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CHAPTER 9VOCABULARY REVIEW provider.Diction inflection, cultivate Jargon pitch. invariably monotone multitasking.tedious.enunciation.clarity. STAT tactful screen SKILLS AND CONCEPTSPart I: Answering Incoming Calls and Taking Phone Messages “Hello, this is Peter Young. I saw Dr. Beard on Monday about a rash on my forearms. This thing isn’t getting any better, and the cream she prescribed for me isn’t helping the itching, and it’s very uncomfortable. Is there anything else we can do to help it? My number is 972-555-9873.” The message was received at 8:30 am on Thursday, February 3.Who should receive this message?Answer: The clinical medical assistants, Trina and/or DeanQuestions to ask the patient when returning this call:What does the rash look like now? Color? Texture?What is the cream you are using?How often are you using the cream?Have you been in contact with anything unusual or different since your visit to the office?Is it the same or worse than when you were in the office?What is your pharmacy's phone number?What action should be taken after speaking to the patient?Answer: Pull the medical record, if not already done. Place the phone message with the record and give it to the physician.Gerald Morris called Dr. Beard’s office to ask whether his insurance has paid for his last office visit. He is an established patient and has worked as a city police officer for more than 10 years. After asking to place Mr. Morris on hold, you pull up his account on the computer. No insurance payment has been credited to his account, and there is a note indicating that his insurance was not in effect at the time of his office visit. Mr. Morris’ phone number is 972-555-8824. He requests a call back as he is concerned about this information. This message was taken at 3:45 pm on September 4. Who should receive this message?Answer: The insurance biller, Gloria RichardsonQuestions to ask the patient when returning this call:Are you still employed with the city police department?Has your insurance company at work changed recently or since your last visit to the office?What is the name of your insurance company?Have you gone from full-time to part-time work?What is the name of your benefits administrator at work?Can you give me the toll-free number to the insurance company from your insurance card?Have you recently received a new insurance card?What action should be taken after speaking to the patient?Answer: Call the benefits administrator at the patient’s work and make certain that he is still employed and was eligible for benefits on the day of the office visit. If so, call the insurance company and determine why the claim was not paid. Determine if the claim needs to be resubmitted to the insurance company. Note all conversations and information obtained either in the medical record, on the financial record, or in the database, according to office policy.“Hello, this is Savannah Yarborough. I visited with your receptionist earlier today, and she indicated that one of the medical assistants has resigned and you will have a position available in a few weeks. I am very interested in interviewing and presenting myself as a candidate for the job. I am a certified medical assistant with 6 years’ experience. Please give me a call at your convenience at 817-555-9902. I look forward to speaking with you and perhaps scheduling an interview.” This message was taken at 1:30 pm on May 1.Who should receive this message?Answer: The office manager, Julia CarpenterQuestions to ask when returning this call:What experience do you have as a medical assistant and in what type of practice?Why are you looking for employment at this time?What are your goals for the next 5 years?Why are you interested in our clinic?Can you come in for an interview?What is your contact information?Can you forward a resume to our office?What action should be taken after speaking to Ms. Yarborough?Answer: Schedule an interview date and time if she seems to have the qualifications for the position.19. Mr. Juan Ross called today at 10:15 am to get his prescription for Ambien refilled. His pharmacy is Wolfe Drug, and the drugstore phone number is 214-555-4523. He is allergic to penicillin. Mr. Ross’ phone number is 214-555-2377. Mr. Ross’ message was received on July 23.Who should receive this message?Answer: The clinical medical assistant, Trina or DeanQuestions to ask the patient when returning his call:Answer: The patient has provided all of the information necessary for his request to be presented to the physician. Unless the physician has additional questions, all the information is there to carry out the request, if approved by the doctor.What action should be taken after speaking to the patient?Answer: Forward the request to the physician, and if the refill is approved, call it in to the pharmacy. Note this in the medical record. In addition most patients appreciate a return call to let them know that the physician approved the request and that it has