Telephone Etiquette

     Proper telephone etiquette is essential to the growth and success of the practice.  In today's society, it is become common practice for people to treat other people with disrespect and apathy, particularly over the telephone.  This type of attitude has no place in an orthodontic office.  EXCELLENT customer service is essential.  In order to do so, you must listen to the patient/parent and deal with the problem appropriately.  You can relieve a patient's concerns about a big problem and can minimize the problem in his/her mind with proper handling of the telephone call.  On the other hand, a little problem can be blown out of proportion if the telephone call is handled inappropriately. 

     When you answer the telephone say "Good Morning/Afternoon, Dr. Smith's office.  This is (your name).  How may I help you?"  Listen carefully as the caller tells you who she is.  Write the name down if necessary.  When talking with the caller try to use the caller's name.  Too many businesses have employees that answer the telephone with the "don't care a bit attitude" or "why are you bothering me attitude."  Patients/parents deal with these businesses every day.  It is very frustrating for a very busy parent to call somewhere to deal with a problem and then spend an inordinate amount of time on the telephone with a not helpful employee.  Parents today are pressed for time, stressed out and over-worked.  Sometimes they take their frustrations out on you over the telephone.  Although this is unfair to you, you can help the situation, by being helpful and efficient on the telephone, and you may brighten their day or at least not contribute to the negativity of it. 


1. First patient contact:  The first telephone call that a patient makes to the office is critical since it makes a lasting impression.  It gives the patient an idea of what the office is like even before the patient comes in.  Parents frequently are very apprehensive about the first visit to the orthodontist because they have visions that the cost will be so high that they will have to give up their car and/or house.  You must alleviate their fears and make them feel at ease with the first telephone call.  If you do not, the patient may be a no-show for the consultation appointment. 


Sample scripts:

     Ask what the child's name is and how old he is to give you an idea whether treatment will likely be phase I or comprehensive treatment.  "Let me tell you about our consultation appointments.  At this appointment the doctor will look at you/child's name and give you an idea as to what problems are present, how they may be corrected and how long treatment is expected to last.  He will also provide you with an accurate estimate of the treatment fee and discuss payment options.  The appointment lasts about 15 to 30 minutes depending on how may questions you may have.  The fee for the consultation appointment is X dollars (whatever the fee is in your office)."  After the patient has scheduled the appointment, ask if he needs directions to the office.  If the patient is unsure about whether he wants an appointment, ask if he would like to receive some written information in the mail.  If so, send the appropriate office brochures.  Also, give him directions to the office's web site.  


2. Complaints about inconvenient office hours:  In today's society a common belief is that "MY time is more valuable than anyone else's, and I want everything to fit MY schedule."  This arises from the fact that many parents are single, over-worked, under-appreciated, stressed out and very pressed for time during the work week.  It also arises from the belief that people today are entitled to more free time than ever before.  When parents complain about inconvenient office hours, acknowledge their frustrations, but also explain that the office is operated by women who also have family commitments.


Sample script:  "I am sure that an evening or weekend appointment would be more convenient for you, but if I worked evenings and weekends I would never get to see my children."  or  "I would like to offer evening and weekend appointments, but my kids won't let me."  or "I have a second job as a housekeeper and mother which starts at 5:00pm."  This approach does two things.  First is diffuses the parent's anger by showing them that you too have the same problems and time restraints as they do.  Secondly, it provides a reasonable excuse (the need to care for your children) that few parents will argue with you about.  However, if you project the "take it or leave it" attitude or the "too bad you don't like the office hours" attitude, you will evoke an angry response every time.  Offer the parent an appointment and remind her that the office runs on time, and that you will get her child in and out as quickly as possible so that minimal time will be spent away from work/school.


3. Insurance questions about being "a preferred provider or a participating dentist":  Being a preferred provider or a participated dentist for a given insurance program means that the doctor has signed a contract to provide services to patients under a given plan.  The contracts vary, but for the most part it means that the participating doctor has agreed to accept direct payment from the insurance company and has agreed to accept a predetermined fee for a given procedure.  Typically the patient doesn't have to pay anything up front or only has to pay a small copayment ($10 to $20).  Patients like to pay very little or nothing up front, and this motivates them to seek out participating doctors.  The insurance company wants this because it saves them money.  Usually, the insurance company provides patients with a list of preferred providers.  You must deal with this problem very carefully, because most patients are far more likely to select a doctor based on their insurance policy rather than the quality of treatment provided by the doctor.  Therefore, it is ESSENTIAL that you provide patients with the CORRECT information about insurance.  Most offices will file all insurance claims for all insurance policies.  If there are no participating dentists for a given policy in this area, the insurance company may pay claims to your doctor as if he were a participating doctor.  Occasionally, the insurance company will pay the claim, but will pay a lesser amount than if the doctor were a participating doctor.  Be sure to the patient understands that just because the doctor is not a participating doctor, DOES NOT mean that the insurance company will not cover the orthodontic treatment your office.  If your office is a preferred provider for insurance companies, make sure you know which ones that you participate with.

