and experience solutions, with a consolidated, targeted strategy
  • Data management and integration, sharing intelligence from different segments of the collective healthcare ecosystem, including payers, providers, pharmaceutical companies, and durable medical equipment (DME) providers
  • Process optimization through automation and analytics, with a population health management (PHM) focus

A New Breed of Patient Engagement and Experience

Often, consumers of healthcare services encounter confusing phone directories, difficult-to-navigate-websites, and representatives who may not have the training or resources to make a patient encounter meaningful and productive. One of the most critical areas where BPOs can contribute is by helping provider organizations improve the patient experience and drive better health outcomes.

With the added patient choice in today’s marketplace, patient engagement, and experience—an area traditionally of lesser importance to health systems—is now critically paramount to attracting and retaining patients, driving healthier outcomes, and achieving higher ratings.

Patient engagement and experience is often a critical missed opportunity for provider organizations of all sizes. Patient access centers are legitimate business departments and have an important role to play in the transition to value-based, patient-centric care. They have the potential to create new streams of revenue. They engender patient brand loyalty. Most importantly, access centers are a critical first impression that ultimately determines whether a patient chooses to purchase healthcare services.

In a patient-centric healthcare economy, BPOs offer the right balance of technology and talent for seamless, patient-experience delivery. BPOs play an effective front-line role to drive revenue and patient satisfaction, reduce no-shows, and eliminate the need for patients to fish around for answers to their questions. These partners can more effectively employ their analytics and automation expertise to make the patient experience as easy as possible through both personalization and self-service—striving for that perfect balance between automated bots and live, human-touch interaction.

Data Management and Integration

In the new healthcare landscape, PHM is a key area of focus for providers. According to a May 2017 Deloitte Center for Health Solutions survey of hospital CEOs, population health analytics investment is the highest-rated analytics priority for healthcare organizations.

The amount of data attached to every patient has grown exponentially. This must be gathered, integrated, and interpreted according to compliance guidelines and processes that can vary widely between payers and providers. Additionally, the datasets held by payers and providers can be different. For example, payers possess data on claims, financial analytics, and risk models. Providers have administrative and clinical data that includes case histories and outcomes.

BPOs with both payer and provider expertise can best assist, by bridging the data gap between these two organizations. For example, BPOs not only have claims data from provider groups but also from payers. By leveraging this comprehensive information, providers have a better, more holistic view of patient health. Armed with this intelligence, providers can positively affect a patient’s health outcomes, through PHM processes that also bend the cost curve.

Further to this point, each data set is valuable, but in isolation it doesn’t provide a holistic and contextual perspective of the patient. Providers need to leverage health plan data to move from episodic care to delivering outcomes-based care across the care continuum. Payers need access to patient information to work with providers to establish appropriate care plans for their members. Again, this is where BPOs bridge the gap for providers, as well as payers.BPOs offer the right balance of technology and talent for seamless, patient-experience delivery. Click To Tweet

Automation and Analytics with a PHM Focus

With better patient engagement and data integration to leverage PHM, there is an ideal scenario for best use of automation and analytics. BPO partners can bring the requisite advanced automation and analytics, as key drivers of business improvements or process changes. With more understanding and awareness of the data coming downstream, BPOs know how to analyze these data points and decouple nonessential activities with automation for a positive impact on health outcomes and to drive costs down.

They also can offer “automation and analytics as a service,” relieving organizations of the capital and time investment of developing these abilities in house. Today’s cognitive computing capabilities will affect more complex, judgement-based activities (like origination and underwriting) with compliance objectives, too. Agility, speed, and accuracy are all positive customer satisfaction results derived from these transformations. Most impactful may be the automation data and applied analytics that will dramatically improve outcomes, for more forward-thinking strategies.


Today, BPO partners take an active role in helping provider organizations manage change, internally and externally. This puts them in a better position to take advantage of the opportunities found by optimizing patient experience journeys. By selecting the right partner, hospitals and health systems can position themselves to gain a competitive advantage in the present, while setting themselves up for an even brighter future.

Anand Natampalli is a senior vice president, global business development, for HGS, a provider of end-to-end business process services for numerous Fortune 100 health insurance companies and large provider organizations.

