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Identify the people that will lead your centralized call center initiative
This is a disruptive and transformative change in your small business or your medical practice.
Make sure you identify a steering committee that will take on this initiative and will guide/coach the team.
This could include your office manager, site supervisors, patient access director (if you have one), front desk/receptionists and a lead from your medical billing department.
For my clients, this includes the receptionists from each office location and the office manager.
I had excluded the medical billing department and found out that they have a LOT of inputs into what the receptionist must do / the information that the front desk must gather from patients to avoid downstream issues in the medical billing process.
Keep in mind that appointment scheduling service and revenue cycle management services teams go hand in hand.
Two peas in a pod.
Determine the locations and providers participating in the centralized medical call center roll out
You could take one of these approaches to the centralized call center roll out.
All practice locations and all doctors
– in this approach you decide on a cut over date and transition your entire practice and all its providers to your centralized healthcare call center.
There are several pros and cons to this approach.
- Planning tends to be very thorough in this case and the committee tends to view this a lot more seriously (as there’s no rolling back).
- That makes for stringent standards as well
- Stakeholders are a lot more actively participating. This is because they realize that all functions are being transitioned over the call center.
- You will identify various scheduling gaps in this process. This happens because all locations come together towards the same goal.
- You will develop a centralized scheduling workflow . This is consistent with best practices. This does not allow for variations based on doctors’ personal preferences
- This is a big bang approach.
- Investments are made up front, in one shot.
- The risks are higher in this approach as this could lead to larger disruptions, should the roll out not work perfectly from the get-go.
- Providers are hesitant because of their perception of loss of control over their own schedules.
- Planning requires more time – hence, executive management tends to view this as analysis-paralysis.
Opt–in of doctors
– in this approach, your providers / doctors make the decision whether they want to participate / open up their schedules to a centralized call center or not.
For the providers that do accept to participate, all their locations are made available for scheduling.
This has the biggest provider buy in from the get go.
It is a lot easier to handle as the staff has to manage only those providers’ preferences.
It also allows patients to “follow” a doctor / provider of their choice.
This allows us to test the waters and iron out the kinks in the transition process before bringing other providers onboard.
This is only a stop gap solution.
If the end goal is to transition to a full fledged centralized healthcare call center, then this does add a bit to the confusions during the interim.
You will typically confuse staff about which schedules are available to the centralized call center vs which ones are not.
You will have several dependencies between provider schedules (based on visit types) that are not accounted for in this approach.
Opt–in of locations
– in this approach, you start a trial / pilot with only a few locations (or even a single location).
This allows you to start with locations that have a lower call volume.
This also allows you to start this “trial”, iron out the issues in call handling/scheduling before transitioning the entire practice / health system to using the centralized call center.
These are very similar to the issues you will face with the option above (opt in providers)
I ended up taking approach #1.
Centralized call center location
Learn how to establish a location with enough space to accommodate increases in call center staff when needed
I knew that once the centralized call center started providing tangible benefits to the practice, this would increase the volumes of patient calls and would increase the volume of patients seen.
This in turn would also improve the practice reputation, which will contribute to increased patient visits and appointment calls.
I needed to be ready for the growth of this practice – which in turn would grow the call center staffing and the team size as well.
Based on the latest increase in minimum wages in the USA, our first approach was to have this call center location in USA states where the minimum wage was not as high as that of NYC.
However, after a lot of budgetary discussions and calculations, this option turned out to not be sustainable moving forward with the growth plans of the practice.
Next option was to locate the call center in Asia (India or philippines). Considering the fact that a large part of the patient population spoke South asian languages, our call center location needed to be based in India.
Director of patient access for the centralized call center
Initially, this might not seem as very important, but having a single coordinator / director of all patient access challenges is crucial. This person is directly responsible for patient access, satisfaction, maintaining KPIs related to patient AND provider satisfaction.
Translate current scheduling system to a centralized scheduling system
One of my clients was using CareCloud’s EPM for scheduling. Each location had receptionists and front desk staff that would book appointments. There were several scheduling rules based on provider timings per day as well.
On top of this, some specialists wanted to see specific visit types (e.g. RETINA, GLAUCOMA etc) while some ODs could very easily do other consults.
In addition to this, not all providers were at par with various payers.
This meant that not all patients could be easily assigned to / appointed with all doctors.
Some patients had personal histories with specific providers as well – all added to the complexities of scheduling.
Most health systems’ front desk / receptionists have to deal with this situation wherein it is nearly impossible to translate such “localized knowledge” to a systemized process.
This almost always also led to longer training.
I also needed longer onboarding time needed to get a new hire productive.
When patients called for appointments, it took almost 10 minutes to get the patient an appropriate appointment that would work both for the patient and the practice.
The idea was to have the “system” do most of the work by processing these rules and presenting appropriate available appointment dates/times to the patient.
The longer term goal that I kept in mind was that the same functionality would also be made available on our client’s website – so that patients can self schedule their appointments.
Based on my client’s goals, I connected a custom scheduling software to Carecloud, pulled in all the providers, schedules, block-outs, appointment templates etc and used a business rules engine in our custom software to achieve this.
The intent was to reduce scheduling times to less than 1 minute
Integrate practice management software with your call center software
However, none of the call center software are really integrated with EMRs.
Your practice management software will not be connected to the callcenter software.
That’s where most of the challenges crop up.
For a call center customer service representative to be effective, they need to have easy access to your EMR / EPM and their access needs to be up-to-date in real time, as changes to your appointment calendar occurs, as patients flow in and out of the system.
Do not overlook this crucial step.
You can try to get the job done by with assembling spreadsheets.
However, keep in mind that as soon as you export data from your practice management software into a spreadsheet, that data is, effectively, stale and out of date.
Our call center software integrates with most, if not all leading practice management software.
For this particular client, we needed to connect with Carecloud and our team was able to connect with Carecloud using its APIs.
We also have the option to connect via HL7 – should we choose to.
Integration with HL7 is associated with added costs.
I opted to not take that route and stuck with APIs instead.
Hiring the right call center supervisor and call center agents
The talent pool for call center customer service representatives is large and in many call centers, you can get away with having remote agents working from home.
However, healthcare call centers face a challenge wherein they need to handle HIPAA and SOC2 compliance very seriously.
Hiring a call center supervisor is crucial and depending on the size of your call center team, you might have to hire more than 1 team leads as well.
My general recommendation is that one manager should have no more than 10 direct reports.
So, if you have 30 call center agents, you are going to need 3 managers (at a minimum).
Our recommendation is not to skimp on hiring a call center supervisor.
Call centers have a work culture of their own and unless you have led a call center before, you are in for a rude shock.
The industry behaves in a certain way and agent burnout + attrition is very high. You need to constantly be hiring and maintaining a bench of call center customer service representatives to be good at this game.
You also need to be very careful of the agents you hire for your centralized healthcare call center.
Keep in mind that these are patients you are dealing with and patients need to be handled in a slightly different fashion than any other traditional call center customer.
You need to hire call center agents with empathy..
That’s quite possibly the biggest job requirement. You also need to hire bilingual agents.
In my case, we hire customer service representatives that speak English, South asian languages and Spanish.
I have noticed that only about 10% of callers truly do need Spanish support (we had thought otherwise).
Do not underestimate the training program for your call center. I cannot state this strongly enough.