CHAPTER
6
Oral and Written
Communications
UNIT
1
Telephone
Communications
6-2
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Answering the Phone in the
Medical Office

Automated answering systems



6-3
Often include a menu that answers the call
by the third ring
Direct the call to the proper person or
department
At the beginning of the message the
caller should be reminded to hang up
and call 911 if it is an emergency.
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Answering the Phone in the
Medical Office


6-4
Training and a phone call screening
manual should be available for
reference.
A set of questions should be asked as
quickly as possible to determine the
condition of the patient.
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Answering the Phone in the
Medical Office


Any medical situation for which the
assistant has not been trained should be
directed to another assistant or to the
physician.
Emergency instructions and numbers
must be available when a call is referred
to 911.
6-5
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Examples of Routing Calls
Type of Call
Routed to
Critical lab results
Physician (immediately)
Progress report from
patient
Billing or insurance calls
Record message for
physician
Administrative MA
Referrals
Clinical MA
Patient requesting medical Physician
advice
6-6
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Handling Nonemergency Calls



Get as much information from the caller
as quickly as possible regarding the
condition of the patient.
If you must place the caller on hold, ask
if the caller can hold, and wait for a
response.
Find out a good time to call the patient
back.
6-7
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
The Telephone Message




6-8
A message pad and a pen or pencil
should be kept at each phone station.
Another message pad and pen should
be kept by each answering machine.
Messages must be complete and
accurate.
Deliver the message as soon as
possible.
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
The Telephone Message






6-9
Caller’s full name (use correct spelling)
Nature of the call
Action required
Date and time of the call
Initials of person receiving the call
Phone number (including the area code)
that the call should be returned to
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
The Telephone Message



Before hanging up, read the complete
message back to the caller.
Ask the caller if there are any further
questions.
Always allow the caller to hang up first.
6 - 10
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Leaving a Phone Message

HIPAA guidelines include:



6 - 11
Maintaining the confidentiality of the patient
Calling only phone numbers given by the
patient
Identifying yourself and the office when
calling
(continued)
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Leaving a Phone Message


No medical information or test results
can be left on a recording device or with
another individual.
Take special care to make sure that no
information can be overheard by a third
party.
6 - 12
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Handling Callers Who Refuse
to Identify Themselves


Suggest that the patient write a letter to
the physician.
The letter should be marked personal so
that the physician will receive the letter
unopened.
6 - 13
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Unit Summary


What is the purpose of screening phone
calls?
What information must be included in all
telephone messages?
6 - 14
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
UNIT
2
Schedule
Appointments
6 - 15
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Establishing Methods of Scheduling


The schedule should flow at a pace that
promotes a good professional working
relationship.
Considerations for scheduling



The number of rooms available
The schedule of the physicians
Unexpected interruptions
6 - 16
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Goals of Appointment Scheduling

Patient’s goals



6 - 17
Minimum wait for
an appointment
Minimum wait in
the office
Maximum time
with the physician

Physician’s goals




Cost-effective use
of time
Spend needed time
with patient
Uninterrupted time
Time for referrals,
emergencies, etc.
(continued)
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Goals of Appointment Scheduling

Medical assistant’s goals




A smooth-running office
Close the office on time
A lunch hour and breaks
Meet patient’s and physician’s goals
6 - 18
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Establishing a Matrix


Determine the proper type of
appointment book for the office.
Mark off all time during which patients
cannot be seen.

