The daily functioning of a medical practice relies on good communication skills.
As you have learned in previous chapters, effective communication involves excellent skills not
only in speaking and listening but also in conveying nonverbal and written messages. Medical
assistants and other health professionals must use effective communication skills in such daily
Speaking with patients and other professionals on the telephone
Corresponding with patients and other health professionals in writing
When applying effective communication skills in these areas, health professionals must meet
patient expectations for professionalism, as well as HIPAA regulations on how patient
information can be communicated or disclosed (Box 26-1).
LE A R N ING O BJECTI VES 11. Describe the process of placing a caller on hold when
You will be able to do the following after completing this chapter: 12. List the seven types of information documented when taking
Key Terms a phone message.
1. Define, appropriately use, and spell all the Key Terms for this 13. List three types of outgoing calls that administrative medical
chapter. assistants may make.
Greeting Patients Scheduling Appointments
2. Describe how a warm, professional greeting affects 14. Explain the importance for patients, medical assistants, and
patients. physicians of managing office appointments efficiently and
3. Demonstrate the correct procedure for giving patients verbal
instructions on how to locate the medical office. 15. Demonstrate the correct procedure for preparing and main-
taining the office appointment book.
4. Explain the purpose of the medical practice information
booklet. 16. List one method of blocking off, or reserving, time not to be
used for patient scheduling.
5. Demonstrate the correct procedure for constructing a patient
information brochure. 17. Explain the considerations for canceling a patient
Managing the Telephone 18. List 10 abbreviations commonly used in scheduling
6. Describe how a medical assistant's tone of voice affects appointments.
telephone conversations. 19. Demonstrate the correct procedure for scheduling a new
7. List 12 guidelines for telephone etiquette and explain the patient for an office visit.
importance of each. 20. List six appointment-scheduling techniques and explain the
8. Demonstrate the correct procedure for answering a multiline advantages and disadvantages of each.
telephone system. 21. List two special problems that can occur in scheduling
9. Explain the considerations for screening incoming calls. appointments and explain what can be done to prevent
10. Explain the importance of a triage (protocol guidelines) each.
manual. 22. Explain the purpose of an appointment reminder.
Medical Office Communication chapter 26 475
23. Demonstrate the correct procedure for scheduling a patient
for outpatient diagnostic testing.
Handling Mail Read the following scenario and keep it in mind as you learn about
24. Explain why it is important to sort incoming mail. the importance of communicating effectively in the medical office in
25. List four classifications of U.S. mail. this chapter.
26. List eight special services offered by the post office that can
help medical offices track, insure, and receive delivery con- Tara is a new medical assistant at a physician's office. Dr.
firmation for the mail they send. Vickers has hired her to answer the phone and to greet
patients as they arrive, as well as to assist with making
27. Demonstrate the correct preparation of an envelope.
appointments as needed. On a particularly busy day, the
Managing Written Correspondence phone is ringing with two lines already on hold and a new
patient arrives at the reception desk. Steve, the physician's
28. Explain the proper use of a letter and a memo in medical
assistant, asks Tara to make an appointment for another
patient to see Dr. Vickers as soon as possible. Since the
29. List nine guidelines for preparing effective written communi- office makes appointments in a modified wave, Steve tells
cation in the medical office. the patient to wait to be seen because Tara has found an
30. Identify proofreader's marks used to edit written opening in about a half hour. In all the confusion, Tara
correspondence. does not return to the patients who are on hold for several
31. Demonstrate the correct procedure for composing, keying, minutes, and one of the calls is an emergency.
and proofreading a business letter and preparing the Furthermore, Tara is short-tempered with the new patient
envelope. who has arrived at the office. Tara's frustration about the
32. Demonstrate the correct procedure for composing a busy schedule she is expected to keep shows, and the
memo. new patient states that she is not sure that she has
chosen the best physician's office for her medical care.
33. Describe the format used to prepare a manuscript based on
clinical research performed in the office. What effect will Tara's frustration have on this medical
office? How would you have handled this situation
34. List seven types of medical office reports and describe the differently?
purpose of each.
35. Analyze a realistic medical office situation and apply your
understanding of medical office communication to determine
the best course of action. GREETING PATIENTS
36. Describe the impact on patient care when medical assistants As a medical assistant, you may serve as a receptionist. The
have a solid understanding of communication in the medical receptionist is the first person a patient sees in the medical
office. Make sure the patient's first impression of you and the
medical practice is positive. If a patient is calling for the first
time to schedule an appointment, make sure the patient
knows how to find the office. Procedure 26-1 shows how to
use verbal instructions to give patients directions for locating
the medical office.
