5 Tips for Health Call Center Success

| URAC Staff

Patient experience plays a big and increasing role in measures of quality, accounting for eight of CMS’s 34 quality care measures for ACOs, for instance. That’s why many providers and health plans are taking steps to make sure their call centers enhance patients’ satisfaction rather than leave them hanging up in frustration. 

“It’s just like with any customer service line, if we have to wait on hold forever, it leaves a bad taste in your mouth,” said Bonnie Zickgraf, integrated services manager for URAC. “Plus, with social media, the bad experiences are 10 times more magnified than the positive ones.”

Best practices in health call centers are a must for organizations to meet the demands of today’s consumers who expect instant access to information, right at their fingertips. URAC’s Health Call Center Accreditation includes 40 Core standards for providers and another 22 standards for call centers themselves, and Zickgraf offers these five tips for achieving call center best practices:

  1. Provide adequate training. Given the high stakes of a single negative patient experience, Zickgraf said proper training is the No. 1 challenge facing health call centers. “You have to look at how your staff is trained to advocate for the patient, get the right answers at the right time and do it expediently,” she said.
  2. Be ready to track and report. “One of the biggest demands on a call center is that their customer wants reports,” said Zickgraf. “How many calls do they get? What kind of calls? Are they clinical or non-clinical? What are the bad experiences?” Thorough tracking could also help a self-insured employer see an increase in a particular diagnosis among employees, for instance, allowing the organization to allocate additional resources in that area. As a fundamental part of URAC’s standards, call centers must meet thresholds in several key metrics, including: average speed of answer by a live person (within 30 seconds); average blockage rate and abandonment rates (less than 5 percent); and call-back speed (returning clinical calls within an average of 30 minutes).
  3. Establish policies for physician reporting. “There has to be a mechanism for the patient’s attending physician to receive clinical recommendations provided by the health call center to a consenting patient during the call,” Zickgraf said. Protocols should consider what action each patient call will trigger, such as automatically notifying the patient’s doctor if the call center has advised that a patient go to an emergency department if the call center is obligated to do so.
  4. Consider the potential of telehealth. The next big trend that Zickgraf foresees in this market is the integration of telehealth with health call centers. “It’s something a lot of call centers don’t offer,” she said. “Physicians’ offices, for instance, are strapped for time and resources, and they can expand their network, and patient access, by getting into telehealth.”
  5. Keep up with technology. There’s a growing trend across industries toward voice biometrics, which can allow many consumer calls to be completely automated, as are moves toward integrating mobile technology into consumer interactions in new ways. “Technology is moving so fast, and it often moves faster than what budgets allow,” said Zickgraf. “In the future, health call centers will be expanding, not just in volume but in technology and the services they have to offer. They will have to expand to keep up with the consumer marketplace.”

In conclusion, URAC’s Health Call Center standards can help set the foundation for developing and maintaining quality health call center operations. Centers can then focus future organizational growth through optimized staff training programs and high-demand technological advances.

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