3 Criteria for Selecting a Healthcare Call Center Provider


Patient satisfaction has become an extremely important measure of a healthcare organization’s success, and should be top-of-mind for all hospital executives and patient access managers. As one point of proof, a 2016 research study showed 96% of patient complaints were related to customer service, not quality of care. Significantly, 53% of the unhappiest patients said communication was their biggest frustration.1

Healthcare system leaders responsible for financial performance should also be concerned about the patient satisfaction. Hospitals that score well on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which uses the most widely tracked patient experience measures, tend to be more profitable. Those with “excellent” ratings between 2008 and 2014 had an average net margin of 4.7%, compared to 1.8% for hospitals with “low” ratings.2 On top of all this, patient experience constitutes seven of the 33 accountable care organization quality measures defined by the Centers for Medicare & Medicaid Services (CMS).

Clearly, patient satisfaction is a key driver of everything from patient loyalty to quality of care to pre- and post-service payment collection success.

The Importance of Improving the Call Center

Patients are consumers, and their expectations of service have increased as they bear more financial responsibility for their healthcare. They want a seamless journey from the first appointment and at every contact point throughout the continuum of care. The overall patient journey should be taken into consideration whether their calls are administrative (scheduling, referrals, pre-admission and post-discharge communication, etc.) or clinical (chronic care management) in nature.

The call center of a healthcare organization is a linchpin of this journey. Handling patient calls in a caring, professional and timely manner is vital, but many hospitals find it difficult to accomplish on their own. A remote, outsourced call center for the health system is a proven way to help ensure consistently high levels of patient service and operating efficiency.

What to Look for in a Healthcare Call Center Provider

The call center is often the “face” of the healthcare organization to patients, which makes it especially important to choose the right outsourcing vendor. Here are three areas where your partner should excel:

1. Quantifiable Service Levels

When evaluating medical call center providers, numbers matter. If they don’t have volume capacity and scalability, they may not be able to deliver the service you and your patients expect. Look for:

  • Capacity to handle more than 60,000 patient calls per year
  • Ability to answer calls in less than 60 seconds
  • 99% call routing accuracy
  • Processes for quick and accurate call resolution
  • Real-time call metrics dashboards displayed throughout the call center
  • Robust infrastructure for scalability and security

2. Schedule Scorecard

Schedule optimization is key to increasing patient volume and staff utilization, improving the patient experience and driving revenue. Ask your health system call center vendor to describe their track record in healthcare and patient access, and provide proof of their ability to:

  • Consistently increase scheduled appointments, reduce missed appointments for healthcare providers and optimize physicians’ schedules with current patients
  • Handle physician referrals to reduce patient leakage
  • Improve eligibility and medical necessity validation
  • Improve pre-service payment collection
  • Routinely check-in on the patient’s overall satisfaction with the scheduling process

3. Soft Skills

As research shows, the way people are treated heavily influences satisfaction with the overall patient experience. A prospective hospital call center partner should be able to articulate their approach and how they hire representatives with strong “soft” skills such as compassion, respect and treating patients with dignity. Listen for descriptions such as concierge approach, VIP treatment, caring, friendly and warm, and ask if they monitor soft skills in patient satisfaction surveys.

Soft skills, of course, should be complemented with ongoing training in every area your call center handles, including appointment scheduling, pre-admission education, referrals, disease management programs, nurse advice, triage, post-discharge follow-up and billing/collections. To help ensure all patients receive excellent personal service, your hospital call center vendor should have representatives who can support more than 200 languages.

Take the time to verify if your health system call center vendor can demonstrate their ability to:

  • Improve pre-admission and post-discharge communication
  • Show improvements in patient satisfaction ratings related to contact support services

Benefits to Expect from Change Healthcare

Hospitals and health systems that outsource their call centers to experienced providers, like Change Healthcare, often enjoy benefits across many aspects of their business, including:

  • Improved physician scheduling and workload balance
  • Shorter call hold times and quicker answers
  • Reduced eligibility and authorization denials
  • Fewer no-shows and less referral leakage
  • Higher self-pay collection
  • Increased value-based reimbursements requiring high patient satisfaction metrics
  • Increased patient satisfaction with providers
  • Infrastructure cost savings

Change Healthcare’s comprehensive medical call center solution handles daytime and after hours patient calls, enabling your organization to quickly answer patient inquiries in a timely and professional manner. Help improve patient satisfaction scores and your financial health with Change Healthcare.

1Study: 96 Percent of Online Complaints About Doctors Fault Customer Service, Not Quality of Care, Nasdaq Global Newswire, April 25, 2016, https://globenewswire.com/news-release/2016/04/26/832480/0/en/Study-96-Percent-of-Online-Complaints-About-Doctors-Fault-Customer-Service-Not-Quality-of-Care.html
2The value of patient experience, Deloitte, accessed December 15, 2016, https://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/articles/hospitals-patient-experience.html?id=us:2em:3na:chs2908:awa:lshc:071316