Answering Services Can Help Medical Clinics Do More for Less

Call Center Sales Pro, providing proven healthcare call center solutions

By Janet Livingston

Everyone in healthcare knows the key challenges the industry faces: do more, do it better, and do it for less. These pressures confront healthcare providers, coming from both the insurance companies that reimburse them and the patients that they serve.

But how can providers achieve these objectives of doing more, doing it better, and doing it for less, when these goals run counter to each other? Finding a solution requires innovative thinking and doing things in new ways.

Enter the venerable telephone answering service. Today, leading answering services are stepping up to this challenge.

For decades answering services have provided telephone support to the healthcare community by answering calls, taking messages, and dispatching emergencies. They’ve done this afterhours and 24/7. When it comes to supporting medical clinics and healthcare practices, answering services can do these things. But they can also do much more.

Two Key Considerations

EMR Integration: One key way to make your answering service invaluable to a medical clinic or healthcare facility is to integrate your answering service platform with their EMR (electronic medical record) system. This allows you to automatically transfer the information you gathered from the clinics’ patients to the clinics’ EMR platform.

Without this capability, one of two things will occur. Either someone will need to manually rekey the information, or the information will forever remain isolated. Neither scenario is a good one.

The first instance requires hours of labor each day to reenter the information. Plus, as with any manual process, there’s a chance of data-entry errors. This will then put into question the reliability of the information and reflects badly on your answering service, even though the problem occurred after the data left your facility.

In the other scenario, though you’ve provided important information to the clinic, it’s of little value to them because it sequestered in an isolated database that’s not integrated with their main systems.

This is why EMR integration is so critical. Any answering service that can provide it distinguishes themselves from the competition. Plus, grateful clinics will form long-term relationships with their answering service because they don’t want to lose this valuable feature.

Smart Phone Integration: Virtually everyone in healthcare carries a smart phone (and sometimes more than one). This mobile technology has become indispensable in today’s business world, including the healthcare industry.

Leading answering services offer a data portal to their clients. This portal provides a powerful tool to access their account and the information in it. The next step is extending this functionality to the smart phone, such as with Amtelco’s miTeamWeb. This and other similar products enable answering service clients to review their answering service information, make updates, and manage their account at any time, from anywhere, using a smart phone app. This puts control of answering service accounts literally in the hands of its clients.

These apps work great out of the box and require little configuration for basic functionality. However, the most powerful answering service apps allow for customization in how the information is displayed, as well as to create widgets to accomplish specialized tasks and enhanced integrations.

For all its value and power, creating the widgets—especially the more complicated ones—requires technical knowledge and carries the need for programming skills. Not every answering service can do this, but those who can provide tremendous value to their clients.

Again, this enhanced service offering distinguishes one answering service from most others. It allows an answering service to better serve its clients in ways that the competition can’t match.


Most answering services can work for medical clinics and healthcare facilities. However, answering services that integrate with clinics’ EMR systems and provide sophisticated smart phone integration distinguish themselves from other less-equipped providers.

Which type of answering service do you want to be?

 Call Center Sales Pro, a full-service healthcare call center consultancyJanet Livingston is the president of Call Center Sales Pro, a premier consultancy and service provider for healthcare call centers and answering services. Contact Janet at contactus@ccsp.us or call 800-901-7706.

Medical Call Centers Are Here to Stay

TeamHealth Medical Call Center

By Gina Tabone

Changes to the United States of America political scene are upon us and most certainly will have an impact on the provision of healthcare. Regardless of party affiliation, several healthcare reform objectives need to remain in the forefront by future government leaders. Examples include enhancing quality of care, improving interdisciplinary coordination and collaboration, and better utilization of available resources.

Focusing on these concepts will contribute to the goal of improved outcomes for both individuals and the patient populations we serve. The benefits achieved from the implementation of the triple aim must continue, regardless of who is leading the country. Nurse triage, as a component of an integrated medical call center (MCC), is a pivotal—and no longer optional—intervention.

The world of medical call centers has finally gained the recognition and credibility in the healthcare marketplace that many of us have been trying to expound for two decades. Centralized medical call centers are rapidly emerging as the backbone of health systems because they are integral in achieving better patient outcomes.