been called in to the pharmacy.20.Mr. Benjamin Adams called to speak to the office manager to express his dissatisfaction with the times that he was offered for an appointment. His job is strict about attendance, and he cannot leave work until 4:00 pm. He has requested appointment times after 4:00 pm, but the scheduling assistant tells him that he cannot have an appointment any later than 4:00 pm. Mr. Adams is concerned that he will not be able to be at the clinic at that exact time, and he is frustrated that the clinic is not more responsive to his needs. He called at 2:15 pm on March 14. His phone number at work is 972-555-6343, and his cell phone number is 214-555-8080.Who should receive this message?Answer: The office manager, Julia CarpenterQuestions to ask the patient when returning the call:What is the earliest time that you can arrive after 4 pm?Are you aware of our early morning or late evening appointments (if applicable)?Can you alternate an appointment at 4:15 or 4:30 this week with one at noon next week? Begin the call with the phrase, “How may I help you?”What action should be taken after speaking to the patient?Answer: Schedule an appointment that will meet the patient’s needs and follow up to make certain that he arrived on time. Monitor the patient to make sure that he is not trying to abuse the privilege. 21.“This is Ms. Garrett from Blue Cross/Blue Shield, and it’s 10:00 am on June 5. I am calling to discuss employee benefits for the coming year with the office manager. BCBS provides insurance coverage for your clinic employees. Would you please have the office manager return my call when she has a few moments to talk? My number is 800-555-0024, extension 415. Thank you!” Who should receive this message?Answer: The office manager, Julia CarpenterQuestions to ask when returning the call:What major changes do you anticipate for the coming year on our policy?Will there be a cost increase?Will any benefits be added or removed?How long do we have to make a decision about renewing the policy?Have any new policies or plans been created that will enhance our employees’ benefit package?When can you come in to discuss the renewal?What action should be taken after speaking to Ms. Garrett?Answer: Prepare the information from the last fiscal year for review and comparison. Notify any employees who need to attend the meeting with Ms. Garrett. Circulate a memo to employees to gather questions from the staff about coverage options. Notify the physician of the time and date of the meeting in case he or she wishes to attend as well.22.“This is Sarah at Cline Meador Lab with a stat lab report. It’s 9:35 am on November 16. The patient’s name is Laura Williamson, and her WBC count is 18,000. Please notify Dr. Beard immediately. The lab phone number is 800-555-3333, and my extension is 255. If he has any questions, please have him give me a call. Thanks.”Who should receive this message?Answer: Dr. Beard, primarily, and secondly, the clinical medical assistant, Trina or DeanQuestions to ask or information to verify when returning the call:Answer: There may be no questions for the laboratory, but the patient will need to be contacted and the physician may want to place her on antibiotics. Determine the physician’s wishes, and call the prescription in to the patient’s pharmacy, if indicated. What action should be taken after speaking to Sarah?Answer: Follow doctor’s orders to handle the situation.23.Judy Jordan has migraine headaches and occasionally takes hydrocodone to relieve the pain. Dr. Beard leaves the office for the weekend at noon on Friday, and office policy dictates that he is not to be paged except in cases of emergency. Patients with routine or lesser health issues are to be instructed to either make an appointment to come in and see the physician or go to the emergency room. Judy calls at 4:45 pm on Friday afternoon, March 9, after Dr. Beard has left the office. She requests that the staff authorize a refill for her pain medicine and insists on speaking to the office manager, who is currently in a meeting. Her phone number is 214-555-9822. Who should receive this message?Answer: The office manager, Julia CarpenterQuestions to ask or information to verify when returning the call:How long has the headache been bothering you?What have you tried to relieve the pain?Are you completely out of medication?Dr. Beard has already left the office for the weekend. Do you need to go to the emergency room?What action should be taken in this situation?Answer: Use your best judgment in deciding whether to call Dr. Beard. Document his orders in the medical record. Call the pharmacy, if indicated, and authorize the refill. Call Judy and explain that Dr. Beard has made an exception for her in this instance and that in the future, she must make a refill call at the correct time.Gary Burritt is moving out of state, so he calls the office because he needs a copy of his medical records. Dr. Beard prefers to send medical records directly to the receiving physician. Mr. Burritt’s