1. 1
Telephone Techniques

2. Learning Outcomes 1.1 Explain the importance of communication skills.
1.2 Explain how to manage incoming telephone calls.
1.3 Describe how the Health Insurance Portability and Accountability Act (HIPAA) applies to telephone communications.
1.4 Describe the procedure for calling a new prescription or prescription renewal into a pharmacy.

3. Learning Outcomes (cont.)
1.5 Compare the types of calls the medical assistant handles with those the physician or other staff members handle.
1.6 Describe how to handle various types of incoming calls from patients and from others.
1.7 Discuss the importance of proper telephone etiquette.
1.8 Describe the procedures for taking telephone messages.

4. Learning Outcomes (cont.)
1.9 Explain how to retrieve calls from an answering service.
1.10 Describe the procedures for placing outgoing calls.
1.11 Explain the function of telephone triage in the medical office.
1.12 Explain the uses of a facsimile machine in a medical office.

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
Learning Outcomes:
1.1 Explain the importance of communication skills.
1.7 Discuss the importance of proper telephone etiquette.
1.8 Describe procedures for taking telephone messages.
Pronunciation: Saying words correctly.
Enunciation: Clear and distinct speaking; not mumbling.

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
Poor telephone management results in
Learning Outcomes:
1.1 Explain the importance of communication skills.
1.2 Explain how to manage incoming telephone calls.
Caring
Attentive
Helpful
Bad feelings
Misunderstanding
Unfavorable impressions

7. Communication Skills Using tact and sensitivity Showing empathy
Giving respect
Being genuine
Learning Outcome:
1.1 Explain the importance of communication skills.
1.7 Discuss the importance of proper telephone etiquette.

8. Communication Skills (cont.)
Displaying openness and friendliness
Refraining from passing judgment or stereotyping
Being supportive
Asking for clarification and feedback
Learning Outcomes:
1.1 Explain the importance of communication skills.
1.7 Discuss the importance of proper telephone etiquette.

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
Learning Outcomes:
1.1 Explain the importance of communication skills.
1.7 Discuss the importance of proper telephone etiquette.

10. Communication Skills (cont.)
Complete
Concise
Clear
The 5 Cs of
Communication
Learning Outcome:
1.1 Explain the importance of communication skills.
Completeness: The message must contain all necessary information.
Clarity: The message must be legible and free from ambiguity.
Conciseness: The message must be brief and direct.
Courtesy: The message must be respectful and considerate of others.
Cohesiveness: The message must be organized and logical.
Cohesive
Courteous

11. Apply Your Knowledge
1. What two things does proper telephone management do?
ANSWER: Proper telephone management keeps patients informed and ensures patient satisfaction.

12. Certainly! 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!

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.8 Describe the procedures for taking telephone messages.

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.3 Describe how the Health Insurance Portability and Accountability Act (HIPAA) applies to telephone communications.
1.7 Discuss the importance of proper telephone etiquette.
HIPAA guidelines: Follow your office’s standards or written policies regarding privacy and confidentiality of patient information communicated by telephone.

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.6 Describe how to handle various types of incoming calls from patients and others.

16. Routing 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
Generally, three types of calls are received in the office:
1) Administrative Issues
3) Clinical Issues
2) Emergency Calls
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.6 Describe how to handle various types of incoming calls from patients and others.

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.5 Compare the types of calls the medical assistant handles with those the physician or other staff members handle.
1.6 Describe how to handle various types of incoming calls from patients and others.
Prescription renewals: If approval for the renewal is not noted in the patient’s chart, discuss it with the physician and have the physician sign off on the chart before calling the renewal in to the patient’s pharmacy.

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.5 Compare the types of calls the medical assistant handles with those the physician or other staff members handle.
1.6 Describe how to handle various types of incoming calls from patients and others.
If a patient prefers to discuss symptoms only with the doctor, follow office protocol. Depending on the doctor’s preference and availability, call the doctor to the phone or take a message so the doctor can return the call.
A routing list specifies who is responsible for handling certain types of calls.

