10 signs that it may be time to outsource your hospital call center

Patient experience, customer service, patient satisfaction scores and value-based performance are now part of hospitals' and healthcare providers' everyday vocabulary. Value-based care is pushing organizations to achieve financial objectives that are tied to improving the patient experience. Providers who lose patients because of poor customer service or poor physician referral processes can mean a direct hit on revenue and, ultimately, on the bottom line.

In addition, the Centers for Medicare & Medicaid Services (CMS) requires hospitals subject to the Inpatient Prospective Payment System (IPPS) annual payment update provisions to collect and submit data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey in order to receive their full IPPS annual payment update. If they don't, their annual payment update may be reduced by two percentage points. The HCAHPS survey measures patients' perceptions of their hospital experiences, which include responsiveness of hospital staff and other service measures.

Balancing customer service and clinical care

C-suite executives responsible for the patient experience can be overburdened. Staff members often wear too many hats, leaving customer service and, in particular, call center service to suffer. Many healthcare organizations don't realize they have a problem until revenue shortfalls and patient satisfaction scores show otherwise.

Signs of medical call center vulnerability

So how can you spot service vulnerabilities that may put you at risk and signal the need for outside help from a professional services firm? Here are 10 signs that it might be time:

1. You fall short of healthcare call center benchmarks. If 5 percent or more of patients hang up before they're helped, hold times are longer than 60 seconds and/or call routing accuracy is under 99 percent, your call center may be understaffed or lacking training.
2. Patient satisfaction scores are going down. In healthcare, 96 percent of patient complaints are related to customer service¹.If your scores are trending down, your call center may be a big part of the problem.
3. Medical call center staff turnover is high. Many healthcare providers fill call center jobs with entry-level people who have front-desk or scheduling experience rather than professional customer service experience. As a result, people may bid out of the call center for other jobs in the organization, or they may be terminated because they don't have the skills or empathy to handle patients appropriately.
4. You don't review recorded calls and screen captures against practice guidelines. One key to a successful call center is to reduce variation by scripting and enforcing scheduling or other "telephone" task protocols.  Often, healthcare leaders don't have the time or technical telephony resources to evaluate their customer service quality, thereby exacerbating patient dissatisfaction, which leads to administrative and/or provider complaints.
5. You don't give your call center staff ongoing coaching and training. Not only does a lack of training usually affect patient satisfaction, it can lead to a revolving door of employees who feel frustrated and unprepared to deliver customer service. Continuous quality improvement and reinforcement training is key to low turnover and high satisfaction for patients.
6. You don't know how much revenue you lose from patient leakage.  To protect and grow revenue, healthcare providers must monitor appointment volume versus the prior year, chase "no show" offenders and proactively call patients to encourage preventive health or return visits. Few providers have time to prioritize patient leakage using current staff.  
7. Your providers are stressed with work overload and unbalanced schedules. If your internal call center has insufficient resources to manage large patient volumes, your providers can be at risk for burnout. In addition to focusing on patient satisfaction, it is as equally important to improve provider satisfaction to maintain top medical talent for your organization. 
8. Referring providers are frustrated with your service. If a referring provider can't get through to make an appointment for their own patients, it may put revenue and future physician referrals at risk. Many healthcare organizations don't have the resources to handle these calls any differently from patients calling on their own, resulting in archaic processes like voicemail requests and faxing of referrals.
9. The patient access experience varies from practice to practice. A seamless patient access experience is especially important in large healthcare systems. Without an efficient centralized call center, patients have to make multiple calls or be routed from one department to another with inconsistent service and procedures.
10. Poor data entry burdens the entire revenue cycle. When internal call center representatives fail to verify insurance, set payment expectations or enter patient information correctly, it can lead to rejected claims, more work on the backend and patient frustration with the whole experience.

Why medical call center outsourcing works

Running a call center requires specialized expertise – even more so when the calls entail patient questions about their health issues and possible financial challenges. Often, outsourced medical call centers know how to hire representatives with good listening skills, calm demeanor, a service mentality and empathy for patients. They can provide agents with ongoing, in-depth training on the medical aspects of the job and how to represent healthcare providers as if they were members of their staff.

If the majority of all patient care occurs in a physician office setting, and patients have to call for appointment scheduling, why would you risk putting inadequate resources in place to manage your call center?

About the Author:

Keith Slater, vice president of business development, Change Healthcare

¹Patients' No. 1 complaint? Front-desk staff," by Kelly Gooch, April 26, 2016, Becker's Hospital Review, http://www.beckershospitalreview.com/hospital-management-administration/...