CHAPTER
11
Telephone
Techniques
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11-2
Learning Outcomes
11.1 Explain the importance of communication skills.
11.2 Explain how to manage incoming telephone calls.
11.3 Describe how the Health Insurance Portability and
Accountability Act (HIPAA) applies to telephone
communications.
11.4 Describe the procedure for calling a new
prescription or prescription renewal into a
pharmacy.
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11-3
Learning Outcomes (cont.)
11.5 Compare the types of calls the medical assistant
handles with those the physician or other staff
members handle.
11.6 Describe how to handle various types of incoming
calls from patients and from others.
11.7 Discuss the importance of proper telephone
etiquette.
11.8 Describe the procedures for taking telephone
messages.
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11-4
Learning Outcomes (cont.)
11.9 Explain how to retrieve calls from an answering
service.
11.10 Describe the procedures for placing outgoing
calls.
11.11 Explain the function of telephone triage in the
medical office.
11.12 Explain the uses of a facsimile machine in a
medical office.
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11-5
Introduction
• Telephone calls must be professionally
and effectively handled
• Telephone etiquette
– Common courtesy
– Proper pronunciation, tone, and
enunciation
• How to handle difficult situations and
complaints
• How to document messages
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11-6
Using the Telephone Effectively (cont.)
Good telephone techniques leave the patient with a
positive impression of
• You
• The physician
• The practice