The new administration has wisely sought healthcare advice from the most innovative physician leaders in the United States. For example, Toby Cosgrove, of Cleveland Clinic, and John Noteworthy, of the Mayo Clinic, were invited to meet with President Trump to share their thoughts on the Affordable Care Act (ACA) and offer ideas to plot out the best plans for the future. Improving patient experience of care requires open access channels. Click To Tweet

Concerns were expressed that the current model needs to focus more on patient health and wellness and less on the avalanche of paperwork. This has negatively impacted the day-to-day responsibilities of clinicians who are held accountable for reporting on hundreds of quality indicators. These points of contention are agreed upon by most caregivers. Cleveland Clinic and Mayo Clinic have improved patient access, outcomes, and satisfaction by integrating state-of-the-art integrated call centers with clinical access across their multi-state enterprises.

Hopefully, their example will resonate and continue to motivate other organizations to rapidly integrate outsourced or optimized in-house MCCs as a proven solution for reaching the three goals of the triple aim: improving the patient experience of care, improving population health, and reducing the per capita cost of healthcare.

Improving patient experience of care requires open access channels. Access means that patients can receive the most appropriate level of care needed, in a timeframe best determined by specially trained nurses guided by evidence-based tools. The patient learns to expect reliable advice that takes their current health state into account and is consistently available day or night. Gaps in care are eliminated, and delays are avoided, leading to favorable patient outcomes and higher reimbursements in a fee-for-value model. When patients’ wellbeing is enhanced, everyone gains—especially patients. MCCs can stake a claim for making this happen.

The year 2017 will have many organizations taking a close look at their operations and making tough choices about what functions are best accomplished internally and which ones can be entrusted to an outside partner. IT departments are now being outsourced by some of the largest hospital systems in the country. IBM is, by far, the vendor of choice. Patient Financial Services is another service with options for outsourcing where the benefits to an organization outweighs the cost incurred. Incentives for meeting targets are common. Last, there is a surge by strategic decision makers to explore nurse triage services being performed by an outside call center partner.

The common denominator in all three areas where outsourcing is increasing is the fact that there is a reliance on human capital and all the contingency costs that goes along with being an employer. High labor costs often consume up to 70 percent of many call centers’ operating budgets. Outside partners can assume the responsibilities with greater efficiency, better outcomes, and lower costs.

There is also the possibility that many vendors are willing to assume some of the risks associated with the successful attainment of goals. The choice to retain, outsource, or develop a hybrid of both is a multi-faceted decision that is reserved for leaders at a higher level than the call center. Organizations must evaluate which option best aligns with their mission, vision for the future, and strategic plans.

Medical call centers are branching out and taking on a variety of responsibilities that are well suited to be conducted remotely and reliant on state-of-the-art technology and a dedicated workforce. Once the technological infrastructure is created, the MCC can be enhanced to take on additional functions.

The task of appointment scheduling is the most common function of many MCCs and often happens in tandem with the strategy of centralization. Electronic Medical Records (EMR) products have customized templates embedded with providers’ schedules that are used for office visits, imaging, or procedural appointments. Outbound calling campaigns are often conducted in conjunction with scheduling for appointment reminders.

Centralizing all medication refill requests is emerging as a successful addition to many MCCs. Call center technology such as CRM allows for requests to be tracked, acted upon, and measured, ensuring that established targets are being met in a timely manner. Without measurement, there is little possibility for improvement.

Patients can expect a standard process for medication needs and defined timeframes for responses or resolution. Medication management and compliance is critical for optimal outcomes, so implementing a process that fosters it is a good idea. Patients stratified as high-risk garner the most advantages, which contribute to maximum reimbursements for medical treatments.

MCCs have taken on the significant task of not only caring for the acute needs of primary care patients, but also the chronic needs of vulnerable high-risk patients. The successful coordination and transition of care is central to every health system’s strategy for sustainability today and growth tomorrow.

Nurses are the clinicians assigned to figure out how to morph from case management to transitional care coordinators. Regular communication between patient and caregiver is vital and is often done via telephone, text, or email. Training the newly created transitional care nurses in the fundamentals of remote patient care is imperative and is based on the standards of care for telephone triage nurses. The practice of triaging acute symptoms has branched out and will serve as the starting point for nurses involved in coordinating care.

