Healthcare Practice Management

Tips on the people, processes and technologies you need to run your healthcare call center

Patients are behaving like consumers these days. Unless you are blessed to be operating with no-shows less than 10%, you will most likely need to put in some extra efforts to improve patient visit volume.

Every day you deal with last minute cancellations from patients, no show patients that didn’t bother to even notify you, patients that made an appointment and never showed up (no-encounter patients), patients that have fallen out of care because (let’s face it) your staff had no time to deal with nor had a good grasp of an effective patient recall strategy etc..

Let’s face it – I am talking about you. Yes, you.

Here are a couple of tips and tricks based on my learning over the last few years.

Tip #1 – Use a healthcare focused CRM

I operated on spreadsheets for a long time, but finally I gave up and moved to a healthcare focused CRM myself.

Tip #2 – Spreadsheets are OK too

You don’t HAVE to use a CRM (and deal with HIPAA related challenges) – if you have a team that can do wonders with spreadsheets, you are OK here

Tip #3 – Get into a routine – with blinders on.

This team should NOT be focused on anything other than to increase patient volume. This means that no matter what else is happening with your practice operations, this team will stay on course – will not waver from their focus.

Your routine – Basically every day/week/month your team is going to prepare the list of no shows / cancellations / patients fallen out of care / community outreach / website appt requests etc etc from the day before, add to your list of patients to call, call these patients and update the spreadsheet with outcome from the call.. Rinse, repeat (trust me, life is easier with a healthcare focused CRM).

Tip #4 – Prepare for and understand the backlog

Considering that not more than 10-25% patients will pick up the call, be prepared that your team’s backlog of patients to call will keep growing everyday.

So, if you start with 100 patients in your campaign, on Monday your team might get you 20 outcomes (patient declined, wrong number, appointment scheduled / rescheduled, Do not call / DNC, lost to another practice, lost for another reason like a move, significant life event etc). That leaves (100-20) 80 patients in your team’s backlog. On Monday, you are going to have another 10 patients that were a no-show. So, the total backlog at the beginning of Tuesday is going to be 10+80 = 90. This list will keep growing and snow-balling.. Prepare for this.

Tip #5 – Automated/power dialer will help

If you do not use an automated dialer (not a robocall, different from predictive dialing), each one of your agents can manually dial about 200 patients a day. Plan your team accordingly and understand when you are going to add/remove team members (based on your backlog).

Tip #6 – Teach the technology or hire a team that knows the technologies

Choose the technologies your team is comfortable with. It’s better if you use a healthcare CRM for this but if you cannot, just start with spreadsheets to handle this data. If your team has never worked with a CRM before, they probably would not be able to handle a CRM that well.. In that case, you will need a good data analyst team to provide your call center with the correct non-duplicate patient data.

Choose wisely.

As time passes, you’ll notice that some patients will start appearing more than once in your campaign spreadsheets.. Make sure these spreadsheets don’t have duplicates and two of your agents call the same patient too many times. (This really ticks patients off)..

Tip #7 – Hire staff with the right outbound calling mindset

Make sure that you have identified the RIGHT staff (or a BPO team) that is accustomed to calling at least 150-200 patients a day and is experienced in either leaving voicemails (takes longer), sending text messages or convincing your patients to agree to be reappointed. Keep in mind that if you are leaving a voicemail, you should not call the same patient back within 2-3 days (minimum).. That’s why I prefer not leaving voicemails when possible – this allows my team to try calling the patient again (there’s no “right” or “wrong” strategy here.. You decide what’s right or wrong for your campaign).

This is not the same skill-set as ones needed for “appointment reminder” calls.. These calling agents/staff need to have some “sales” skills.

Tip #8 – Do not use the SMS capability of your EMR.

If your EMR automatically sends SMS to no-shows or cancelled patients, you could try to leverage that – however, in my experience, once you send an SMS to a patient (for appointment reminder or no-shows or patient reviews etc), they tend to write back on that same SMS thread. I have seen that happening way too many times wherein a patient sends an SMS back asking to reschedule an appointment or cancel their appointment or has a question about their medication etc..

Not having direct access to an SMS conversation with the patient (via EMRs) led me to decide on NOT using the SMS capabilities of an EMR.

Tip #9 – Leaving voicemails vs not, choose wisely

I do not leave voicemails as that leaves the ball in the patient’s court – I prefer to keep the ball in my court. Keep in mind that if your staff is leaving voicemails that are not pre-recorded, you are not going to be able to make as many dials. So, either reduce the expected call volume per day or ensure you use a healthcare CRM (or another technology) that automatically leaves voicemails if the patient does not pick up the call (70-80% times patients don’t pick up).

Tip #10 – Rotate your outbound calling numbers.

You will also have to understand that most phone companies start marking your phone number(s) as a “robocaller” or a “spam likely” if you make more than 200-250 calls from the same number per day. Make sure you have identified a bank of phone numbers to make high volume outbound calls from.

If you do not have access to a large number of outbound phone numbers (DIDs), just head over to the MANY VOIP providers (e.g. Amazon, skype, twilio, plivo etc) to get yourself multiple outbound phone numbers.

Even if you were to make only 200 calls a day, over time, your outbound number is bound to get marked as “spam likely” or “robocaller”.. You simply need to monitor your outbound dial numbers and as soon as a few providers have marked your number as “spam likely”, just release this number and buy a new one (buying numbers is dirt cheap, so it’s not really a big deal).

Tip #11 – Decide whether patients can call back on the outbound number or not.

When you buy outbound phone numbers (DIDs) or whether you call from your office phone, sometimes callers are going to call you back based on the missed call (even if you are leaving voicemails). Patients don’t always call back during normal business hours and setting up a voicemail on those VOIP outbound phone numbers is not as easy as setting one up with your voice carrier. On top of that, you staff or the BPO team you’re working with will be working on shifts – so they will need to plan to return those voicemails. This slows down your daily operations, so decide wisely what you want to do here.

Tip #12 – Have a dedicated team (inhouse or hire a dedicated BPO team)

I have tried keeping an inhouse team handling all patient calls but the costs of doing so in NYC area is simply not sustainable. Plus, my clients work primarily with a specific patient population that puts a lot of such pressures on practice management (practice administrators). On top of that, I noticed that whenever an emergency situation came up, my clients pulled people for “all hands on deck”. Do NOT take this approach. This team should be dedicated, with laser focus.

My clients also have a diverse patient population that does not necessarily speak only English (combination of English, Spanish, Hindi, Bengali etc). If you are lucky to have an inhouse team that can support these languages, then you should keep that – else, leave it to the BPO companies to take on this headache for you.

Tip #13 – Train each week

If you are hiring a BPO team – start with solid training on various call types and how to handle these situations. I recommend spending a couple of hours each week on training this team. Each week, this team is going to report back various scenarios that came up during the week. Make sure you set aside 2-3 hrs per week to train them. Over a few weeks, you will see the fruits of your labor.

Tip #14 – Make sure that your team has access to your EMR

This probably should be tip #1. Without having direct access to your EMR (of course, HIPAA secure, BAA protected), this team will be making mistakes. It’s sort of like tying their legs and asking them to run. Don’t do it.

I am going to add more to this list as I find more time. Meanwhile, feel free to try these tips out. If you need any help, reach out to me.

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