19. Apply Your Knowledge Very Good!
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.
Very Good!

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
Diagnostic Reports
Document what information is given to the patient
Questions about Medications
Get approval for renewals
Answer questions about medications
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.6 Describe how to handle various types of incoming calls from patients and others.
Appointments: Take caller’s name, daytime telephone number, and reason for visit. Repeat information to verify.
Billing inquiries: If a patient is dissatisfied for any reason, document all appropriate comments and relay the information to the physician or office manager.
Diagnostic reports: If results are abnormal, physician must speak with patient. Tell patient the office has received the results and the physician will call as soon as possible.
Questions about medications: All prescription renewals must be documented in the patient’s medical record, along with the date and the initials of the person who authorized the renewal.

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.6 Describe how to handle various types of incoming calls from patients and others.
Guidelines for dealing with an angry caller
Listen carefully and acknowledge the person’s anger
Remain calm, speak gently and kindly; do not interrupt the patient; do not act superior or talk down to the patient
Let the patient know that you will do your best to correct the problem
Take careful notes and document the call
Do not become defensive
Never make promises you cannot keep
Follow up promptly on the problem
Inform the physician, even if the situation is resolved; inform the physician immediately if patient threatens legal action

22. Emergency Calls 911 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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.6 Describe how to handle various types of incoming calls from patients and others.
911

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.3 Describe how the Health Insurance Portability and Accountability Act (HIPAA) applies to telephone communications.

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.3 Describe how the Health Insurance Portability and Accountability Act (HIPAA) applies to telephone communications.
Other physicians – exception
If information is requested by a physician to whom your office has referred the patient for care, you may release medical information specific to the care. Because of the referral, there is a contract involved for continuity of care.
Conference calls
Newer telephone equipment can provide teleconferencing
Call-in conferencing

25. Excellent! 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!

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!
Learning Outcome:
1.7 Discuss the importance of proper telephone etiquette.
Telephone etiquette: Good manners on the telephone.

27. Using Proper Telephone Etiquette (cont.)
Saying words correctly
If the name is difficult to pronounce, ask the patient how it is pronounced
Pronunciation
Tone
Positive
Respectful
Learning Outcome:
1.7 Discuss the importance of proper telephone etiquette.
Saying words in a clear and understandable manner
Eating, chewing gum, and incorrect placement of the phone interfere with enunciation
Enunciation

28. Making a Good Impression
Project an attitude of helpfulness
Always refer to the caller by name
Thank the caller before hanging up
Exhibiting courtesy
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
Giving undivided
attention
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.7 Discuss the importance of proper telephone etiquette.
Exhibiting courtesy
Apologize for any errors or delays
Always allow the caller to hang up first
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
Putting a call on hold

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.7 Discuss the importance of proper telephone etiquette.

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
Learning Outcomes:
1.2 Explain how to manage incoming telephone calls.
1.7 Discuss the importance of proper telephone etiquette.

31. Apply Your Knowledge Super Answer!
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.
Super Answer!

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
Learning Outcome:
1.8 Describe the procedures for taking telephone messages.

33. Taking Messages (cont.)
Always keep a pen and paper near the telephone so you are prepared to record the message.
TO:____________________________________________
Date_________________ Time______________
Message
FROM:_________________________________________
Telephone ( )__________________extension________
Message Details:
Your name or initials
Contents of a Telephone Message Pad
Learning Outcome:
1.8 Describe the procedures for taking telephone messages.
Message description should include status or any action to be taken, such as “Urgent,” Please call back,” or “Wants to see you.”

34. Telephone Logs Manual Electronic 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 ed
Learning Outcome:
1.8 Describe the procedures for taking telephone messages.

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
Learning Outcome:
1.8 Describe the procedures for taking telephone messages.
Do not commit the physician to returning the call; instead, say “I will give your message to the physician.”

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
Message
Learning Outcome:
1.8 Describe the procedures for taking telephone messages.