It is up to those of us established in the medical call center world to continue to proclaim the unlimited value of a MCC to the healthcare industry. In many healthcare organizations, more than 10 percent of employees spend most of their day doing their job on the telephone. The benefits of centralizing and consolidating the work they do are undeniable.

C-suite leaders must accept the fact that medical call centers are no longer considered an expense but an investment with impactful ROI.

Initially there were call centers; then access centers came along, followed by contact centers. In 2017, we are now called engagement centers. The task at hand is to capture the limited attention of decision makers and educate them on the role MCCs play in a fee-for-value system and the distinct results that are possible. The future may be uncertain, but there remains a need for products, services, and expertise that bring the call center to the forefront of patient care.

TeamHealth Medical Call CenterGina Tabone, MSN, RNC-TNP, is the vice president of strategic clinical solutions at TeamHealth Medical Call Center. Prior to joining TeamHealth, she served as the administrator of Cleveland Clinic’s Nurse on Call 24/7 nurse triage program.


6 Essential Technology Tools for Today’s Medical Answering Service

By Aaron Boatin

The telephone is the most popular way for patients to contact their medical practice. Whether they are a current patient wanting to schedule an appointment, a potential patient looking for information, or someone with an emergency, the practice – and its answering service or call center – needs to be equipped to handle calls during and after business hours.

The key is up-to-date technology. As a medical answering service or outsource healthcare call center, you must have the right technology to handle healthcare calls. These tools will set your healthcare call center apart from the competition and ensure your clients feel taken care of, listened to, and supported.

Here’s what you need to provide:

1) Secure Text Messaging App: HIPAA (Health Insurance Portability and Accountability Act) compliant secure text messaging is a great option as pagers are phased-out and medical offices want to streamline customer service efforts. With this app your clients can send secure text messages simply and efficiently to any member of their team from a web browser.

An enhanced option will also offer clients the ability to message multiple staff members at the same time. Plus you need to also communicate with your clients via HIPAA compliant secure text messaging. In today’s fast-paced world, secure text messaging is an excellent way to keep everyone in touch, on the same page, and on schedule.

2) Secure Client Web Portal: The two most essential elements of a medical answering service web portal are that it’s secure and that clients can update and manage information about their practice. Make sure your website portal has an extended validation certificate that verifies it’s controlled by a legal entity. This extra level of encryption makes sure your clients’ patients’ sensitive PHI (protected health information) data is safe and secure.

The risk of not having a secure website is significant. Any messages containing PHI puts your call center and your clients at risk for a HIPAA data breach violations. Not only can those violations add up to some serious coin, but they will also affect your reputation and credibility as a medical answering service.

You must have a portal that is easy to access and update. Any time a client needs to change a schedule or update phone numbers, you want them to be able to do so with ease. The information they enter in your portal should automatically link to your medical answering service platform for your team to use.

3) Real-time Access to Patient Messages and Information: Thorough, well organized, and easy-to-understand records are every medical practice’s dream. Giving your clients real-time access to their patients’ messages and information is an essential part of providing premier service.

You need to offer them a record of which physician was reached and their response time to the patient. Look for solutions that allow clients to import this data into their patient electronic health records (EHRs) to streamline the process and avoid forcing them to reenter information.

4) Online Access to Patient Call Audio: Patient experience is more important than ever. In fact, patient experience influences the level of reimbursement your clients receive from insurers. That’s why it’s a huge benefit to allow your clients the ability to listen to recordings of how their patient calls were handled. This way they can verify their callers had an optimal experience.

5) Web On-Call Software: Make sure you provide a way for clients to quickly update their ever-changing on-call schedules. This will help keep you from contacting the wrong person when they aren’t on-call and avoid mismanaged emergencies.The best web on-call tools are mobile optimized and have a secure text messaging capability. Click To Tweet

The best web on-call tools are mobile optimized, allow schedule sharing, and have a secure text messaging capability. An efficient on-call system will also keep your clients happy and allow your staff to do their job as professionally as possible.

6) Appointment Reminder Service: One of the biggest losses of revenue for many medical practices comes from patient no-shows. You should offer the ability for your clients to upload appointments to you. Then you can reach out to scheduled patients to remind them of their appointment. This provides a way for patients to confirm or cancel their appointment. By getting this information ahead of time, your healthcare clients will have a reasonable opportunity to fill vacated appointment slots. These automated reminders will no longer burden your clients’ and will help them keep their schedule full.

