Remote receptionists? Outsourcing hits the front office

2008 08 14 15 07 00 180 Receptionist 70

When patients call the office of Kalpana Madhavan, D.M.D., in Rockville, MD, they might end up talking to a receptionist in Idaho. Or Montana. Or any of six other states. It all depends on who is handling her account that day.

Dr. Madhavan is one of the first customers in a new service, offered by Planet DDS of Irvine, CA, that matches receptionists working from home with dentists working from their offices. "It keeps me productive," Dr. Madhavan said. "I think it's taking dentistry to a level that we never imagined."

“It keeps me productive. I think it's taking dentistry to a level that we never imagined.”
— Kalpana Madhavan, D.M.D.

Dentists have long contracted with bill collecting services; some have used after-hours medical answering services; and multioffice practices have tried centralizing office management. But the notion of an individual dentist contracting with a remote receptionist to make and confirm appointments and pursue insurance claims is relatively new, said Irvin Lubis, D.M.D., a former periodontist in Boonton, NJ, who now works as a practice management consultant for dentists.

The possibilities are growing with new Web-based practice management software that allows people in disparate locations to enter information into the same appointment book and access the same charts and insurance records.

Other companies offer such services, including Call Desk of Portland, OR, which also has U.S.-based receptionists. But Planet DDS claims to be the only one specializing in dental practices. The business is not based on medical answering services but on the airline Jet Blue, whose customer service representatives work from home, said William Jackson, D.D.S., vice president of Planet DDS.

The Planet DDS price structure is also unusual. The company charges $1.25 per inbound call and $1.50 per outbound call, with volume discounts. (Call Desk charges $150 a month for phone services.) For collections, Planet DDS takes a cut of 2% to 3%. Dr. Jackson claims this is about half of the going rate. The company can charge less because of the efficiencies afforded by the Web-based practice management software, he said.

The software can be used without the virtual receptionists, but if you want the virtual receptionists, you have to use the software. It costs $150 per month for a small office and $250 per month for a large one. (While that's more expensive than buying software to run on your own computer, Dr. Jackson said, it offers other advantages: it's accessible from anywhere with an Internet connection, and it automatically backs up your data.)

How it works

New patients who call Dr. Madhavan's office will get a Planet DDS receptionist who can schedule an appointment for them and take down their insurance information, as well as guide them to a Web site where they have the option of entering their medical history. "By the time the patient walks in, they have already verified the insurance," Dr. Madhavan said. After the appointment, a virtual receptionist processes the billing, allowing Dr. Madhavan and her two assistants to focus on dentistry.

The service is not for everyone, Dr. Lubis said. He is leery of trusting someone who works far away to handle the minute-by-minute demands of running an office. "The person at the desk is the quarterback," he said. "In an emergency, she moves people up, she moves people down. She has to have her finger on the pulse of it."

And David Landau, D.D.S., a cosmetic dentist in San Diego, said he wouldn't be interested because his busy practice relies on delivering a "value-added" experience for all patients, and communication is critical to ensuring this happens.

"I think it is an idea that could work in many practices, but I am skeptical if it would fit mine," he said. "My practice consists of two doctors, three hygienists, and eight or nine other team members. In many ways, it would be great to have fewer people to manage, but I would worry about the continuity of communication. Our business model is high-quality dental care supported by a high-service, 'value-added' experience."

But Dr. Madhavan, who recently opened her practice, said the service fits the needs of a small office. The answering service allows her assistants to spend most of their time chairside. But both are trained to work in the front office, so if someone walks in the front door, they can respond to the chime with a friendly smile. A second phone line rings into the office so Dr. Madhavan's suppliers can reach her directly.

Dr. Madhavan likes having fewer employees on her payroll. She also likes paying per phone call so she is not charged for services she isn't using; she once hired a receptionist who spent a lot of her time in the office planning bridal and baby showers. When the receptionist went on vacation, Dr. Madhavan found herself puzzling over which new patients had insurance. Now that never happens, and the service has eliminated a lot of headaches, she said.

So far, every time Planet DDS has offered a new service, she has bought it. "Right now the service is only 9 to 5," Dr. Madhavan said. "I would like it to be 24/7 because I have a new practice and I want to capture every patient who calls."

This would probably mean hiring receptionists outside of the U.S. Dr. Jackson said his company has had conversations with people in India and the Philippines, but mostly about dealing with insurance companies. Many of his clients don't want prospective patients to hear an Indian or Filipino accent on the other end of the line, he said.

Dr. Madhavan, who grew up in India, isn't bothered by the accent. But she's still not sure she would want a virtual receptionist there.

Her concern? U.S. insurance policies might be incomprehensible to anyone who didn't grow up with them.

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