Good telephone management
shows that the staff is
• Caring
• Attentive
• Helpful
Poor telephone
management results in
• Bad feelings
• Misunderstanding
• Unfavorable
impressions
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11-7
Communication Skills
• Using tact and sensitivity
• Showing empathy
• Giving respect
• Being genuine
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11-8
Communication Skills (cont.)
• Displaying openness and friendliness
• Refraining from passing judgment or
stereotyping
• Being supportive
• Asking for clarification and feedback
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11-9
Communication Skills (cont.)
• Paraphrasing to ensure
understanding
• Being receptive to the patient’s
needs
• Knowing when to speak and
when to listen
• Being willing to consider other
viewpoints
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11-10
Communication Skills (cont.)
The 5 Cs
of
Communication
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11-11
Apply Your Knowledge
1. What two things does proper telephone
management do?
ANSWER: Proper telephone management keeps
patients informed and ensures patient satisfaction.
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11-12
Apply Your Knowledge
2. What are the 5 Cs of communication and what
does each mean?
ANSWER: The 5 Cs of communication are:
• Completeness – the message must contain all needed
information
• Clarity – it should be legible and free from ambiguity
• Conciseness – it should be brief and direct
• Courtesy – it should be respectful and considerate
• Cohesiveness – it should be organized and logical
Certainly!
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11-13
Guidelines for Managing Incoming Calls
• Answer calls promptly
• Be able to take a message
• Greet the caller with the medical office
name and your name
• Identify the caller and demonstrate a
willingness to assist him or her
– If the caller does not give his or her name, ask
for it
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11-14
Guidelines for Managing Incoming Calls (cont.)
• Be courteous, calm, and pleasant
• Identify the nature of the call
• Use the caller’s name when saying goodbye at
the end of the call
• Comply with HIPAA guidelines for confidentiality
of patient information
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11-15
Screening Calls
• Tips
– Find out who is calling
– Ask what the call is in reference to
•
Helps to determine who can handle
the call
– Decide whether to put the call through
•
Do not put through callers who refuse to identify
themselves
– Determine what to do if the call is personal
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11-16
Routing Calls
Generally, three types of calls are received in the office:
1) Administrative Issues
3) Clinical Issues
2) Emergency Calls
• Follow the office policy to determine calls that
should be
– Put through immediately
– Returned later
– Handled by another staff member other than the
physician
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11-17
Routing Calls (cont.)
• Calls handled by the medical assistant
– Appointments
– Billing inquiries
– Insurance questions
– Diagnostic reports
(lab and x-ray)
– General administrative
questions
– Reports from hospitals and
patients
– Referral requests
– Prescription renewals (if
previously approved by the
physician)
– Patient complaints
regarding administrative
issues
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11-18
Routing Calls (cont.)
• Calls requiring the doctor’s attention
– Emergency calls
– Calls from other physicians
– Patient requests regarding test results
– Patient requests to discuss their symptoms
– Requests for prescription renewals
– Personal calls
A routing list specifies who is responsible
for handling certain types of calls.
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11-19
Apply Your Knowledge
The medical assistant is just returning from lunch, and the office
telephone is ringing. When the medical assistant answers, the
caller interrupts her greeting and says, “No, do not put me on
hold again, I have been on hold for 10 minutes!” How should
the medical assistant respond to this caller?
ANSWER: The medical assistant should remain calm, allow the
caller to express his or her concerns, apologize for any
inconvenience, and inform the caller that you would like to help.
The MA should not attempt to shift the blame by telling the caller
that he or she was just returning from lunch and instead should
put effort into assisting the caller.
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11-20
Types of Incoming Calls
Calls from
Patients
Medical Assistant Role
Appointments
• Make or change appointments
Billing Inquiries
• Clarify bill or charges
• Help set up payment
arrangements if possible
• Document what information is
given to the patient
• Get approval for renewals
• Answer questions about
medications
Diagnostic Reports
Questions about
Medications
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11-21
Types of Incoming Calls (cont.)
Calls from
Patients
Medical Assistant Role
Reports of Symptoms • Listen carefully and document
• Schedule appointment as needed
Progress Reports
• Route follow-up calls to the
physician
• Document call in patient record
Requests for Advice • Do not give any medical advice
Complaints
• Remain calm and listen carefully
• Apologize for any inconveniences
• Follow through to resolve issue
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11-22
Emergency Calls
• Must be routed to
the physician immediately
• Includes serious or life-threatening
conditions such as
• Severe
bleeding
• Drug reaction
• Injuries
• Poisoning
• Suicide attempts
• Severe burns
• Loss of consciousness
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11-23
Types of Incoming Calls (cont.)
• Never use office phone for personal calls
– Limit cell phone use to essential calls only
• HIPAA and confidentiality apply to telephone
calls
• Attorneys
– Follow office guidelines carefully
– Never release any patient information unless the
physician authorizes you to do so
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11-24
Types of Incoming Calls (cont.)
• Other physicians
– Route calls to the physician
– Do not disclose any patient
information
• Salespeople
– Request that information be
mailed to you about new products
– Pharmaceutical representatives may be seen
by the physician
• Conference calls
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11-25
Apply Your Knowledge
A medical assistant working in a large medical/surgical
practice answers the telephone. The caller states “Hi,
I’m Dr. X., did Dr. C. perform Mrs. A. W.’s surgery
yesterday?” How should the medical assistant respond?
ANSWER: The medical assistant should request that Dr. X hold
to speak with the physician. You may not disclose any
information concerning a patient, including whether or not patient
A.W. had surgery, even to a physician. In addition, this may not
really be Dr. X.
Excellent!
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11-26
Using Proper Telephone Etiquette
• Customer service is critical
• Use your telephone voice
Speak directly into the receiver
Be friendly; convey interest and
respect
Use non-technical language, but
never use slang
Use a normal tone, but attempt
to vary your pitch
Pitch is the high and low level of
your speech
Make the caller feel important!
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11-27
Using Proper Telephone Etiquette (cont.)
Pronunciation
Tone