37. Apply Your Knowledge Answer True or False to the following:
Right!
Answer True or False to the following:
___ Documenting calls can protect against legal actions.
___ Confidentiality is just as important when making telephone calls as in written communication.
___ You should ask for the patient’s SSN if you have to pull his/her record.
___ You should repeat key points to verify information. T T F
Date of birth T

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
Learning Outcome:
1.8 Describe the procedures for taking telephone messages.

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
Learning Outcome:
1.9 Explain how to retrieve calls from an answering service.

40. CORRECT! 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
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
CORRECT!

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
Learning Outcome:
1.10 Describe the procedures for placing outgoing calls.
It is important to determine the time zone and time of day in the location you are calling before you place a call.
Front of phone book
Telephone operator
Internet:
Finding area codes online

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
Learning Outcome:
1.10 Describe the procedures for placing outgoing calls.
Allow time for person to answer telephone
At least a minute or 8 rings
Longer for elderly or disabled people

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
Learning Outcome:
1.10 Describe the procedures for placing outgoing calls.

44. r Apply Your Knowledge PERFECT!
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

45. Learning the Triage Process
Telephone Triage
Telephone triage is used as a process of deciding what action to take
Learning the Triage Process
Telephone staff are given guidelines to handle common conditions
Telephone staff must determine whether caller requires additional care
Telephone staff cannot diagnose or treat
Specific information must be obtained, such as name, age, symptoms, and anxiety
Learning Outcome:
1.1 Explain the function of telephone triage in the medical office.

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
Learning Outcome:
1.1 Explain the function of telephone triage in the medical office.

47. Telephone Triage (cont.)
Level of Severity
Categorizing the Problem
Manage by telephone
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
Learning Outcome:
1.1 Explain the function of telephone triage in the medical office.

48. Telephone Triage (cont.)
Taking Action
Clinical triage – based on office guidelines
Determine extent of problem (Is this an emergency?)
Decide on appropriate action
Learning Outcome:
1.1 Explain the function of telephone triage in the medical office.
Telephone situations must be handled correctly to protect the health and safety of the patient.

49. Apply Your Knowledge Great!
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!

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
Learning Outcome:
1.12 Explain the uses of a facsimile machine in a medical office.
Faxed documents: Keep a fax log for court-mandated documentation. Keep records for at least three years.

51. Telephone Slamming and Cramming
Unauthorized changes
Report to carrier immediately
State and federal crime
Cramming
Unauthorized charges
Learning Outcome:
1.2 Explain how to manage incoming telephone calls.

52. Pagers and Cell Phones Pager Cell phone
Personal telecommunications device for short messages
Types
Only receive messages
Send and receive and numeric messages
Cell phone
Mobile voice or data communication
Remember to maintain patient confidentiality
Learning Outcome:
1.2 Explain how to manage incoming telephone calls.
Cell phone use
Cell phones are not considered secure lines
To maintain patient confidentiality, have brief, generic conversation on cell phone, and then follow up on land line or in person.

53. Impressive! 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!

54. In Summary
1.1 Effective communication skills are important because they employ a positive image and assist with satisfying the expectations of the patient.
1.2 Answer incoming telephone calls promptly. Be courteous and pleasant at all times on the telephone.
1.3 In compliance with HIPAA, information communicated by telephone should be confidential and private so that information cannot be overheard.

55. In Summary (cont.)
1.4 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.
1.5 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.

56. In Summary (cont.)
1.6 Always refer to your policy and procedure manual regarding how to handle incoming calls appropriately. Remember to always be courteous.
1.7 Customer service is critical when using the phone, and provides your office with a tone of professionalism.
1.8 When taking telephone messages, always have a pen and pencil near the phone. Proper documentation protects the physician.

57. In Summary (cont.)
1.9 Retrieve messages from an answering service at a set scheduled time, identify yourself, write down pertinent information, and repeat information—confirming that you understand.
1.10 When placing outgoing calls, check the time zone, obtain information from the physician that needs to be provided, and arrange for consultations if needed.

58. In Summary (cont.)
1.11 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.
1.12 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.

59. When people talk, listen completely. Most people never listen.
End of Chapter 1
When people talk, listen completely. Most people never listen.
~ Ernest Hemmingway