The July 2019 Issue



Healthcare Call Center Work Can Be Hard

Don’t Focus on the Angry Masses but Grab onto a Good Call Whenever Possible

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan-call center

Working in a call center is challenging. Although it’s been a long time since I answered calls in one, I’m still aware of how hard it is. That’s because I’m now on the other end of the phone, such as for dealing with healthcare related issues.

In truth, I try to minimize my interaction with healthcare personnel, in large part because of the hassle that occurs once the appointment ends. I spend much more time trying to get the bill paid then I spent talking to the healthcare professional in the first place.

Attempting to get my provider to work with my payor is challenging at best, and a futile endeavor at worse. Neither party will talk to each other, which means me talking to them separately. This requires me phoning their respective call centers. Then I ping-pong back and forth, working hard to reach a resolution but making little progress. Too often I get a slightly different response each time I call. 

Currently, I have two outstanding medical invoices, which I’ve been working on for several months. It would be far simpler to ignore the negotiated fees and pay the billed amount in full, but because I must have insurance, I might as well try to use it. Right?

A recent call to my provider quickly escalated into a confrontation, with them threatening to turn me over to collections and me begging them to allow me to pay the negotiated fee as payment in full. They would have none of it. I may have raised my voice. I may have said some things I’m not proud of.

I hung up with equal parts remorse and frustration.

Three days later I called back for another round. I had new information. I knew I’d reach a different rep because they’re a large organization, and I’ve never talked to the same person twice.

Guess who answered the phone? Yep, the same person I failed to treat with respect on my prior call. I groaned to myself. I sucked in a lungful of courage and opened my mouth. “Hi! I talked with you a few days ago and wasn’t very nice. I’m sorry.”

She didn’t know what to say. Truly, she was speechless. After a silence long enough to make me wonder if I should apologize some more, she meekly said “Um . . . thank you.”

Although we had a civil conversation this time, I got no closer to getting my bill paid. I guess it’s time for another round of calls.

Call center work is hard, especially when callers don’t want to hear the information agents have to tell them. Difficult calls are common, so healthcare call center reps must take a small win whenever they can. If they hold onto it, it might help them weather the plethora of angry callers that are bound to follow.

Peter Lyle DeHaan is the publisher and editor of Medical Call Center News and AnswerStat.


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Bridging the Access Gap

By Tom Cox

For many patients, finding the right physician and booking an appointment isn’t consumer friendly. Unfortunately, the process isn’t much easier on the other end, either. Even the best call center agents struggle trying to field hundreds of calls a day and book appointments in a timely manner. They use multiple systems with disjointed information, or worse, they flip through binders trying to find the appropriate provider for the patient. These procedural flaws bring pain to everyone involved, but the fall-out is patients getting frustrated with the difficulty and disengaging—often never receiving the care they need.

But there is hope. New digital care coordination solutions enable call centers to bridge the access gap with automated business rules, guided search, and real-time scheduling in a single platform.

Getting There Faster with Guided Search: Before digital care coordination, patients had no other option but to schedule a doctor appointment by phone. Many of these calls—especially for larger healthcare organizations—went to call centers where agents fielded the calls and scheduled the appointment. In other cases, with no centralized call center, the providers’ office staff took the calls among their other duties. 

Underneath what may seem like a simple task of scheduling over the phone lies a much more complex process: searching through binders of scheduling protocols and then flipping between different customer relationship management (CRM), electronic medical record (EMR), and practice management (PM) systems, all while the patient remains on the line. Phone calls could take up to twenty minutes while agents manually sifted through pages of information or put the patient on hold to verify insurance and other scheduling details.

Now, guided search, provided by digital care coordination, automates all scheduling protocols. This enables call center agents to find the right physician quickly and then schedule an appointment. Call center agents ask patients a set of qualifying questions, and the platform uses those responses to match patients to the best fit provider based on their care need. Once identifying a provider, call center agents have a real-time view of the provider’s schedule, allowing them to book an appointment on that call. What once was a manual, time-consuming process is now completed in a few minutes.

Guided search is particularly useful for health systems and other provider organizations tasked with navigating the complex and complicated world of specialty care. Scheduling protocols are more particular for specialists. The dangers of scheduling the wrong specialist risks care delays, consequential outcomes, and wasted time for both patient and provider. 

Making It Better with Analytics: The other critical factor is the availability of real-time analytics. While guided search is important for connecting patients to the right care, ongoing, accurate, and easily dissectible analysis of the process is necessary for straightening out any kinks and maximizing system efficiency. 

Rather than manually generating a report that is just a snapshot in time, a platform with built-in real-time analytics capabilities can make that information—and more—available at any time. Analytics can point to trends, averages, and benchmarks useful for optimizing the appointment scheduling process. 

Customized reports can track items such as provider utilization, pinpointing any bottlenecks in the scheduling process and highlighting areas to preserve time and resources. 

Faster, Easier Access to Care: Bridging the access gap is more than improving the scheduling process. Organizations should also consider the elements behind scheduling that prevent patients from getting the care they need in a timely manner. In most cases, there are two factors: the ability to identify the right doctor for a specific care need, and the ability to track scheduling and referral patterns, identifying areas for improvement. 

Tom Cox is the CEO of MyHealthDirect, a leading provider of digital care coordination solutions.


Healthcare Call Center News

Call 4 Health CEO Joe Pores Receives Excalibur Award

The Sun Sentinel honored six business leaders with its annual Excalibur Award, including Call 4 Health’s CEO Joe Pores. The Excalibur Awards recognize outstanding contributions to their organizations and communities. 

Awarded May 7, 2019, the Excalibur Awards honor business leaders in South Florida for 2018. The awards recognize business achievement and civic contributions each year, starting in 1978. The winners for this esteemed business leader of the year award were selected by a panel of the Sun Sentinel Media Group and nominations from the public.

Call 4 Health employs 300 people in Delray Beach, with offices near Baltimore and Nashville, where it employs 200 more. The company, which handles 1.5 million calls each month, generates more than $20 million in annual revenues, with an annual 25 percent growth rate.

Formed in 1997 as a medical answering service, the company expanded over the years from answering doctor office’s calls to offering advanced healthcare services including patient registration and appointment services for healthcare systems, hospitals, and hospice organizations. Additionally, some hospitals outsource their internal switchboard function to Call 4 Health


A Thought for Today

“Experience makes us see an enormous difference between piety and goodness.” -Blaise Pascal