phone number is 512-555-6679. Today’s date is December 20, and this message was received at 11:45 am. Who should receive this message?Answer: The insurance biller and medical records clerk, Gloria RichardsonQuestions to ask or information to verify when returning the call:What specific information does the patient need from the medical record?Has the patient located a new physician as yet?What is the patient’s new address?Is the patient willing to wait until a new physician is located so that the records can be sent directly to the doctor?What action should be taken in this situation?Answer: If the patient agrees to wait, then forward the records to the new physician. However, if the patient insists on having a copy of the records, the office must provide them.25.Allan Jenkins is calling from the cleaning service to let the office manager know what supplies he needs. He leaves a message stating that they are out of window cleaner, paper towels, liquid cleanser, and floor cleaner. He says that she does not have to call him back, but they will be cleaning again on Friday evening and will need the supplies at that time. This message was received on Wednesday, April 7 at 8:10 am. The caller leaves his phone number, 903-555-2378, in case the office manager has questions.Who should receive this message?Answer: The office manager, Julia CarpenterWhat action should be taken in this situation?Answer: Secure the supplies requested and have them available for the cleaning service. As a courtesy, call Allan back and leave a message to assure him that the supplies will be available on Friday evening.26.“Hello. My name is Christina Cawtel, and I was referred to your office by Dr. Preston for an evaluation of an ovarian cyst. Today is Wednesday, October 4, and it is 8 am. I would like to make an appointment for early next week if possible. My phone number is 817-555-9325. Oh, and by the way, I need to know if you are a provider for Aetna, because my company just changed to their managed care plan. I probably need to have a mammogram, too, and want to see if you will order it before I come in for the appointment. Thanks.”Who should receive this message?Answer: The scheduling assistant, Stephanie DicksonQuestions to ask or information to verify when returning the call:What is your address, phone number, etc.?What is your Aetna policy number?Do you need directions to the office?Can you arrive for an appointment on (day) at (time)?Can you arrive 15 minutes early to complete paperwork?What action should be taken in this situation?Answer: Schedule the appointment, then verify the patient’s insurance. If the insurance is valid, prepare any necessary paperwork for the patient’s first visit.27.“My name is Janeen Shaw and I am Dr. Beard’s patient. It is just before 2:00 pm, and I am trying to reach you as soon as you open your office after lunch. I am having a hard time breathing, and I have stomach pains. I am hurting all over my upper body, on my chest, my arms, my neck…just everywhere. I'm sweating, and I'm very nauseated. I’m 45, and I'm almost never ill. I wanted to find out if I can come in for an appointment today. Please call me back as soon as possible. My phone number is 601-555-3423. Thank you…please call as soon as you can. I really feel awful.”Who should receive this message?Answer: The clinical assistant, Trina or DeanQuestions to ask or information to verify when returning the call:What is the address where you are located?Are you alone?How long have you had these symptoms?Do you have transportation to the hospital?What action should be taken in this situation?Answer: The patient should be kept on the telephone while an ambulance is called and dispatched to her home. If the next-of-kin is known, that person should be called as well. Notify the physician of the situation and determine his or her orders.Part II: Handling Difficult CallsBriefly explain how the following callers and types of calls should be handled.28.Angry callersAnswer: Lower the tone of voice slightly, which may make the caller calm down to hear what you are saying. Address the issue without skirting around it. Avoid getting angry yourself, and do what is possible to resolve the patient’s issues while remaining within the confines of office policy.29.Sales callsAnswer: Do not completely disregard salespersons, but do not allow them to monopolize time or telephone lines, either. Keep these calls quick and to the point. Most professional salespersons realize that the physician’s and the staff’s time is extremely valuable and will respect this. Developing a good rapport with representatives (“reps”) from the companies whose products are frequently used in the practice may result in discounted prices and first news of sales and promotions.30.Emergency callsAnswer: The person answering the telephone should first determine whether the call is truly urgent. Emergency calls could include such conditions and/or symptoms as chest pain, profuse bleeding, severe allergic reactions, cessation of