Thursday, May 28, 2009

Front Desk Issues

This article was written by one of our members.

Front Desk Impressions
By a patient and staff trainer.

Here at PMSA, we often discuss training and how important everyone in the practice is in the impression that your practice gives your patients. This week for me, this really became apparent. I have a chronic condition that has required that I go to a specialist on a regular basis. The specialist that I have chosen is in a new high rent area that is known for the upscale care that the providers in the area provide for their patients. In this particular practice, the physicians only hire RNs or higher to work in the back office. They do not hire medical assistants and focus in advanced education for all clinical staff. The back office is a warm caring, highly trained area. My only complaints have ever been the tendency to call me “hon” or “sweetie” by the staff and the name tags.

All of the clinical staff has “P.A.” after the staff member’s name. I asked what this stood for since two of the girls had already mentioned that they were RNs. I wondered if they actually did have PAs on staff and was told no, but there are ARNPs. I then asked what it stood for and the staff was not able to tell me. Having P.A. on the name tags is confusing and goes back to our argument here at PMSA of staff misleading patients of their training. There have been several cases of lawsuits of medical assistants or front desk staff referring to themselves as “nurses”. I am sure this was not intended at my providers, but it is confusing and especially troubling when the staff cannot explain the meaning.

As mentioned the clinical staff is highly trained, unfortunately this does not seem to follow through with the front desk. I was early for my appointment when the office opened in the morning and actually got there before a couple with a child. The couple was waited on first and when the receptionist was done with the family, I tried to check in and had my head bitten off. “I will get your chart when I get a chance, just sit down.” I was amazed, I had waited patiently and she was actually done with the family that arrived after me when I tried to sign-in. Having worked a front desk for many years, I try to be understanding on how you can get busy, but she did not even try to acknowledge me or speak to me again. I found out later she even had my date of birth wrong in the chart and if she had actually checked me in, she might have discovered the mistake. The nurse had to write the correct date in the chart. I have had many problems with the front desk, including being given the wrong information for a procedure. Over several visits, I have watched as they discussed patient information at the front desk, took personal calls and basically do most of the things that we tell staff not to do, but find that they often do anyway.

The providers have gone to a lot of trouble to make sure the clinical staff is professional and providing the best care possible (except for the “sweetie” problem). I think they would be amazed at the behavior of their front desk. Over the course of my visits, I have had the chance to hear other patients discuss how rude the front desk is and how they hate to deal with some of the front desk.

This is something that happens all of the time in practices. Working as a manager, I have been guilty of focusing attention on the clinical staff, but the front desk is the first and the last contact patients have with your patients. Often patients do not say anything, but switch providers or tell others about the way they were treated in your practice. I really like my provider and have improved while under his care. I am planning on letting the practice know about the type of service that patients receive and see what happens. I am hoping that they will extend the same high level of care and training that they expect from the clinical staff and start expecting it from the front as well.


To help practices with staff training, PMSA offers training modules, membership, webinars and an upcoming conference. Visit our website at www.thepmsa.org to learn more.

Monday, May 18, 2009

Phone tips

One of the greatest skills you can have is good phone etiquette. Much of your day will be spent on the phone and how you handle the phone can really step you apart.
Create a good impression:
· Answer promptly; most offices require that the phones be answered by the third or fourth ring.
· Always answer with a friendly greeting. Most companies have a format to use. Try smiling when you speak on the phone, the listener can hear the smile.
· Do not chew food, gum or drink something while on the phone.
· Do not use your keyboard if possible-the caller can hear the clicking.
· Speak clearly and slowly and modulate your voice. Either raise your voice if they are hard of hearing or lower it, if you have a normally loud voice.
· Move the receiver two-finger widths away from your mouth to provide a cleaner sound.
· Keep in mind who can hear your conversation. Be careful giving out personally identifiable information over the phone when other patients can hear you. Due to HIPAA, ask the caller to identify themselves and give a piece of personal information to identify them before discussing any information related to medical care, appointments, or billing. If the caller is not the patient then check the chart to ensure that you are able to speak to the person

Putting Callers on Hold
· Before you place the person on-hold, ask permission. If they ask why, provide an answer.
· When taking a caller off of hold, always thank them for holding.