Example: Block off the time between 12:00
and 1:00 p.m. for lunch.
6 - 19
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Scheduling Appointments
over the Phone




6 - 20
Find out the name of the patient and the
last time he or she was seen at your
office.
Verify the patient’s insurance status.
Find out the reason for the visit.
If the patient asks to speak to the
physician, offer to take a message and
have the physician call back.
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Scheduling Appointments
over the Phone



Find out if mornings or afternoons are
better for the patient.
Offer two appointment times.
Verify the completed appointment by
asking the patient to repeat it back to
you.
6 - 21
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Scheduling a Patient Who
Is Always Late

Avoid interruptions to the office by
scheduling patients who are always late
right when the office returns from lunch
or at the end of the day.
6 - 22
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Handling Cancelled Appointments



Note cancellations or no shows in the
patient’s chart.
The appointment time may be given to
another patient.
The record of appointments that have
been cancelled or times the patient has
not shown up provide legal protection for
the practice.
6 - 23
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Abbreviations Used in Scheduling
Appointments
NP
New patient
Ref
Referral
CPE Complete physical
exam
FU Follow-up exam
Cons Consultation
NS
No show
Surg Surgery
RS
Reschedule
CP
Chest pain
C
Canceled
P&P
Pap and pelvic
Inj
Injection
6 - 24
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Unit Summary


What is the proper method for handling
cancellations or no shows?
How would you describe the methods of
scheduling identified in this unit?
6 - 25
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
UNIT
3
Written
Communications
6 - 26
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Correspondence Medical Assistants
May Need to Prepare







Notes
Interoffice communications
Form letters
Information sheets
Business letters
Professional letters
Personal letters
6 - 27
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Occasions for Form Letters






Return to work or school approvals
Annual diagnostic examination reminders
Delinquent account reminders (usually in
three increasing levels of request
intensity)
Office visit verifications
Athletic participation approvals
Providing information to referred patients
6 - 28
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
HIPAA and Correspondence

Most physicians have developed specific
Release of Information (ROI) forms that
follow HIPAA guidelines to prevent
disclosure of information to those not
directly involved with providing health
care to the patient.
6 - 29
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Examples of ROI Form Use

Patients are requested to sign
authorization release forms to:




Request a consultation from a specialist
Have a specialist provide results to the
referring physician
Provide information to a hospital or nursing
care facility
Ensure third-party approval of a procedure
6 - 30
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
HIPAA Regulations Regarding Access
and Correspondence



Access may be limited within the office to
only those employees who have a need
to see the file.
Preparing written communications may
be limited to only approved individuals.
Others would be prohibited from access
to patient information as directed by
HIPAA regulations.
6 - 31
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More HIPAA Regulations

Other employees would be prohibited
from access to patient information as
directed by HIPAA regulations.
6 - 32
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
The Purpose of Information Sheets


Help to reinforce what you have
explained verbally
Serve as a reminder to the patient and
include:



Preparation guidelines
Date and time of the appointment
Location and contact information for an
appointment
6 - 33
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Six Criteria for Written Communications
1.
2.
3.
6 - 34
To officially inform the staff of a policy or
decision
To contact professional colleagues
To correspond with professional
associations
(continued)
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Six Criteria for Written Communications
4.
5.
6.
To request or respond to medical
consultation
To engage in business communications
with suppliers, consultants, attorneys,
and insurance companies
To send personal messages
6 - 35
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
The Eight Parts of Speech
6 - 36
Noun
assistant, office, laboratory, computer
Pronoun
he, she, I, it, they
Verb
assist, perform, write, compose, take,
measure, is, are, being
Adjective
efficient, tall, thin, happy
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
The Eight Parts of Speech
Adverb
well, frequently, usually, quickly,
quietly
Preposition of, with, over, under, above, by, near
Conjunction and, but, or, if, for, because
Interjection
wow, hurray, ouch
6 - 37
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Nine Standards for Producing a
Mailable Business Letter
1.
2.
3.
4.
5.
6 - 38
Appropriate letter placement on page
Right margin is fairly even
Generous top and bottom margins
Punctuation follows acceptable
business practices
Spacing follows acceptable business
practices
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Nine Standards for Producing a
Mailable Business Letter
6.
7.
8.
9.
Words at the end of a line are divided
correctly
Letter content is accurate as dictated
All enclosures indicated in the letter are
included
No spelling errors are present
6 - 39
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Twelve Components of a
Business Letter
Letterhead
Preprinted name, complete address,
phone number (optional)
Date line
Date letter is dictated or composed, if not
dictated
Inside address Address of person to whom the letter is
being sent
6 - 40
Salutation
The greeting to the recipient
Reference
To identify what or about whom the letter
is concerning
Body
The content of the letter
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Twelve Components of a
Business Letter
Complimentary Expressing the closing of the letter
closing
Sender’s
Signature of the writer
signature
Title
Writer’s title, if appropriate
Reference
initials
Enclosures
Copies
Initials of the person who typed the letter
Any identified materials to be sent with the
letter
Identifies another person or persons to
whom a copy of the letter is sent
6 - 41
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Standard Proofreading Marks
6 - 42
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Eleven Common Errors in Written
Communications
1.
2.
3.
4.
5.
6.
Words ending
in “s”
Combinations of
punctuation
Capital letters
Numbers
Apostrophes
Hyphens
7.
8.
9.
10.
11.
Periods
Commas
Two-letter words
Dashes
Double letters in
words
6 - 43
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Unit Summary