K E Y TERM S As you recall from Chapter 24, the reception desk should
be accessible to patients when they enter the office. In addi-
tion, the counter height needs to be high enough to maintain
autopsy report modified-block format
the confidentiality of patient information. You must keep
certified mail modified-wave scheduling
several considerations in mind when greeting new patients
cluster scheduling necropsy
and established patients, as well as other visitors to the
consultation reports new patients
discharge summary open-hour scheduling
double booking operative report
emergency patient information brochure New Patients
established patients progress notes Patients new to the medical office (first visit or first visit to
full-block format proofreading the office in 3 years) need to feel welcome. Some practices will
history and physical (H&P) radiology report mail a "new patient packet" before the patient's first office
report registered mail visit. If forms have not been sent previously, give the new
manuscript streaming scheduling patient a pen and the forms that must be completed; these
matrix time-specified scheduling forms are discussed in Chapter 34. Explain the policies of the
medical practice information transcriptionist medical office, or give the patient a medical practice informa-
booklet wave scheduling tion booklet, or patient information brochure, that provides
476 Section IV Administrative Medical Assisting
HIPAA: the Privacy Rule and Security Rule
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandates that the privacy and security of patient informa-
tion be maintained in a confidential manner. This process begins when the individual arrives for their first appointment. Patients
must be given detailed written information concerning their privacy rights. This includes the steps the practice will take to protect
their privacy and how the medical practice will use patients' protected health information (PHI).
To document that the medical practice made an effort to comply with this regulation, the practice must obtain a written acknowl-
edgment from the patient that he or she has reviewed these rights. Acknowledgment may be in the form of a signature or the
patient's initials on the notice signifying that he or she has received the required information. If the patient declines to acknowledge
receiving a Notice of Privacy Practices, this must be documented in the patient's chart. This documentation shows a good faith
effort was made by the practice to inform the patient and details the reason for failure to accomplish this act and comply with the
Medical practices must also post a Notice of Privacy Practices in the office, usually in the reception area. Additional copies of
the notice should be made available if a patient requests a copy. The regulation also requires medical practices to have a written
policy and procedure in place for determining who has access to patient medical information. For example, the policy may state
that the receptionist may view the names of the patients coming into the office but may not view patients' records.
To accommodate computerized information, two types of access codes (passwords) should be used. The first set would allow
the receptionist to view the physician's schedule but would not allow the receptionist to view patient records. The second set
would allow the physician, nurse, and medical assistant to view the patient records for the purpose of patient care. A tracking
system that keeps detailed information of all staff members viewing a patient's medical record should be in place.
The HIPAA regulation also addresses the issues of sign-in sheets and calling the names of patients who are sitting in the waiting
Can a medical practice use patient sign-in sheets and call out the names of patients in the waiting room?
Yes; the practice can do both, as long as the information disclosed is appropriately limited. The Privacy Rule allows for incidental
disclosure as long as appropriate safeguards are in place. For example, the sign-in sheet cannot contain confidential patient infor-
mation (e.g., reason for the visit, medical problem). It is best to change used sheets with clean ones periodically during the day.
Calling patients by name is still the most acceptable, courteous, and respectful way to "invite" patients into the examination
this information (Box 26-2). An information booklet or bro- BOX 26-2
chure should provide answers to nonmedical questions. Pro-
cedure 26-2 explains information necessary to construct a Patient Information Booklet
brochure. Figure 26-1 provides samples of various types of The patient information booklet (or brochure) communicates
brochures used to provide information to a patient about a policies of the practice, (e.g., payment must be made at the
medical practice. time of service). It clarifies appointment policies, office hours,
Let patients know that when they finish reviewing the bro- prescription refill policies, and so on. It should avoid technical
chure, you will be glad to answer any questions about the terminology and should be written as if the staff is speaking
medical practice. In addition, inform patients that you are to the patient (e.g., "We want to make your medical care our
available to help them complete the forms, if necessary. Some- number-one priority").
times patients have trouble reading or seeing, and just handing A patient brochure, or medical practice information
them a form to be completed may be seen as uncaring. People booklet, should answer frequently asked questions, thus
saving staff time by limiting the need to repeat information.
unable to read are embarrassed to say so, and therefore they
This reduces telephone calls about office policies (e.g., office
may not fill out the forms correctly. Some may not understand hours). The booklet invites the patient to be an active partici-
the questions being asked because of medical terminology pant in his or her care.
used in the forms. Patients may not want to admit they need
help or may be confused.
