Patients call your hospital for a wide variety of reasons, especially if you have an 800 number that routes to a patient call center. But no matter why they call – whether it’s a medical emergency or they just need directions – every contact deserves a human response from a knowledgeable representative who truly cares about patients’ wellbeing. In many hospitals, however, overworked staff and inefficient processes lead to long hold times, inadequate answers and incorrect call routing. Patient satisfaction, reputation and revenue are all at risk.

Why patients call

An analysis of hospital call centers shows that six types of calls represent a large percentage of the total. Knowing what these calls are about and being ready to handle them proficiently are the first steps to creating a great patient experience. The most common calls are for:

1. Appointments and directions.
Patients who need to make, cancel or change an appointment for X-rays or other hospital services often don’t know how to reach the right department directly. They call the 800 number looking for help navigating your system, and if they’re put on hold or routed incorrectly, they’ll hang up and go on to the next hospital, especially if they’re new or not firmly anchored to you. Handling these calls correctly can help prevent patient leakage to providers outside your network.

2. Medical emergency.
When a person’s life or health is at risk, they call the hospital expecting a quick answer and the appropriate action. The call center representative must be able to immediately triage the situation and decide whether to call an ambulance, direct the patient to the emergency room or urgent care facility, or refer them to a physician’s office. In addition to safeguarding the patient’s health, the right response can build loyalty and a positive perception of your facility.

3. Nurse advice.
Patients who don’t have primary care physicians or don’t use the healthcare system regularly call the hospital to describe their illness or injury and get free clinical advice. While these calls are not emergencies, they do require trained representatives who can determine the patient’s needs, whether it warrants a physician’s visit and where to route the call. Referrals to physicians in your network can secure new patients and generate long-term revenue.

4. Prescription refills.
While patients should call their prescribing physicians for prescription refills and medication questions, many opt for the hospital 800 number for convenience, or because they’re between providers. Worst case, they’re simply looking for drugs. The call center representative must be trained to determine whether the person is a patient and, if not, try to schedule them with one of your providers to establish the relationship and future revenue.

5. Health insurance.
Questions about what insurance plans your hospital accepts often spike in January after open enrollment, but patients call year-round with these and other questions about becoming a patient. Knowledgeable patient access representatives can verify eligibility and authorization up front to help avoid 75 percent of claim denials later.

6. Marketing.
Savvy hospitals market themselves with newsletters, free seminars, lectures and classes to spotlight their specialties and attract new patients to their health systems. When people call for information and to make reservations, they expect the same service they receive from other consumer outlets. When the patient call center handles these calls efficiently, the hospital not only closes the marketing loop, they can track the effectiveness of their marketing tactics.

Telephone trouble signs

Call center customer service gaps are not unique to hospitals, and many of the same problems apply. The number one reason for customer dissatisfaction, for example, is waiting too long on hold.² Is that a problem in your organization? How about the amount of time people have to navigate an automated system before they talk to a live agent? Seventy-five percent of consumers believe they spend too much time with automation.³ Here are some other symptoms of a less-than-healthy medical call center:

• Five percent or more of patients hang up before they’re helped.
• Patient wait times are longer than 60 seconds.
• Call-routing accuracy is less than 99 percent.
• Patient-satisfaction scores are trending down.
• Turnover among your healthcare call center representatives is high.
• You lack the capabilities to record patient calls.
• You don’t have time to provide ongoing coaching and training to your staff.

Every call counts

It only takes two negative phone experiences to diminish a person’s perception of a service provider.⁴ The massive decision tree faced by representatives in a hospital call center can be overwhelming, especially if they’re not clinically trained.

The answer for many hospitals is to outsource the patient call center function to reduce the burden and challenges of telephone triage and improve patient satisfaction. A professional healthcare call center can reduce cancellations and lost patients; improve call response time and call routing accuracy; improve revenue cycle speed, quality and efficiency; and improve patient satisfaction and loyalty. Costs go down, reimbursements go up, staff productivity increases and the bottom line improves.

About the Author: Keith Slater, Vice President of Business Development, Change Healthcare

¹ http://www.dcsglobal.com/files/EligibilityVerifier.pdf 
² “Consumer Survey Reveals the Customer Care Experiences That Most Impact the Relationship Between Cable Operator and Subscriber.” CSJ International Press Release. May 12, 2010. 
³ Harris Interactive Customer Experience Impact Report 
⁴ “Consumer Survey Reveals the Customer Care Experiences That Most Impact the Relationship Between Cable Operator and Subscriber.” CSJ International Press Release. May 12, 2010.

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