breathing, injuries resulting in loss of consciousness, and broken bones. Often the physician will instruct the patient to go straight to the closest hospital emergency room or to call an ambulance. Office policy and procedure manuals should dictate the action to take in such emergency situations.31.Unauthorized inquiry callsAnswer: Some individuals call the physician’s office requesting information to which they are not entitled. These callers must be told politely but firmly that such information cannot be provided to them because of privacy laws. Insistent callers should be referred to the office manager or physician.32.Callers with complaintsAnswer: When callers complain, use an approach similar to the one used with angry callers. Do not make an attempt to blame, and never argue with the patient. Find the source of the problem, and then present the options to the caller as to how the situation can be resolved. Remember to treat callers in the same manner that you would wish to be treated.Part III: Using a Telephone DirectoryUsing your local telephone directory, locate the following telephone numbers for your city or community.Nonemergency number for the police departmentAnswers will vary according to location.General information number for the nearest airportAnswers will vary according to location.Local tax office Answers will vary according to location.American Red Cross officeAnswers will vary according to location.Acute care hospitalAnswers will vary according to location.Mental health and mental retardation centerAnswers will vary according to location.Meals on Wheels Answers will vary according to location.American Cancer SocietyAnswers will vary according to location.Part IV: Answering the TelephoneUse the local telephone directory to find telephone numbers for the following medical specialty offices in your area. Call these offices to determine how they answer the telephone. Explain the purpose of your call to the staff member who answers the phone, and record the phone greeting they use in the space provided below.OphthalmologistAnswers will vary according to location.OncologistAnswers will vary according to location.General practitionerAnswers will vary according to location.ChiropractorAnswers will vary according to location.Cosmetic surgeonAnswers will vary according to location.DermatologistAnswers will vary according to location.Part V: Short Answer Questions screening.tone chew gum The mouthpiece of the telephone handset should be held 1 inch from the lips. confidentiality third physician.Conference directions .Part VI: Time Zones 1:00 pm 5:00 pm 7:00 pm 4:00 pm .noon Part VII: Telephone TechniqueWhere are you?At what telephone number can you be reached?What are the chief symptoms?When did they start?Has this happened before?Are you alone?Do you have transportation?The phrase that often calms an angry patient is "Let me help you."Always ask the patient’s permission to place him or her on hold and to transfer the call. Identify the person on the phone when a call is transferred to the physician or another person in the facility. It is considered poor customer service to transfer the call to a co-worker’s voicemail without warning the caller that the person is not available. Any person who refuses to give a name should not be put through unless the medical assistant has been specifically instructed to do so. If the person is not immediately available, ask the caller whether he or she would prefer to be put through to voicemail. Some callers simply believe their call will receive more attention if a human takes the message. If the caller insists, take a written message and deliver it to the proper person as soon as possible.The individual could be a patient, so every attempt to identify the patient and assist him or her should be made. Such callers may also be salespersons who are fully aware that if their identity is revealed, they will never get the opportunity to speak to the physician. These people may be firmly told, “Dr. Frank is busy with a patient and has asked that we take messages for her. If you will not leave a message, you may wish to write a letter to her and mark it ‘personal’.”List the seven components of a proper telephone message.The name of the person to whom the call is directedThe name of the person callingThe caller’s daytime, evening, and/or cellular telephone numberThe reason for the callThe action to be takenThe date and time of the callThe initials of the person taking the callCASE STUDY Answers will vary.CHAPTER 9 QUIZ clarity. 11:00 am True automatic call routing. answering service. Answers may include the following:chest painprofuse bleedingsevere allergic reactioncessation of breathinginjuries resulting in a loss of consciousnessbroken bonesinflection. monotone.TrueList two ways to deal with an angry caller:Lower the tone of voice and speak softly.Assure the patient that the issue is important to you and you will work toward a resolution. ................
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