If you are a healthcare call center or medical answering service, your healthcare clients expect you to have these tools and offer these services. Make sure you are ready.

Aaron Boatin is the president of Ambs Call Center that services the healthcare industry.

New Opportunities for Medical Answering Services

By Ravi Raheja

For several years, answering services have been a critical component to continuity of care when medical offices are closed. They have traditionally relayed urgent messages to the doctor on call and informed patients about office hours and other needed information.

Due to the increasing demands of medicine and the availability of sophisticated technology, answering services have started to provide expanded services, such as appointment scheduling and physician referral, in addition to relaying urgent messages to the physician on call. In addition, more and more people are working outside of their regular 9 to 5 jobs, and they expect the same level of availability at their doctor’s office for appointments, nurse on call availability, and questions.

Traditionally, the office, the answering service, and the nurse triage service work together but as discrete entities. Now with the advance in integration technology and EMR, there are several points of integration that can be implemented to improve efficiency and have the three entities work as one single unit. Here are the different points where integration can improve efficiency and patient care.

Call Schedule Integration: Currently an office may have to call both the answering service and the nurse triage service to inform them about on call schedules and scheduling changes. This creates confusion, inefficiency, and the possibility of errors because some parties may not get the information or receive it in time. Today, technology makes it possible for doctors to have access to a Web-based scheduling system that automatically updates the answering service and nurse triage systems. This portal enables access 24/7 and secure access from mobile devices.

Appointment Scheduling Integration: When patients call and talk to the triage nurse, many need follow-up appointments in the office the following day. If the nurse triage system is integrated with the practice EMR, the nurse can schedule the appointment at the initial point of contact. In addition to being a convenience for patients, it increases continuity of care and prevents people from going to the ER since they know they have an appointment.

Integration with EMR: When the nurse triage system is integrated with the practice EMR, triage encounters are sent directly to the EMR. Technology has advanced enough that the nurse can securely get a brief medical history from the EMR before triaging the patient. This can dramatically improve care by giving telephone care providers access to patient history such as allergies, medication, and important past medical history.

Integrating Answering Service Messages with EMR: When a patient calls to request a referral, a prescription refill, or an appointment, an answering service can take the information and enter it directly into the EMR so that is shows up as an inbox message at the doctor’s office. This saves time and ensures messages are not missed. Patients do have access to patient portals, but many of them still want to talk to a live person. Integration allows the answering service to act as a true extension of the practice and provide continuity of care

Integrating Answering Service Calls with Nurse Triage: When a patient calls after hours to request a nurse call, the answering service enters the information into their system. Currently non-integrated systems coordinate patient information via fax or email. Faxing can cause a potential loss of information and delay in nurses seeing urgent requests. The information sharing can be significantly improved if the data gets directly entered into the nurse triage system.

In conclusion, with the technology available today, outsourced answering services and nurse triage services can act as a true extension of each practice. With the proper integration system in place, all three entities can securely and efficiently work as a single unit.

Ravi Raheja, MD, is the director of sales and technology at The TriageLogic Group. He can be contacted at 855- 887-4243.

[From the February/March 2013 issue of AnswerStat magazine]

Medical Answering Services

By Bradley Hagen

Medical professionals are busy people and reaching them immediately can sometimes be difficult. Medical answering services provide a reliable link between patients and doctors. When doctors use a medical answering service, the answering service handles their patient related calls and keeps a record of their schedules. Depending on the degree of emergency and the doctors’ instructions, they forward calls to them or relay messages to on call physicians on behalf of the patient. This way, doctors can spend less time managing patient calls and focus more on their work.

Medical answering services are different from general telephone answering services. Sometimes referred to as answering services for physicians or doctors, they serve the medical industry specifically and are tailored to healthcare professionals. They do not handle other types of business, sales, or marketing calls. In the United States, there are many companies that provide medical answering services. Most offer live medical answering services 24 hours a day, 7 days a week, and some have bilingual agents.

Signing up for a medical answering service and using their service is simple. Any physician, doctor, hospital, or healthcare professional with an established practice can employ a medical answering service to facilitate communication with patients. Better communication between the patients and the practice increases patient satisfaction, lowers practice costs, and allows the prioritizing of responses. With fewer administrative calls, no worry about missed messages, and a permanent record of communications, a practice can now determine how much to offload from its busy front office.