What type of form letters would you find
in the medical office?
How does HIPAA affect correspondence?
6 - 44
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
UNIT
4
Receiving and Sending
Office Communications
6 - 45
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Sorting Incoming Mail

Sort by type



Sort by category



6 - 46
Personal mail is placed on the physician’s
desk unopened
Special deliveries are opened immediately
Mail from patients
Mail from physicians
Mail from insurance companies
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Sorting Incoming Mail





Miscellaneous sources
Journals, newspapers, and magazines
Drug samples
Advertisements
Generally done by the office manager,
the receptionist, or the administrative
medical assistant
6 - 47
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Opening Incoming Mail





Have a letter opener, paper clips, a
stapler, and a date stamp ready.
Open letters along the flap edge.
Remove all contents of the envelope.
If requested, attach the envelope to the
correspondence.
Date stamp the correspondence and
attach any enclosures.
6 - 48
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Annotating Incoming Mail




6 - 49
Identify the important points of the
correspondence.
If necessary, pull the patient’s file and
attach correspondence to the chart.
Drugs samples are placed in a
designated area.
Notifications of meetings, miscellaneous
correspondence, and professional
journals are placed under the stack of
mail.
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
How to Handle Vacation Mail




Discuss what to do with the mail before
the physician goes on vacation.
The physician may want you to call to
discuss the mail, or copy and forward the
mail.
Never send the originals to the physician.
Keep track of what you send to the
physician.
6 - 50
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Postal Services the Office
May Require


If the office will be closed temporarily or
permanently, go to the post office and
complete the necessary form to have the
mail held or forwarded.
Purchase stamps and additional postage
for meter machines.
6 - 51
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Processing Metered Mail




Change the date on the meter daily.
Apply the correct amount of postage by
weighing the mail before affixing
postage.
Check the imprint to be sure it is clear
and readable.
Use fluorescent ink in the meter.
6 - 52
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Six Classification of Mail
1.
Express

2.
Priority


3.
Preferential handling and expedited delivery for
materials up to 70 lb. and 108 in. in combined
length and width
If the item is over 11 oz. it is handled as priority
mail.
First-class mail

6 - 53
Fastest and guaranteed delivery 365 days a year
Letters, postcards, stamped cards, greeting cards,
checks, money orders
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Six Classification of Mail
4.
Periodicals

5.
Standard mail (A)

6.
Applies only to printed materials from publishers
and registered news agents approved for
periodical privileges
Used by retailers, catalogers, and other
advertisers to promote products and services
Standard mail (B)

Used for parcels weighing 1 lb. or more
6 - 54
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Reasons to Use a Certificate of Mailing


To show evidence that something was
mailed
To show evidence that a deadline was
met
6 - 55
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Reasons to Use Certified Mail