Saying words correctly

Positive

If the name is difficult to
pronounce, ask the
patient how it is
pronounced

Respectful
Enunciation


Saying words in a clear and understandable
manner
Eating, chewing gum, and incorrect placement of
the phone interfere with enunciation
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11-28
Making a Good Impression
Exhibiting
courtesy
Giving undivided
attention
Putting a call
on hold
• Project an attitude of helpfulness
• Always refer to the caller by name
• Thank the caller before hanging up
• Give the caller the same level of
attention as if he or she were right in
front of you
• Listen attentively to get accurate
information
• Always allow the caller to state the purpose of
the call prior to placing the caller on hold
• If the wait will be lengthy, offer to call back
instead of placing the caller on hold
• Return to the caller at 2-minute intervals
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11-29
Making a Good Impression (cont.)
• Handling difficult situations
– If the call is not an emergency, and you are in
the middle of an urgent situation, offer to
return the call
• Remembering patient names
– Using the caller’s name during a conversation
makes the caller feel important
• Checking for understanding
– Ask questions to ensure that the caller
understands what you have discussed and
that you understood the caller
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11-30
Making a Good Impression (cont.)
• Communicating feelings
– Try to communicate an understanding of the
caller’s feelings (empathy)
– Callers tend to have a better perception of the
office if empathy is communicated
• Ending the conversation
– Summarize important points
– Thank the caller for calling (use the caller’s
name)
– Allow the caller to hang up first
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11-31
Apply Your Knowledge
What should you do when you have to place a
caller on hold?
ANSWER: When a caller has to be placed on hold, first ask
the purpose of the call. Then tell the caller why you need to
place him or her on hold and how long the wait will be.
Check with the caller at frequent (2-minute) intervals. Offer
to call back if the wait will be lengthy.
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11-32
Taking Messages
• Documenting calls
– Protects the
physician against
legal action
– Document in the
patient record
• Clinical issues
• Referrals
– Messages must be
accurate and
legible
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11-33
Taking Messages (cont.)
Always keep a pen and paper near the telephone so you
are prepared to record the message.
Contents of a Telephone Message Pad
TO:____________________________________________
Date_________________
Time______________
Message
FROM:_________________________________________
Telephone (
)__________________extension________
Message Details:
Your name or initials
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11-34
Telephone Logs
• Manual
– Spiral-bound, perforated
message book
– Top copy or original is given
to the message recipient and
a copy is kept in the book
• Electronic
– Message is keyed in as it is
received
– Copy can be saved, printed
out, or e-mailed
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11-35
Taking Messages: Tips
• Keep pen/pencil on hand
• Take notes as information is
given
• Verify spelling
• Verify callback number
• Do not make a commitment
on behalf of someone else
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11-36
Taking Messages (cont.)
• Ensuring correct information
– Get the correct spelling of the caller’s
name
– If you have to pull the patient record,
ask for date of birth
– Repeat key points for verification
• Maintaining patient confidentiality
– Do not repeat any confidential information over the
telephone
– Maintain confidentiality with written messages
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11-37
Right
!
Apply Your Knowledge
Answer True or False to the following:
T Documenting calls can protect against legal actions.
___
___
T Confidentiality is just as important when making
telephone calls as in written communication.
F You should ask for the patient’s SSN if you have to
___
pull his/her record. Date of birth
T You should repeat key points to verify information.
___
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11-38
Telephone Answering Systems
• Single telephone or complex
multiline systems
• Common equipment and
services used in the medical
office
– Automated voice mail
– Answering machine
– Answering service
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11-39
Telephone Answering Systems (cont.)
• Retrieving messages from
answering service
– Set a regular schedule and call
at scheduled times
– Identify yourself and the practice
name
– Write down all pertinent
information on telephone log
– Repeat the information to verify
– Route messages per office policy
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11-40
Apply Your Knowledge
What steps should you take to retrieve messages
from an answering service?
ANSWER: To retrieve messages from an answering
service you should
1. Set a regular schedule and call at scheduled times
2. Identify yourself and the practice name
3. Write down all pertinent information on telephone log
4. Repeat the information to verify
5. Route messages per office policy
CORRECT!
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11-41
Placing Outgoing Calls
• Locating telephone
numbers
– Patient record
– Office file of
commonly used
numbers
– Telephone
directory, directory
assistance, or the
Internet
• A fee is charged for
directory assistance
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11-42
Placing Outgoing Calls (cont.)
• Applying your telephone skills
– Plan before you call
– Double-check the phone number
– Allow time for the person to answer
– Identify yourself
– Ask if the time is convenient
– Be ready to speak when the person answers
– Be sure the person has paper and pencil if
you are giving information
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11-43
Placing Outgoing Calls (cont.)
• Arranging conference calls
– Calls between several people at different
locations
– Remember the different time zones
– Suggest several time slots as options
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11-44
Apply Your Knowledge
The medical assistant has been informed that the office
physician and the consulting physician must speak with the
daughter of an unresponsive patient recently diagnosed with
a terminal condition. The daughter resides out of town. What
would you do in this situation?
ANSWER: This situation requires that three parties be able to
communicate at the same time to each other. Setting up a
conference call would be most plausible.
PERFECT!
r
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11-45
Telephone Triage
Telephone triage is used as a process of deciding what
action to take
Learning the Triage Process
 Telephone staff cannot
diagnose or treat
 Specific information must
be obtained, such as
name, age, symptoms,
and anxiety
 Telephone staff are
given guidelines to
handle common
conditions
 Telephone staff must
determine whether
caller requires
additional care
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11-46
Telephone Triage (cont.)
• Automated telephone triage
Remind patients of upcoming appointments
Conduct patient surveys
Give patients test results
Managing referrals
Assist with preventive care
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11-47
Telephone Triage (cont.)
Level of Severity