A medical answering service will need the daily schedule and contact numbers of the doctors, nurses, and PAs. Many medical answering services provide a Web-based service to post an on call calendar, which allows doctors or their staff to easily make changes by logging in. According to the patients’ need and the doctor’s schedule, they can also do the appointment scheduling. Medical answering services document every message taken on behalf of the practice.

Another common option is a free mobile app, providing doctors access to critical patient and callback information. Callbacks are documented with the time and duration of the call and even provide an option to record the call. It’s HIPAA compliant, retains complete documentation from message origination to callback, allows private response to interoffice messages, and has an option to call patients back, showing an on-file office number as the caller ID to keep the cell phone number private.

Professional medical answering operators undergo instruction in medical terminology and methods of handling urgent calls from both patients and medical staff. They are trained to react with speed and precision, dispatching urgent messages quickly and accurately.

Operators send complete messages to on call doctors instantly, using an alphanumeric or digital pager, text-capable mobile phone, or smartphone to take advantage of the features of a mobile app. They also note any detailed instructions regarding prescriptions or cautionary notes that may exist for each patient. This helps the telephone operators who take the call to direct them to specific individuals with required information, depending on the specifics of the call. These services need to be HIPAA compliant, so only deal with a medical answering service that can provide certification they are HIPAA compliant.

The doctor can determine the best way to be contacted and get regular text and phone messages according to his or her schedule and patient status. Medical practices can opt for a full-time or part-time service, depending on their needs. The billing and charging of services is item specific, resulting in a cost-effective service.

Medical answering services are a proven technology to help a medical practice or doctor’s office save time and money and can offer business day services that increase revenue. A good medical answering service will improve the patient experience and become a value added part of a practice instead of a necessary expense.

Bradley Hagen is the director of interactive marketing at SolutionBuilt, which represents TeleMed Communications, a provider of call center and telephone answering services to the healthcare community.

[From the October/November 2012 issue of AnswerStat magazine]

Integrating Answering Service with Nurse Triage

By Charu G. Raheja

Nurse triage centers across the country are being asked to cut costs and offer more services. One of the biggest expenses in today’s triage centers is the cost of nursing time. With the correct tools and workflow, answering services can play an important role in decreasing the use of nursing time, leading to significant cost savings in nurse triage, improved nurse satisfaction and patient care, and increased service offerings.

In the traditional triage center model, physicians subscribing to the service have their own answering service. When a patient calls, the physician’s answering service takes a message and relays the information to the triage center via fax. In turn, nurses receive the faxes, enter patient information into the system, and triage the calls. This traditional model poses several potential problems and time costs. First, nurses need to take the time to enter each patient’s information themselves prior to taking the call. Second, this method does not allow nurses to accurately gauge acuity of the callers and call volume unless they are constantly running back and forth from the fax machine or there is a nurse supervisor assigned to distributing calls, both of which lead to increase use of nursing time.

Alternatively, some call centers have patient calls transferred directly to the nurse, and then patients wait for a nurse to pick up the phone. This method is also inefficient and has a high nursing cost.  First, it can lead to significant hold times for patients depending on call volume – shorter waiting times require overstaffing of nurses and thus higher costs for the triage center. Second, nurses still have to enter basic patient information themselves once they are on the phone with a patient. Third, similarly to the traditional method, this alternative does not allow nurses to gauge acuity of the callers waiting to be helped. Overall, both of these models lead to inefficient use of nursing time and, in some cases, less than ideal patient care.

Answering services can play a significant role in reducing costs and improving patient care by entering calls into the triage system directly. Answering services already have the systems in place to handle large numbers of patient phone calls. They also usually have 24/7 staffing, as well as Internet access, so they can have a live operator answer patient calls and enter basic information about the patient and reason for calling directly into the triage system. The help of an answering service in entering calls allows nurses to review the acuity and volume of incoming calls and can dramatically reduce nursing time by having patient information already in the system. This allows nurses to focus on triaging the calls, thereby improving nurse satisfaction and patient care.