Certified mail provides proof of mailing
and proof of delivery.
This service is available only for firstclass or priority mail.
It is appropriate to use when the
physician is terminating the care of a
patient.
Signed return receipts provide evidence
to be placed in the patient’s chart.
6 - 56
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Reasons to Use Registered Mail




Registered mail provides protection for
valuables and important mail.
Registered articles are under tight
security from point of mailing to point of
delivery.
First-class or priority mail is required.
Return receipt and restricted delivery is
available.
6 - 57
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Restricted Delivery

Restricted delivery means that the mail
can only be delivered to a specific
addressee or someone authorized to
receive mail for that addressee.
6 - 58
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The Purpose of a Return Receipt



A return receipt is the sender’s proof of
delivery.
The receipt shows who signed for the
item and the date of delivery.
Can be purchased for:



Mail sent cash on delivery (COD)
Express mail insured for over $50.00
Registered, certified, or restricted mail
6 - 59
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Six Means of Communication
Other Than by Mail
1.
2.
3.
4.
5.
6.
Fax machines
Pagers
Voice mail
Cellular phones
Conference calls
Teleconferencing
6 - 60
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Six Uses for a Fax Machine

Send and receive
1.
2.
3.
4.
5.
6.
Information regarding patients
Letters
Medical and lab reports
Orders for office or medical supplies
Insurance claims
Prescription orders
6 - 61
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Characteristics of an
Electronic Address



6 - 62
The address begins with the person’s
name, an abbreviated form of it, or any
other words or numbers the individual
desires.
The business or company name may
appear.
This is followed by the @ symbol, which
is followed by the Internet service
provider’s information.
(continued)
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Characteristics of an
Electronic Address

The Internet service provider’s
information is followed by a “dot” and an
abbreviation such as “com,” “org,” “gov,”
or “net” to designate commerce,
organization, government, or the
Internet.
6 - 63
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Computer Viruses

Computer viruses are information that is
sent electronically to interfere with or
destroy electronic files.
6 - 64
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Guidelines to Avoid Acquiring a
Virus through E-Mail




Before opening any e-mail, look at the
subject line and who sent it.
Never open files with the suffixes “exe” or
“vbs” unless you are expecting an
executable or script file.
Use antivirus software to scan e-mails.
Be aware of the latest patches and
software upgrades that address security.
6 - 65
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Unit Summary


What are the six classifications of mail?
In addition to mail, what forms of
communication can be used by a
medical office?
6 - 66
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
UNIT
5
Office Management
Equipment
6 - 67
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Why You Use a Calculator When
Supplies Are Received

Calculators are used to verify the
accuracy of invoices for ordered items.
6 - 68
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Seven Types of Materials That
Are Often Photocopied
1.
2.
3.
4.
5.
6.
7.
Prepared literature
Correspondence
Insurance forms
Patient records
Laboratory reports
Account information
Information sheets
6 - 69
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Why Records Are Microfilmed


Microfilm is used to preserve materials
by reducing them to minute film images.
Microfilm provides record security and
uses minimal storage space.
6 - 70
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Four Items Known as
Computer Hardware
1.
2.
3.
4.
The hard disk drive
The central processing unit (CPU)
The monitor
The keyboard
6 - 71
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Why Backing Up Computer
Data Is Necessary


Electrical surges and power outages can
destroy information.
Computer hard drives can crash and all
programs and stored data can be lost.
6 - 72
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Unit Summary



What is computer hardware?
What is computer software?
Why do you back up computer data?
6 - 73
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Keys to Career Success


Communication is the key to career
success.
Successful medical assistants not only
communicate verbally with staff and
patients, but also understand the
importance of written communication and
nonverbal communication.
6 - 74
Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Hot Links to Career Success

www.cc.nih.gov/ccc/ceg/info.html


Confidentiality Education Group (CEG)
www.usps.com

United States Postal Service
6 - 75
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