Manage by telephone
Categorizing the Problem
Manage in office
Send patient to emergency
care facility
 Advise the caller that the recommendations are based on
the symptoms and are not a diagnosis
 Have the caller repeat instructions you give
 Instruct the patient to call back if symptoms worsen
Document critical elements of the conversation
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11-48
Telephone Triage (cont.)
 Clinical triage – based
Taking Action
on office guidelines
 Determine extent of
problem (Is this an
emergency?)
 Decide on
appropriate action
 Telephone situations must be handled correctly
to protect the health and safety of the patient.
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11-49
Apply Your Knowledge
What is telephone triage and what does it entail?
ANSWER: Telephone triage is a process used to decide what
action to take when a patient calls the office with a clinical
problem. Telephone staff use office guidelines to determine a
course of action based on the of the level of severity of the
problem.
Great!
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11-50
Telecommunications and Faxes
• Automated telephone system
– Recorded voice identifies
department or services
– Numbered choices
• Facsimile (fax) machines
– HIPAA guidelines must
be followed for patient confidentiality
– Fax machine should be located in secure
location
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11-51
Telephone Slamming and Cramming
• Slamming
– Unauthorized changes
• Cramming
– Unauthorized charges
• Report to carrier
immediately
• State and federal
crime
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11-52
Pagers and Cell Phones
• Pager
– Personal
telecommunications
device for short
messages
– Types
• Only receive messages
• Send and receive email and numeric
messages
• Cell phone
– Mobile voice or data
communication
• Remember to
maintain patient
confidentiality
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11-53
Apply Your Knowledge
As you escort Mr. James to the exam room, you
notice that a repairman is looking at a document
on the fax machine. What should you do?
ANSWER: You should ask Mr. James to wait where he is and
excuse yourself to deal with the repairman. Tactfully tell the
repairman that he should not be reading the information on the
fax machine. You should also suggest to the office manager that
the fax machine be moved to a less accessible location.
Impressive!
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11-54
In Summary
11.1 Effective communication skills are important
because they employ a positive image and
assist with satisfying the expectations of the
patient.
11.2 Answer incoming telephone calls promptly.
Be courteous and pleasant at all times on the
telephone.
11.3 In compliance with HIPAA, information
communicated by telephone should be
confidential and private so that information
cannot be overheard.
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11-55
In Summary (cont.)
11.4 When calling in prescription renewals, pull the
patients charts. Make sure you are in a
private location in the office before releasing
information to the pharmacy. Document the
conversation.
11.5 Calls handled by the medical assistant and
other staff members may vary. The medical
assistant handles less complex telephone
calls than does the physician or nurse. Calls
should always be routed to the appropriate
staff member.
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11-56
In Summary (cont.)
11.6 Always refer to your policy and procedure
manual regarding how to handle incoming
calls appropriately. Remember to always be
courteous.
11.7 Customer service is critical when using the
phone, and provides your office with a tone of
professionalism.
11.8 When taking telephone messages, always
have a pen and pencil near the phone.
Proper documentation protects the physician.
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11-57
In Summary (cont.)
11.9 Retrieve messages from an answering
service at a set scheduled time, identify
yourself, write down pertinent information, and
repeat information—confirming that you
understand.
11.10 When placing outgoing calls, check the
time zone, obtain information from the
physician that needs to be provided, and
arrange for consultations if needed.
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11-58
In Summary (cont.)
11.11 Telephone triage is used as a process of
deciding what actions need to be taken by
the physician or other staff members after
the telephone call.
11.12 Fax machines may be used for various
electronic transmissions such as lab reports,
insurance reports, and other approvals.
Make sure that the fax machine is in a
secure and private area.
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11-59
End of Chapter 11
When people
talk, listen
completely.
Most people
never listen.
~ Ernest Hemmingway
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.