1. Chapter 39 Telephone Techniques
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

2. Pretest
True or False
The medical assistant should obtain a caller’s name before placing the caller on hold.
A caller will not be able to pick up nonverbal cues during a telephone call with the medical office.
Call forwarding sends telephone calls to a different extension or telephone number.
Most medical offices rely only on voic during the night and weekends.
Patient insurance information may be sent electronically using telephone lines.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

3. Pretest, cont. True or False
Physicians should not be contacted when out of the office using cell phones or pagers.
A telephone electronic routing system avoids placing incoming calls on hold.
A physician will accept a call from another physician, even if it interrupts a patient examination.
The medical assistant may not take a message from a laboratory that includes the results of diagnostic tests.
If a patient requests a prescription refill, the medical assistant should ask for the pharmacy name and telephone number.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

4. Introduction to Telephone Techniques
The telephone may be the first contact with the medical office
Managing the telephone is one of the most important jobs in the medical office
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

5. Telephone Courtesy
The telephone should be answered promptly, within three rings
The medical assistant (MA) identifies the office and himself or herself
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

6. Telephone Courtesy, cont.
Important to ask politely who is calling
Always speak before putting someone on hold
Avoid putting a physician on hold
Check back at least every 30 seconds with a caller on hold
Avoid doing something else while on the phone
Other work
Chewing gum or eating
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

7. Telephone Personality
Telephone voice gives nonverbal cues
Interest, friendliness, concern, and understanding are communicated
Boredom, anxiety, and lack of concern are also communicated
MA should stay focused on the call and smile
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

8. Telephone Personality, cont.
Use the same volume as when speaking in person
Avoid developing an artificial telephone voice, which often comes across as cold and unreal
Enunciate clearly (speak clearly)
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

9. Effective Telephone Communications
The caller needs to have the MA’s complete attention
Try to complete call without interruption
Being organized facilitates handling calls
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

10. Effective Telephone Communications, cont.
Have information and materials available to handle the majority of phone calls
Message slips
Pens
Appointment book or computer appointment screen
List of frequently called numbers
Desk clock, computer clock or wrist watch to note time of messages
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

11. Effective Telephone Communications, cont.
Begin by identifying the practice and giving own name
Ask for caller’s name if caller fails to identify self
Use complete sentences and avoid being abrupt
Important to use good posture when talking on the telephone
Back supported
Neck in neutral position
Feet flat on the floor or supported on a footstool
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

12. Effective Telephone Communications, cont.
Use headset if answering telephone is a frequent duty
Tucking receiver between head and shoulder places strain on shoulder muscles
Headset allows for good body posture and leaves hands free
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

13. Effective Telephone Communications, cont.
Be clear with callers about when they can expect their calls to be returned
Avoid cutting into a person’s replies—even if he or she rambles
Let the caller know what the MA can and will do for follow-up
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

14. Effective Telephone Communications, cont.
Telephone Headset Leaves Hands Free
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

15. Telephone Technology Multiline Telephones
Multiline telephone with several extensions is commonly used
Flashing light usually identifies line that is ringing
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

16. Telephone Technology, cont.
From Young AP, Proctor DB: Kinn’s the medical assistant, ed 10, St. Louis, 2007, Saunders
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

17. Telephone Technology, cont.
Should handle second call and return to first as soon as possible
Tell first caller he or she will be placed on hold
Handle calls in order
Calls are transferred if caller asks for another person or extension
Caller is identified before transferring the call
Helpful to keep names of callers on hold written down
If hold light continues to flash, should check with caller every 30 seconds to be sure call goes through
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

18. Telephone Technology, cont.
Other Features of Multiline Phones
Speed dialing: storage of frequently called numbers
Call forwarding: send calls to another extension or telephone number
Call park: place call on hold and retrieve from another number
Caller ID: identifies caller’s telephone number
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

19. Telephone Technology, cont.
Answering Machines and Answering Service
Answering service
Used by most physician’s offices when office is closed
Independent company answers telephones for a number of clients
Some offices use an answering machine with message and instructions
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

20. Telephone Technology, cont.
Voice Mail
Voice mail also common
Built into the telephone system
Messages can be left in a number of “mailboxes” for different people
May have mailboxes for each staff member
Each voice mailbox has a separate extension
In some systems can enter last name of person being called if extension is not known
Offices with voice mail also rely on answering services for after hours calls
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

21. Electronic Information Transfer
Fax Machine
Fax machine uses telephone lines to send images (text and pictures) over the phone
Office should have dedicated telephone line for fax machines
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

22. Electronic Information Transfer, cont.
Fax phone number should be listed next to every phone for convenience
If confidential information must be sent via fax, be sure to designate as “Confidential” on the cover sheet and obtain patient consent (unless emergency)
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

23. Electronic Information Transfer, cont.
From Young AP, Proctor DB: Kinn’s the medical assistant, ed 10, St. Louis, 2007, Saunders
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