Transferring a call
· If the caller needs to speak to another person or department, please transfer the caller directly to the desired person's extension, not to the operator. This will save the caller having to explain his/her requests another time, and it will cut the number of times the caller needs to be transferred.
· When transferring a caller, tell them who you are transferring them to and how they can reach that person directly in the future, and announce the caller to the person you are transferring them to.

Taking Phone Messages
When taking messages include the following details:
Callers name and company (if applicable)
Time and date of call
If a return call is required
When and where they would like called as well as a possible alternate number
What the call is regards to

Ending
Always thank them for calling and let them hang up first. This allows think to feel that their call was important and you were not rushing to get rid of them.

Phone skills are an important part of doing business and a true professional works consistently on improving their phone skills. You should always use professional manners, you never know who is really on the line. Due to HIPAA and common courtesy, we should be very cautious about what information is given over the phone. I can say that I am anyone, but how can I prove it? Name and date of birth are easy to obtain. I often ask the patient to identify something on the chart, such as who they have as their contact. If permission was given to another person to give information to, they should be able to give information about the patient, such as date of birth or Social Security number. Have a plan that follows office and HIPAA guidelines on what information is to be given and how to give it.

Things to consider when on the phone:
Can anyone overhear this conversation? If you are calling patients and other patients might overhear personal information about your patient, you might need to consider moving when making calls.

Are you sure that the person on the phone is entitled to the information? Is it the patient on the phone or a family member? Do you have permission from the patient to speak to this person?

Is this highly personal material? Is this PHI (Personal Health Information) something of a confidential nature, such as communicable disease, mental illness, disability, related to abuse or addiction of any kind? If so, take extra precautions when discussing information.

A few guidelines that should be considered when phoning patients include:
· Did you check the patient’s chart to make sure they have not given a preferred method of communication or have limited what can be given?
· Did the patient give permission for another person to have access to any information?
· Is it alright to leave a message? It is hard to tell if it is a secured answering machine or if others have access to it, when leaving messages it is best to give to leave your company’s name or abbreviations if applicable, and number to call back. For appointment reminders leave the date of appointment and a call back number. Many times I have heard staff leave the reason for the appointment, such as mammogram, x-ray, labs, etc. Don’t do that, what if the person listening did not know that your patient was scheduled for labs for STD, they may not want them to know. Use common sense when leaving messages. If there are instructions or results, have them call you back.
· If you have to transfer the call, put them on hold, or call them back once you have the answers, let them know. Know one expects you to know everything; people will appreciate if you tell them that you want to verify something before you answer their question.
· If the person on the phone is rude to you, try to stay clam. Try to remain diplomatic and polite. Getting angry will only make them angrier. Always show willingness to resolve the problem or conflict. Try to think like the caller. Remember, their problems and concerns are important. Patients are often sick, in pain, or scared; keep in mind that this may be a bad time for them. Offer to have your supervisor talk to the caller or call him/her back if the caller persists. Speak slowly and calmly. Be firm with your answers, but understanding.
Your telephone policies can set you apart from others, in a good way or a bad way depending on how you handle them. Evaluate how yourself and see how you are doing. Then see what can be done differently to improve the phone conversations.

By having a polite consistent phone manner, you can set yourself apart from others. You can be a leader and professional in part by the image that you project.

Source: PMSA Front Desk Training Module One

Friday, May 15, 2009

Importance of telephone communications

When someone calls the practice, who is often the first person that they make contact with? Is it the front desk? The front desk has the opportunity to be the major customer service representative of the practice. How they handle callers and patients in person affects the tone of the contact with the practice. If the caller is treated rudely then this leaves a bad impression on the caller. Think of it like this, when you go out to eat and the restaurant’s host or hostess doesn’t not provide you with a friendly greeting and information on when you can expect to be seated, what impression does that make? What does that make you think about the food? Most people will answer that the food is of poor quality or that this is a bad place. That may or may not be true, but it is the perception that the customer takes away. Your callers are customers, what are they taking away from your contact with them? Would they give the practice a good rating or not? Ask yourself what was the best service that you ever had as a patient or customer, are you matching that type of service? Why or why not? What can you do to improve it?