An integrated answering service as part of the workflow provides a more cost-effective, flexible, and efficient triage process. When a patient calls, the answering service takes the information and enters it directly into the triage software. Nurses are then able to view the calls in a format that enables them to judge the acuity, as well as the volume, of calls waiting. This enables the calls to be available in real time – instead of delayed based on fax transmission time. In addition, this enables the nurse to start working on the call without entering the patient data and lets them assess call volume and acuity with a summary of calls appearing on their screen. Furthermore, nurse supervisors are also able to remotely view the queue and nature of calls so that they can keep track of call information to make sure that there is enough staff available to take the calls. In addition to better patient care and improved satisfaction, nurses are able to reduce the time to take the phone calls by about 20%. The savings turn out to be between 75 cents to a dollar on every call in nursing time.

Some hospitals are providing answering services as well as triage service to their clients, allowing them to improve the workflow in their nurse triage as described above. Having an answering service in conjunction to the triage also allows the center to offer a full service to doctors so that doctors don’t need to hire a separate answering service themselves. However, having an in-house answering service is not always necessary.

In the case of smaller hospitals or independent nurse triage centers, providing a full answering service may not be an option from a cost, staffing, and infrastructure perspective. In this case, these triage centers can benefit from a partnership with an existing answering service to provide the answering service component of the call center and to enter patient information for triage calls. Existing answering services already have the infrastructure to take calls, and they can use the Internet to enter patient information for the triage center.

In summary, a partnership between a triage center and an answering center can help improve patient care and satisfaction, improve nurse satisfaction, and decrease costs by allowing the answering service to enter patient information directly into the triage system. Furthermore, doctors also experience improved satisfaction because they don’t need to contract with a separate answering and triage service. Finally, having a system that allows for calls to be entered directly into the system also allows nurse supervisors to remotely view and monitor the queue and adjust the nursing staff based on call volume.

Charu G. Raheja, PhD, is the chair of Triage Logic Management in Winston-Salem, North Carolina. The TriageLogic Call Center Solution offers triage call centers highly secure and comprehensive Web-based tools to handle patient calls consistently, accurately, and efficiently. For more information, contact info@triagelogic.com or call 855-734-4463. 

[From the February/March 2010 issue of AnswerStat magazine]

How a Great Answering Service Can Improve a Medical Practice’s Bottom Line

By D. E. Murray

With rapidly improving diagnostic technologies, physicians are continually challenged to learn more and do more. While patient care may be technically improved as a result, insurance companies and third party administrators are made happy by their efforts, and the care team may take pride in efficient and effective medical treatment. However, patients may often feel as if they are only a small part of a thoroughly mechanized, automated, and impersonal administrative process. Too often, they are right.

Studies have shown that medical litigation is greatly influenced by a patient’s relationship with their physician. The more a patient feels as if they have been heard and can share their concerns with their physician, the less likely that patient is to sue– even when the physician has made an error.

American medicine is practiced in a team environment. The physician is typically in charge of the team, which often includes physician assistants, nurses, aides, technicians, front office staff, and the practice’s telephone answering service. As the practice’s primary ambassador after-hours, the patients who are a physician’s primary consumers may associate a poor answering service with substandard care if calls are mishandled and as a result, the care team is not available to represent themselves. Conversely, an outstanding answering service will project a practice’s focus on patient care and professionalism 24-7.

“A great answering service may greatly assist the patient/physician interface, improve and solidify patient relationships, and add to the practice’s bottom line. If your answering service is merely serving as a voicemail system with a live operator, you are missing the boat,” stated Nancy Duncan, chief operating officer for On Ramp Medical Communications. “Beyond the crucial after-hours interface with patients, a great answering service can add to office profits, patient satisfaction, and retention by providing automated appointment reminders, surgery or appointment cancellations, Rx refill information, and patient surveys.”

A great telephone answering service recognizes that they are an extension of their client’s practice. Answering service staff training should include both initial and ongoing training with a focus on patient service and client profiles. A great service will utilize current and upgraded software and hardware with all-weather capability in the event of power failure. A great answering service will regularly communicate with their clients, keeping them abreast of opportunities to improve patient communication during and after office hours, increasing office profitability.