24. Electronic Information Transfer, cont.
Electronic Data Transmission
, billing, and insurance information can be transmitted using telephone system
There are various technologies for electronic transmission using telephone lines
Modem requires dedicated telephone line
DSL (digital subscriber line) is faster and can use same telephone line for voice transmission
Fiberoptic cable provided by telephone company
Cable modem uses cable television cable
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

25. Electronic Information Transfer, cont.
Method of sending, receiving, and storing messages and files using the Internet
Should be assumed that messages are not secure
MA should not use office for private messages
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

26. Electronic Information Transfer, cont.
Electronic Transmission of Billing and Insurance Information
Information is transmitted via telephone lines to billing departments, billing affiliates, and/or insurance companies
HIPAA Security Rule requires measures to keep patient health information secure
Secure networks
Encryption system, such as SSL (Secure Sockets Layer)
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

27. Electronic Information Transfer, cont.
Cellular Telephones and Smartphones
Cell phone uses radio signals for telephone contact
Smartphone has additional features
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

28. Electronic Information Transfer, cont.
PDA (personal digital assistant) with various software tools
Internet connection
Ability to send and receive s
In some cases, access to patient electronic medical records
Physician cell phone numbers should not be given to patients
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

29. Electronic Information Transfer, cont.
Pagers
Direct dial to pagers (beepers)
Digital pagers: leave a number to return call
Alphanumeric pagers: display a message in addition to telephone number
Used when area has unreliable cell phone service or in larger institutions
Simple pager can be used so that patients can leave the waiting room
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

30. Incoming Calls Electronic Routing System
Electronic (voice mail) routing system directs call to appropriate part of office
Saves expense of a staff person who would otherwise be answering the phone
Electronic routing keeps patients from being put on hold
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

31. Incoming Calls, cont.
Some patients find electronic routing confusing and frustrating
Must listen to a number of options
Person they need to speak to may not be available
Person they need to speak to may not return call promptly
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

32. Incoming Calls, cont. Calls answered by the MA offer the human touch
One person is responsible for routing calls
Person gives a little more attention to individuals who might be confused by voice mail
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

33. Managing Incoming Calls
Performing Telephone Screening
MA decides how important the call is
Routine calls are handled in the order they come in
Calls from physicians are put through at once
Emergency calls are treated as urgent and receive top priority
Calls from the physician’s relatives may be put through
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

34. Managing Incoming Calls, cont.
It is polite to obtain the caller’s name and ask to put the call on hold
MA decides who should handle the call
If caller asks for member of the office staff by name, call is transferred
If caller has a question, MA decides best person to answer call
Most physicians don’t take calls while seeing patients unless they have told staff to put a certain caller through or unless it is another physician
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

35. Managing Incoming Calls, cont.
Calls the Medical Assistant Usually Handles
Requests to schedule appointments
May schedule office appointments or outside laboratory or hospital appointments
May schedule tests for patients
Billing inquiries
Refers to the patient account in the computer
Gives caller the information requested
May refer caller to billing specialist or office manager
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

36. Managing Incoming Calls, cont.
Receiving diagnostic test and laboratory results
Results may be sent by fax or computer
If telephoned, MA takes information on blank laboratory slip
Records patient’s name and date when tests were taken
Pulls patient medical record after taking results and clips results to front
Records all data accurately
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

37. Managing Incoming Calls, cont.
Requests for information
Gives directions to the office
Explains office hours and office’s medical specialty
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

38. Managing Incoming Calls, cont.
Taking Messages
Best to use message pad that makes a copy
If message form does not make a copy, MA keeps a telephone log
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

39. Managing Incoming Calls, cont.
Do not write in a space intended for physician follow-up
Include all information
Date and time
Name of physician or staff member being called
Patient’s full name and date of birth
Clear message that indicates what the caller wants
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

40. Managing Incoming Calls, cont.
Additional information to clarify the message
Medication allergies if patient is ill or requests medication
Telephone number to return call and pharmacy telephone number if appropriate
Initials of MA taking the message
Use message form when transcribing messages from answering machine or voice mail
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

41. Managing Incoming Calls, cont.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

42. Managing Incoming Calls, cont.
Patient Requests for Test Results
Find out when and where the test was done
Locate the medical record and be sure laboratory report and results are in the record
Leave the message and the medical record for the physician
Follow up as instructed by physician
Call patient with results
Schedule follow-up test or appointment
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

43. Managing Incoming Calls, cont.
Patients Reporting Satisfactory or Unsatisfactory Progress
If patient reports satisfactory progress, take brief message
If patient reports unsatisfactory progress, take a more complete message
Place medical record with message for physician to review
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

44. Managing Incoming Calls, cont.
Requests for Medication or Prescription Refills
MA gets patient’s name and date of birth
Identifies medication, dosage, and number prescribed before
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

45. Managing Incoming Calls, cont.
If patient calls, gets the pharmacy phone number and how often the patient takes the medication
If the medication is an antibiotic or controlled substance, asks about symptoms that require a refill
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

