Every medical practice must deal with managing after-hours consults and patient care requests. Unfortunately, most live operators are not medically trained, do a poor job of differentiating between urgent and non-urgent issues, and do an insufficient job of screening calls. As a result, most medical practices receive a large volume of non- urgent phone calls related to issues more appropriately handled during regular business hours. We have found that most On Call Central customers report a significant reduction in after-hours calls after implementing just a few simple techniques. Collectively, these techniques often reduce after hours call volume by 50% or more, significantly increasing the quality of life for medical providers without sacrificing patient care. The following eight techniques are what we have found to be most effective.



  • Divert non-clinical calls. Non-clinical calls, including those for appointment requests, medical records, billing matters, and hours of operation, account for approximately 30% of all after-hours calls. Medical practices can easily divert the majority of these non-clinical phone calls to internal voicemail systems for the appropriate office administrator to handle the next business day.


  • Automate distribution of static and seasonal information. Approximately 10% of calls to medical practices are requests for information that does not vary over time. Information such as your address, business hours, directions to your office, your fax number, and website URL can be communicated in an automated manner accurately and efficiently without bothering the on-call provider, or anyone in your office. This strategy may also be helpful for distributing seasonally relevant information, such as the availability of the flu vaccine in your office.

“These techniques often reduce after hours call volume by 50% or more.”

  • Indicate that you may bill for non-urgent calls. Prior to presenting callers with the option to contact the on-call provider, serve notification that the caller may be billed for the convenience of the service. Note that you do not actually have to send a bill. The mere threat of a bill is generally sufficient to render the 2AM medication refill call non-urgent, allowing your office staff to handle the patient follow-up the next business day. Reviews of On Call Central accounts indicate that as many as 50% of all callers immediately hang up upon hearing that they may be billed for non-urgent matters.


  • Mention a specific amount. A subtle variant of the previous technique is to mention a specific dollar amount that a patient may be billed if they choose to notify the on-call provider. Stating that someone may receive a bill in the amount of $50 for the convenience of the service is more effective than simply telling a caller they may receive a bill of an unspecified amount. The goal is to select an amount at which certain types of nuisance phone calls are filtered out, while allowing urgent phone calls to get through to the on-call provider.
  • Instruct callers to hang up and dial On Call Central directly. Rather than having phones forwarded to an answering service, some practices leave a pre-recorded message on their internal phone system instructing callers to hang up and dial the answering service directly. Seasoned practices managers will be unsurprised to learn that this trivial task can decrease overall call volume by 50% or more in some practices. Callers with urgent medical issues will overwhelmingly call the answering service, whereas patients who consider a simple phone call too daunting a task will simply call the following business day.


  • Differentiate patient versus consult calls. Some practices simply do not want to take patient calls after hours, and instead accept only consult calls from the ER, inpatient units, or other physicians. On Call Central allows practices to create separate options for patient –vs- provider calls, a feature that allows us to engage in differential behavior for each option. Practices may wish to have patient calls forwarded to a back line, whereas consult requests would result in the on-call provider being notified. We have found that it is exceedingly rare for patients to lie about their status (for example a patient selecting the option intended for physicians), and have had no accounts where this has been a persistent problem.


  • Target high utilizers. A high utilizer is defined as a patient who contacts your practice for phone care six or more times per year. A recent study in the Journal of Family Practice shows that high utilizers represent only 0.6% of patients, yet account for 23% of after-hours phone calls. Most medical practices can identify by name their high utilizers, and can significantly reduce the after-hours call volume simply by sending a letter to twenty or fewer patients informing them of a change in office policy as it relates to payment for after-hours services.


  • Automate medication refills. Medication refill requests account for approximately 25% of all after-hours office phone calls, and more than 40% of calls from high utilizers. Because of several practical obstacles, including an absence of 24-hour pharmacies in many rural areas, medication refill requests are a persistent headache for most practices. At On Call Central, we build our phone trees so as to clearly state that your practice does not handle non-urgent medication refill requests after hours, and that your practice has a policy of managing all non-urgent medication refill requests the following business day. Collectively, these procedures result in a drastic reduction in medication related phone calls.


Combined, these eight strategies can drastically reduce non-urgent after-hours call volume in medical practices. If you have questions, or would like advice on the implementation of any of these strategies, please feel free to contact us.

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