A major part of phone etiquette is actually listening to the caller. Learning to listen is an art that most people never really learn. It is something that we do everyday and yet we take it for granted, but how much are we really listening. True listening is an activity that takes skills and effort. Just because you can hear what someone is saying doesn’t mean that you really hear them. When you hear without listening you are no longer thinking about what is being said to you. You can learn more by learning to listen. A few keys are listed for in person and phone calls, but there are many good books on the subject that are available.
1. Focus your attention on the speaker and try not to interrupt or assume information before it is said..
2. Stop doing anything that does not directly relate to the subject.
3. Think about what you know about the subject being discussed.
4. Avoid listening to other issues or thinking about them.
5. Look at the speaker-try to maintain good eye contact
6. Mirror their mannerisms, but don’t go crazy. If they lean forward you should lean forward.
7. Set aside your feelings for the time being-this is a business. Later you can examine your emotions and see how you feel.
8. Plan to learn from the speaker, you may not always agree but you can learn from everyone.
9. Be aware of your non-verbal communications. Sighing and rolling the eyes is never a good one.
10. Lean forward and act interested in the speaker.

These are just a few hints on how to act interested and becoming a good listener.

One of the greatest skills you can have is good phone etiquette. Much of your day will be spent on the phone and how you handle the phone can really step you apart. Next week we will give some additional tips on the phone.

Source: PMSA Front Desk Training Module One

Thursday, May 7, 2009

Don’t believe everything you hear

Can you believe it; people don’t always tell the truth! Hard to believe isn’t it, but it is possible that employee, patients, vendors, and anyone that you deal with might not always be telling the whole truth to you.

For that reason it is important to not always believe the first thing you hear. Often the staff member that complains the most or is the most vocal are that way because they have something to hide.

When you are new, especially if you are new to the office keep in mind that everyone only wants you to see their side of the story, after all that is what is important to them. As a manager it is your job to remain impartial and be fair to all. At first it is important to step back and make no opinions about anyone. After being around the employees you can get a feel of what is the truth and what you need to do in any given situation.

One of the biggest mistakes a new manager can do is to jump in without the facts. You feel you have to do something, but if you go in with both barrels blazing you can do more harm than good. It is much harder to try to undo something you did or to fix a problem then getting it right the first time.

Before you take sides or do something you could later regret-take a deep breathe and think about it. If possible get away from the issue; if possible let it sit until the next morning. That is not always possible, but at least take a minute to think about it before you decide.

From PMSA New Manager's Starting Out 2007

Tuesday, May 5, 2009

New Managers Tips

Being a new manager can be a daunting task but there is help out there. The government has many free web sites that offer a variety of resources, especially for human resources and complaince issues. Consider taking some classes, often community colleges and other free or low cost classes are available. You can also find help with your peers and this group. We are here to make sure you are a success.

Here are a few key areas that will help you to be successful in your new career as a manager.

  • Be precise with all paperwork. Nothing is more frustrating than sending an application in for privileges or other important document than to find out later you missed something. Be sure to double-check all of your work.
  • Keep on top of the paperwork, especially if it involves the payroll. Both the owners and the employees will be the most upset about that one area. There are many ways to handle payroll. One consideration is to out-source it that way all of the regulations should be covered. An added benefit is for a small practice it might be possible to lease the employees and that way their benefits would come through the leasing agency.
  • Create an employee handbook. An employee handbook should be available for all employees upon hire. They should sign a release of receipt of the handbook that is kept in your records.
  • Stay informed of new regulations and updates. The legal requirements in a medical practice change on an ongoing basis. It is important that you stay current. Be sure when checking to make sure of state and local regulations as well.
  • Have a standard policy on how you recruit, what questions you ask, how the entire hiring process is done. Keep records to ensure that you are compliant and being fair to all recruits.
  • Have a standard policy on disciplinary actions and termination
  • Keep staff trained and maintain accurate records on their training

This is just a small sampling of what you can expect in managing a practice, but your focus should be staying current in legal requirements and remaining fair to all (and being able to prove it).