Helping patients with forms also saves time. Some offices
have a private area set aside to answer questions and to fill out area"). Remember, do not address a patient by their first name
forms. This allows for minimal distractions and patient unless the patient has given you permission to do so. If other
privacy. patients approach the desk while you are speaking with a
patient, stop long enough to acknowledge their presence and
tell them you will be available shortly. This lets them know
Established Patients that they are important as well and will receive your full atten-
Personalize the greeting when returning patients come into tion. Every patient should be made to feel that he or she has
the office (e.g., "The doctor will be with you shortly, Ms. the full attention of the office staff and that his or her needs
Jones; please make yourself comfortable in the reception have priority, no matter how busy the office is that day.
Medical Office Communication chapter 26 477
26-1 Give Verbal Instructions on How to Locate the Medical Office
TASK: Provide verbal instructions to a caller on how to locate the medical office.
EQUIPMENT AND SUPPLIES
Pen or pencil
1. Procedural Step. Address the patient or caller in a b. Ask the person to repeat the directions back to you if
polite and professional manner. the location is somewhat difficult to find.
Rationale. The tone and pitch of your voice can promote a positive Rationale. This provides excellent customer service and a favor-
first impression of the office. able impression of the medical office.
2. Procedural Step. Ask the person, "Where will you be 5. Procedural Step. Provide the caller with the office's
coming from?" phone number in case the person needs to call for
Rationale. This provides the medical assistant with a location on further clarification of directions en route. If time
which to base directions. Find the location on a city map if needed. An permits, the medical assistant may mail written
Internet mapping service (e.g., MapQuest) may also be helpful in provid- directions and a map to the patient before the
ing door-to-door directions. appointment.
3. Procedural Step. Determine the most direct route to Rationale. Again, this provides excellent customer service and a
the medical office, with alternate routes if possible. favorable impression of the medical office. Written directions and a map
Provide the person with major cross streets and may be included in the office's informational brochure, which is often
landmarks. mailed to new patients.
Rationale. Providing the most direct route will save the patient or 6. Procedural Step. Ask the caller if they have any
caller time and will lessen the likelihood of not finding the office. Having questions.
alternate routes, cross streets, and landmarks available will be helpful Rationale. Clarifies information provided and helps avoid any
for people unfamiliar with the area. For example, "turn left on McCleary, misunderstanding.
take the next right onto Dearborne. Our parking lot is across the street 7. Procedural Step. Politely end the call after answering
from the bank." Keep in mind that the person may be driving, walking, any questions.
or taking public transportation. Rationale. This action displays a professional approach and pro-
4. Procedural Step. Allow the patient or caller sufficient vides a favorable impression of the office.
time to write down the directions.
a. Repeat the directions back to the person, as needed,
with a cheerful and pleasant tone.
FIGURE 26-1 Brochures provide information to the patient
about the various services that the medical practice offers and
often answers frequently asked questions that the patient needs
478 Section IV Administrative Medical Assisting
26-2 Create a Medical Practice Information Brochure
TASK: Create a "mock" patient information brochure for a medical practice.
EQUIPMENT AND SUPPLIES
Software program that allows for brochure layouts
Examples of local medical practice brochures and local medical office policies
Pen or pencil
1. Procedural Step. Determine the content information 2. Procedural Step. Write and key a short paragraph
to include in the informational brochure to be provided describing each of the topics to be included in the bro-
to patients. chure. Proofread the keyed information.
Rationale. Provides an effective means to communicate with Rationale. The medical assistant can read the content and make
patient's about office policies. corrections as needed. A brochure should never be sent out with incor-
Items for consideration may include: rect information or "typos." Remember, this may be the first interaction
Practice's philosophy statement a patient has with your office and an impression will be formed.
Goals of the practice 3. Procedural Step. Determine the layout of the
Description of the practice brochure.
Physical location of the office (address), including a a. The layout should be visually pleasing.
map b. Consider the placement of the office logo.
Telephone numbers, e-mail address, web page c. Ensure that the name of the practice, address, and
Office hours, day, and time phone number are prominent.
Names and credentials of staff members* d. Some software programs have a brochure template
Types of services that may work for creating this booklet. If a separate
Policy regarding appointment scheduling, no-shows, program is not available, any word processing program
and cancellations can be used.
Payment options 4. Procedural Step. Have the office manager or physician
Prescription refill policy approve the final draft.
Types of insurance accepted a. Make corrections as requested.
Referral policy b. The physician has final approval.
Release of records policy 5. Procedural Step. Print the brochure.
Emergency protocols This may be done at the office if the office photocopier
Who to contact if the physician is unavailable can provide quality copies. Otherwise, submit the bro-
Frequently asked questions chure electronically to a printing company for profes-
Any special needs considerations sional-looking brochures.
Personal information about the physician (e.g., area
roots, special interests, and include special training and
*Some offices choose not to include this information.
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