“At the end of the day, a great answering service recognizes their importance to the patient care equation, understands that they are an extension of the medical practice, adds to the practice’s bottom line, and delivers professionalism and value far beyond expectations of the practice,” continued Duncan. “Remember, your answering service will answer more of your patients’ calls– throughout the course of any given year– than your handpicked staff; their influence on your patients’ satisfaction is enormous.”

D. E. Murray is a freelance writer residing in Florida.

[From the June/July 2009 issue of AnswerStat magazine]

Pairing Nurse Triage with Medical Answering Service

By Ken Bleakley

After-hours telephone services for physicians must be able to address both administrative questions and clinical concerns from patients. Both physician and patient need to be confident that all inquiries will receive a prompt, caring, and authoritative response. This requires the deployment of two different skill sets: medical answering service and registered nurse triage.

Medical Answering Services: An efficient answering service can provide superior value to its clients by conveniently servicing callers through a compassionate and accurate response, including:

  • Answering and messaging services
  • Appointment calls
  • Conference calls
  • Client satisfaction surveys
  • Initial screening for clinical concerns

The staffs who provide these services need not be medical professionals, but they do require medical knowledge. Emphasis is on speed, efficiency, and accuracy in responding to a wide variety of situations using specialized operating systems.

Nurse Triage Services: When the caller requires clinical information or advice, licensed registered nurses using established guidelines and protocols become necessary. Using a dedicated operating system and their own clinical skills and experience, they triage, record, and document clinical calls from patients. Accreditation, insurance, and rigorous quality assurance programs add to the cost and complexity of these services, but provide dependability and confidence in the end result.

Integrated Services: As each of these types of services become more developed to support the medical practice, the need for a simpler, single service to provide the complete after-hours coverage for the busy physician become increasingly desirable. The ability to contract with one unified entity with single billing and a mutually compatible functioning becomes a valuable enhancement. The search and evaluation process are simplified. The service becomes the after-hours extension for each medical practice. On nights, weekends, or whenever physicians need a break, they are able to flip incoming calls to a single number and receive:

  • A compassionate response to patient needs, answered in the practice’s name
  • Committed medical answering services
  • Accredited medical advice and triage by registered nurses when required
  • Medical encounter reports immediately and aggregated reports monthly
  • One predicable monthly bill for services
  • A dedicated representative to address any concerns
  • Optional scheduling and referral services

Meeting the Need: Medical answering services and nurse triage services have responded to the challenge in different ways. Some simply provide parallel services to medical practices that contract them separately. Others offer informal pairing arrangements with different levels of integration. A few provide both services under a single company. While there are advantages to each model, there are also disadvantages.

Parallel service models provide maximum flexibility to medical practices and frequently combine local answering with nationally accredited medical call centers. However, the handoff from one service to the other and from one operating system to the other can be problematical, as can fixing responsibility for errors or delays. Separate billing complicates the task of practice administrators.

The combined service company is automatically equipped to provide a single number to connect the patient to an integrated answering/triage service with a single bill and to assume responsibility for outcomes. However, this model may generate an incentive for the answering service to refer patients to the company’s more expensive nurse triage, even when the call may not be truly of a clinical nature. As the two different functions may not even be in the same location, it does not necessarily assure a smooth handoff between them. In addition, a nurse triage service that is also competing for medical answering business will find it difficult to build cooperative relationships with medical answering services already providing answering services to their own clients.

Optimizing the Roles of Each Service: Once it becomes clear that neither the answering service nor the nurse triage service has any interest or desire to enter the substantially different business of the other, they become natural allies. They can concentrate on providing the one call/one service/one price model desired by medical practices and patients. They can concentrate on making their respective systems as compatible as possible, while enhancing the quality of their respective services. They can also develop joint sales programs focused on mutual specialized or local markets.

The result of these alliances is better and less costly service for the patient and physician alike. More physicians will be able to afford turning over their practices after-hours to reliable professionals. The pairing of local and national capabilities also helps to maintain the personal relationship between doctor and patient during the hours when medical practices are closed. Patients are able to schedule visits to their providers and avoid unnecessary visits to over-crowded emergency rooms.

Ken Bleakley is CEO of Fonemed, whose mission is to connect people by telephone and Internet to health information, services, and products. Fonemed provides nurse advice throughout North America and the Caribbean. For more information, call 800-366 3633.

[From the February/March 2007 issue of AnswerStat magazine]