Automating Management of Overflow Call Volume

Many practices get heavy call volume for just a couple of hours a day. It isn't practical to have an employee come in for two hours to answer phones. Here's how On Call Central can help.


Sporadically high call volume is an increasingly common issue in the modern medical practice.  Peak call times, such as Monday mornings, lunch, and closing time are often characterized by inbound call volume that exceeds a practice’s ability to immediately address patient requests.  During these high traffic periods, waiting times exceed management’s targets, call abandonment rates rise significantly, and patients become frustrated by poor customer service.

Though the problem is obvious, management frequently struggles to cost-effectively remedy overflow call challenges.  It is prohibitively expensive to hire additional employees for sporadic overflow call needs.  An alternative to hiring additional employees—a live answering services—can be similarly expensive, yet still requires your staff members to call patients back to resolve their issues.  There is, therefore, a need to provide practice managers the tools necessary to achieve higher levels of patient satisfaction through the increased productivity of existing labor resources.  This On Call Central white paper shows how practice managers can resolve overflow call challenges through automation, without resorting to additional hiring, or outsourcing to expensive call services.


There are three components to a basic automated overflow call management strategy:

1. Selectively pass overflow traffic to the automated service.

There are three methods you can use to selectively route calls to an external service:

  • Use the phone company’s “find me” service, which automatically forwards unanswered calls to an external number after a specified number of rings
  • Use a similar “find me” service inherent in many office PBX systems
  • Use PBX functionality that immediately sends phone traffic to the overflow provider whenever a specified number of lines are occupied.

Practices with advanced PBX systems will likely choose one of the latter options, whereas practices with older, legacy PBX systems should contact their phone company to inquire about “find me” functionality.

2.  Carefully design, and selectively play, a voice menu specific for overflow traffic.

Voice menu design is a science, and if you fail to put appropriate thought into the wording of your greeting and the logic of your automated system, you will not have success.  When designing your voice menu, keep the following principles in mind:

  • Be temporally accurate.  Implement a system that plays a specific overflow voice menu in a temporally appropriate manner.  Do not play a generic after hours greeting; play a greeting that has been specifically designed for overflow calls during regular office hours.  In general, an overflow voice menu will typically play between the hours of 9AM and 5PM Monday-Friday, while phone traffic received outside of these hours would be directed to an alternate after hours voice menu.
  • Be clear and honest.  Within the greeting, clearly communicate to patients that they have encountered your overflow protocol.  In no case should callers get the impression your office is closed, as it will result in confusion, patient complaints, and more work for your already-busy staff.  Overflow traffic should be handled not with a general voice menu, but with one that clearly explains to the caller that call volumes have temporarily exceed your practice’s ability to immediately answer and respond to their call.
  • Consider a caller’s instincts.  A caller’s natural impulse is to select the first option he feels is remotely pertinent.  Therefore, present non-urgent menu options, as well as all options that do not require a call back, early in the voice menu.  Static information, such as directions to the office, hours of operation, and the practice’s fax number, should be placed early in the menu structure.  Additionally, if your practice deals with seasonal calls, such as inquiries as to the availability of flu vaccine, include this early in your overflow menu as well.  Reserve all options that will require a staff member call back for later in the voice menu.
  • Set appropriate response time expectations.  When your automated system accepts a message from a caller, be sure to communicate an expected time by which the caller should expect a response.  Be conservative in your estimates.  If your staff manages to address the caller’s message prior to the expected response time, the caller will be happy.

3.  Determine the Best Method of Tracking and Responding to Overflow Calls

Once your overflow traffic has been received, and the caller has selected an option that will require a return call from your staff, there are several options as to how the messages will be passed along.  Within On Call Central, there are at least three options, each of which has benefits.  They are:

  • Convey messages via a .wav attachment to email.  The On Call Central email module accepts a message from a caller, then attaches the message as a .wav file and delivers it to a destination address.  Practices can simply configure addresses (e.g. that staff members are responsible for regularly checking during business hours.  As messages are received, each produces a separate email record.  Staff members can then retrieve the messages from the email inbox, and simply delete those that have been resolved (keep in mind that a permanent record is kept within On Call Central).  A benefit of the email approach is that it is simple, and will require almost no effort for most staff members to learn.  One potential drawback is that long messages can result in large email attachments that might be rejected by older, or poorly configured mail servers.
  • Selectively forward calls to a back line with in-house voicemail.  Many On Call Central practices invoke our call-forwarding module to selectively pass traffic to a back line in the office, and they simply allow their own internal voicemail system to pick up and instruct the caller to leave a message.  In many cases, this setup is used to pass certain types of calls (e.g. medication refills) to the appropriate staff.  However, this same method can be used to handle overflow calling for administrative issues, appointments, and other common issues.  Due to the fact that this forwarded call is still passing through On Call Central, a permanent record of the call, including full MP3 audio, is maintained on the On Call Central servers and can be retrieved for later use, if necessary.
  • A third approach is to use the core functionality of On Call Central—the paging module—but to configure it in a manner that is more appropriate for typical call overflow management.  In this scenario, we technically create a call schedule (e.g. “Overflow Calls”) and bind one or more staff members to this schedule.  When a call is routed through this option, On Call Central would automatically detect the caller ID of the caller and ask them to confirm their call back number.  Following confirmation of the callback number, the system would accept a message from the caller, then notify the on call “provider” (in reality someone at your front desk) via their assigned contact method.  Rather than relying on our typical notification methods, such as an SMS or call to a cell phone, we can simply inform your office staff via email that a message is pending at On Call Central, and that they need to login to the web interface, listen to the message, and respond as appropriate.

Collectively, this strategy will allow medical practices to achieve greater productivity out of existing labor resources, and to do so in a manner that is organized, affordable, simple, and easy to implement.  If you are interested in learning more about automated overflow call management, please contact us at 1-855-5-ON-CALL.