Source:

PMSA’s New Managers Starting 2007

Monday, May 4, 2009

Staff Training

Staff training is often one of the most overlooked areas in a medical practice. However, well-trained staff members are the key to providing quality care. Training can help staff members improve their skills and learn how to manage their job effectively. Good training programs offer fresh and interesting ideas for activities. Training is an important part of keeping a practice alive and healthy. They also help staff members grow as professionalsCost can be one of the biggest obstacles in training, however due to the internet and new resources often it can be done inexpensively and be creative at the same time. It helps to have a schedule and some training throughout the year. Often many practices will attempt to “cram” all of their training into a short time period before it expires. This can be especially true when it comes to required training to remain compliant, but in massive cram sessions how much will they retain and learn is questionable.

Some key areas to consider in developing a training program include:

  • What training are you required by law to have in your practice setting? This can vary by the type of service that you provide, but all practices should have HIPAA, OSHA, and HR as a starting place.
  • Assess the needs of the practice and staff. Talk to the staff to see what training they need and want. From the list you develop you can then go through and see what common factors develop. Make these your target areas to begin start on.
  • Then look at what is available. Do you have staff that can teach some of the classes, for example is one of the staff a BLS Instructor? Would they be willing to train the staff and what equipment and resources would they require to accomplish the task? Could you pool your resources with another physician’s office? Maybe you can do the training together to save money. Does the hospital or community offer any courses?

Once you have your list of what is needed then you can start to work on a budget for the classes and start planning on the when and where aspects. In your plan be sure to include a way to evaluate and monitor the success of the training program. Good luck you are on your way to having staff that is trained and knows what they are doing!

From PMSA’s New Managers Starting 2007

Friday, May 1, 2009

Red Flag Rule Delayed

The FTC has announced that the Red Flag Rule that was to go into effect today has been delayed until August 1, 2009.

Originally the ruling was to begin November 1, 2008, but due to the objections of many medical associations and other organizations; the FTC had agreed to delay until May 1st. Then earlier today, the FTC announced this new delay with the statement “to give creditors and financial institutions more time to develop and implement written identity theft prevention programs.” The FTC has further agreed to provide a template to assist entities with a low risk of identity theft comply with the law.

More on the rules can be found at http://www.ftc.gov/bcp/edu/pubs/business/alerts/alt050.shtm
http://www.ama-assn.org/ama/no-index/physician-resources/red-flags-rule.shtml

What It Means To Be a Professional

Having problems with your medical staff acting in a professional manner? Working with medical practices, PMSA has developed training resources for the staff. These are excerpts from PMSA’s Front Desk Training Manual #1.

What It Means To Be a Professional

Many people work in the medical field and are true professionals, but unfortunately there are many that consider this just a job until they can get something better, hit the lottery, or retire. A true professional is the person that exhibits certain traits and skills in their profession and has a continued sense of learning. They are considered to be an expert in their field. Often this comes with education, but not always formal education. It can come from personal experiences, continued education by seminars, classes, networking, and studying books and other material on the topics related to their work.

People judge the office by the way the staff presents themselves. If they appear knowledgeable and look neat, the patient will feel better about the entire office. If the staff comes across rude, uncaring, or messy, the patient will have a lower opinion of the office and these patients are usually the ones that report malpractice issues. Even when the care goes wrong, patients who have been treated well are less likely to seek legal action and are more likely to become regular customers and refer their friends. How you treat the patient and the way that you dress can have a financial impact on you and the office.

Staff that comes to work in dirty or wrinkled clothes is less likely to get a promotion or raise then neatly dressed “professional” staff. Personal appearance can detract from your professional accomplishments and cause others to not recognize your value to the team. It pays to in the long run to be a professional-it can be monetary or just the feeling that you get when you know you look good and are presenting your “professional image.”