     In most orthodontic offices, patients are expected to pay the office directly and allow the insurance company to reimburse them. 


Sample Scripts:

     "Dr. Smith is not a participating dentist, however, this does not mean that you cannot be seen by him.  Our office will file all insurance claims for all insurance policies.  If there are no participating dentists for a your policy in this area, the insurance company may pay most claims to Dr. Smith as if he were a participating doctor."

DO NOT SAY: "Dr. Smith does is not a participating dentist in any insurance policy" and then hang up since this looses a patient that could have been treated by your office.  Be sure to provide the above stated information before the patient has a chance to hang up.

     HMO insurance policies are different than preferred provider policies.   HMO's usually will not cover any services in a non-participating office if there is a participating doctor in the area.  However, if none of the orthodontists in the area participate in HMO's,  this usually means that the HMO will pay the claim, but it will likely pay a lesser amount than if the doctor were a HMO doctor. 


4. Request for fee quotes:  Explain to the parent that the doctor must look at the child in order to determine what problems are present and how they may be corrected.  Treatment fees are based on the severity of the original problem, the length of treatment and the type of treatment.  Do NOT give fee price ranges over the telephone unless your doctor gives you permission.  Do NOT discuss down payments and payment plans over the telephone unless you doctor gives you permission.  Most orthodontists will not allow fees to be given over the telephone.


Sample script:   Ms. Jones I can not give you a treatment fee estimate over the telephone since I do not know what particular orthodontic problems your child has.  Our treatment fees vary depending on the type and severity of the problems.  The doctor can look at your child and tell you what problems are present, how they may be corrected, how long treatment is expected to last and can give you an accurate estimate of the treatment fee.  As soon as I know what the treatment fee will be, I can work out some payment plan options with you."


5. Parents calling for a second opinion or who saw another orthodontist and got a very large treatment fee:  Tell the parent about the consultation appointment.  Stress that treatment fees are based on the type and severity of the problems and that your fees may differ from other orthodontists.  Do not make negative comments about the quality or price of other orthodontists' treatment.  If you must make a comment, simply say, "I understand your concerns."  and then proceed to schedule a consultation appointment as soon as possible.  If a parent is very upset about the treatment fee and/or the stated urgency for treatment, the sooner you can schedule the patient, the better the parent will feel.  Emphasize the positive aspects of your office rather than dwelling on the negative aspects of other orthodontic offices.


6. Questions About Phase I and Phase II Treatment:  Many parents have questions about Phase I and II treatments.  Some of these parents may be in the middle of treatment in other orthodontic offices, while other may have heard "orthodontic horror stories" about very long (4 to 6 years), expensive, two-phased orthodontic treatment from other parents.  Some patients do need two phases of orthodontic treatment, while some do not.  The best way to deal with concerns about two-phases of orthodontic treatment is to educate the parents.  You should explain the following information to the parent.

    The age at which a child needs orthodontic treatment depends on the type and severity of the orthodontic problems that are present.  Some orthodontic problems are more effectively treated at an early age, while others are best treated once the majority of permanent teeth have erupted.  Children with significant orthodontic problems at an early age (6 to 9 years old) may require two phases of orthodontic treatment.  The goals of phase I (interceptive) treatment are to improve growth discrepancies between the upper and lower jaws, to correct immediate dental problems (crossbites, open bites, severe crowding, etc.) that may be present and to minimize the severity of the developing malocclusion.  After phase I treatment, a child may need a second phase of treatment at a later time once the majority of permanent teeth have erupted.  Phase II usually involves a full set of braces (upper and lower) to align the teeth and perfect the bite (occlusion).  Whether or not a child needs a second phase of orthodontic treatment depends on the size and position of the teeth that erupt, the manner in which the teeth fit together, the effectiveness of phase I treatment and the dental expectations of the child and the parents.  Successful completion of phase I treatment does not guarantee that teeth will erupt in perfect alignment and good occlusion, but it may make phase II optional.  However, if the child and parents desire perfect tooth alignment and an ideal bite, a second phase of orthodontic treatment is usually necessary.  Not every child requires two phases of orthodontic treatment.  Mild orthodontic problems can be treated with a single phase of orthodontic treatment.  Severe orthodontic problems can be treated in older children and in adults, but treatment techniques are different.  Severe orthodontic problems that are treated with two phases of orthodontic treatment may produce more esthetic and more stable orthodontic results than if only one phase of treatment is done.  To find out whether a child could benefit from orthodontic treatment, the patient schedule a consultation appointment.

This is a sample of a portion of one training lesson.

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