46. Managing Incoming Calls, cont.
Instruct the patient to check with the pharmacy the next day
Physician follows up directly with the pharmacy or writes a message for the MA to call in
If MA calls the pharmacy, should always document in the medical record
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

47. Managing Incoming Calls, cont.
Sample Message for Prescription Refill
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

48. Managing Incoming Calls, cont.
Calls for Referrals
Patient may call to say he or she needs a referral to see a specialist or to have laboratory work
MA records the necessary information
Checks with the physician to make sure referral is necessary
Completes referral forms as completely as possible and obtains signature
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

49. Managing Incoming Calls, cont.
Calls Requesting Laboratory or Diagnostic Tests
Patient may request a laboratory or diagnostic test
MA obtains authorization from the physician
Completes necessary laboratory slip for patient to pick up or enters information into computer
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

50. Managing Incoming Calls, cont.
Patients with Medical Questions
Take a message for a physician or refer call to other staff member
Office should have written guidelines to screen medical questions
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

51. Managing Incoming Calls, cont.
Calls from Other Physicians
Put calls from physicians right through to the physician
Give the name of the calling physician
May need to transfer the call to another extension for privacy
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

52. Managing Incoming Calls, cont.
Calls from Salespeople
Salespeople are often seen by the office manager, who gives information to the physician
Drug representative must call for an appointment with the physician
These appointments usually made during lunch
Physician must agree before such an appointment is made
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

53. Managing Incoming Calls, cont.
Urgent or Emergency Calls
MA should remain calm and get the following information
Caller’s name
Caller’s phone number
Identity of person who has the problem and relationship to caller
Patient’s symptoms and current condition
Brief history of symptoms or accident
Any treatment that has already been given
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

54. Managing Incoming Calls, cont.
Follow office procedure after determining nature of urgent call using procedure manual
If no licensed professional in the office, the MA must advise the caller
If emergency is serious or life threatening, tell caller to call an ambulance (911)
MA may make the call for the caller
If a case of poisoning, instruct caller to call poison control center for your area
If patient can walk, caller can be instructed to take the patient to the emergency department or call an ambulance
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

55. Managing Incoming Calls, cont.
If problem can be treated in office, gives patient an appointment
If MA is unsure how urgent the problem is, contacts physician for instructions
If in doubt, it is always safer for the MA to instruct the patient to call an ambulance
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

56. Problem Calls The Caller Who Refuses to Give Information
Usually an individual who wants to speak to the physician
Explain that the caller’s name and telephone number is necessary to take a message
Caller can write a letter to the physician and to mark it personal
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

57. Problem Calls, cont. Complaints Listen carefully Avoid getting angry
Act professional and be patient
Get as much information from the caller as possible
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

58. Problem Calls, cont. Avoid hanging up on an angry caller
Keep voice at normal speaking tone
Instruct patient what follow-up to expect and when to expect it
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

59. Problem Calls, cont. Patients with Special Problems
Listen carefully and try as much as possible to understand
Always obtain caller’s name and telephone number
Speak slowly and clearly without shouting
Use simple language
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

60. Problem Calls, cont. Ask if caller understands what you are saying
Get translator if necessary
If patient seems confused, ask if there is another person who can help
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

61. Outgoing Calls Local Calls
Privacy should be provided when making calls to patients
Leave only office name and telephone call with request for patient to call back on answering machine
If calling about bill, discuss only with patient
Organize all information before placing calls
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

62. Outgoing Calls, cont.
If placing a call for a physician, make sure physician is ready to talk first
Staff should not make or receive personal calls except for emergencies
Personal calls tie up phone lines and take time away from work
Outgoing personal calls should occur at lunch time or break on a personal cell phone
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

63. Outgoing Calls, cont. Long Distance Calls
Can usually be dialed directly
To obtain phone number, can use long distance directory at area code
Should be aware of different time zones when making long distance calls
Office may have a code to prevent unauthorized long distance calls
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

64. Outgoing Calls, cont. Conference Calls
Some phone systems allow conference calls among three parties
MA may set up conference calls among more than three parties with a telephone carrier
May need to notify all parties of call number and participant code in writing
Can notify via
Can notify by telephone with follow-up fax
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

65. Posttest
True or False
If a call is on hold, the medical assistant should check back with the caller at least every 30 seconds.
When answering the telephone, the medical assistant should first identify the practice and himself or herself.
Call park places a call on hold so that it can be retrieved from a different telephone.
Voice mail mailboxes each have a separate extension.
Confidential information should never be transmitted via a fax machine.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

66. Posttest, cont. True or False
Physicians may have access to using their smartphones.
A telephone electronic routing system saves the expense of designating one person to answer incoming telephone calls.
Most physicians take calls from patients while they are seeing other patients.
Medical assistants routinely give patients the results of normal diagnostic tests over the telephone.
The medical assistant may take a message if a patient wants a referral or a diagnostic test.
Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.