The attitude that you give off gives a person an impression of you. It is said that you have less than 6 seconds to make an impression on a person. The impression that you make can have lasting consequences, often financial consequences. Well liked and well thought of employees are more likely to get noticed and possibly even receive pay increases. The bottom line is that your attitude could affect your bottom-line. A bad attitude can send you out the door for good.

Sometimes the image that we think we are presenting is not the image the world is seeing. Perception is everything. For that reason it is important to project a professional image. It is important to have a positive outlook this will allow you to have the ability to let many problems roll off without bothering you. Nothing improves relationships with others more than a consistently positive attitude on your part. As the frontline of communications for the practice, your attitude often sets the pace and the tone for the patient’s care and visit. A pleasant verbal exchange during or after a long wait in the waiting room can often turn an unhappy patient around. While it can be difficult to listen to complaints about issues you did not cause, your words of understanding and assurance that staff will address an issue as soon as possible can turn complaints into praise.

If show up to the office in wrinkled clothes or are always late it sends out the message to your employer’s that you do not care about the job. Whether you do or not, keep in mind that things can come back to haunt you. The medical community can be a small one. Many employees have thought that the job they were doing for one place wouldn’t really matter. Then they apply at another office for a job opening, but do not realize that the manager there is familiar with the type of care that they had given at the other office and has seen the way that they dressed. Put yourself in the manager’s position and ask yourself what would you do if the person comes to work in messy clothes or all of the paperwork that they sent my office is incorrect, why should I hire you? What keeps me from thinking you will do the same at my office?

Your attitude can directly affect your own productivity. When you are happy or upbeat, it can help to make the hours go faster. When you act positive, others will respond positively to you. The phrase “do unto others as you would have done unto you,” can work to your advantage. When you are cross or unhappy, it rolls down hill and out to the patient waiting room. You can change your mood to a more pleasant one by smiling and thinking pleasant thoughts. Studies have proven that if you pray or mediate you can relax and improve your attitude-try it yourself! Make sure that on a daily basis the office sees you smiling and being pleasant to others. You need to project a professional image that the other staff can follow, be a positive trend-setter. Being pleasant and polite is a great way to start.

We have all heard the saying “If you can’t say something nice, then don’t say anything at all.” In business this applies when the other employees and patients are listening. Don’t let them catch you saying something bad about your boss, a co-worker, or worse a patient. Most people have made that mistake at some point and it often comes back at a price to the person. Many offices and employees have found themselves in court defending an idle comment that had little meaning to them at the time, it was a carelesss comment made without thinking. The littlest comments can often be the biggest problem! Always watch what you say and do! Think positive and if you need to get it off your chest talk to your manager in private.

You express your attitude before you ever say a word by how you look, stand, walks, and talk. If you look groomed, stand tall, walk confidently, and are cheerful and upbeat, your attitude acts like a magnet. You not only attract others, but they are friendlier towards you because they sense in advance that you already like them. People appreciate a positive attitude for several reasons. Most people would rather be doing something other than work or seeing their doctor. Being with fun positive people makes the time go by faster. Many people have difficult home lives and in some cases going to work or to the doctor’s visit is the highlight of their day. Both positive and negative attitudes travel fast. Everyone wants to be around positive people, being around unhappy individuals can make the day very long and make it difficult to go in day after day.

Having a positive attitude can increase the work being done and decrease the number of errors. When there is a problem, patients are less likely to become upset if they see an office with a positive attitude. How you treat the other staff and your patients will come back to you. Remind yourself to smile and have a good time.

Additional Resources:

http://www.careerbuilder.com/Article/CB-956-The-Workplace-Has-Your-Office-Become-Too-Casual/
http://www.careerbuilder.com/Article/CB-913-The-Workplace-10-Tips-for-Proper-Etiquette/
http://www.careerbuilder.com/Article/CB-964-The-Workplace-Social-Networking-Dos-and-Donts/http://www.careerbuilder.com/Article/CB-891-The-Workplace-7-Signs-of-Poor-Productivity/