Your phone tree is not just a list of numerical options such as “Press 1 for Scheduling.” It is a critical gateway for converting prospective new patients into billable encounters. An improperly configured phone tree can deflect new patients, sending them to your competitors. Practices can often increase their volume (and therefore their revenue) by as much as 20 percent, just by optimizing their phone handling. Here’s how…

It’s not just the number of options on your phone menu, and how your order them– it’s also how you configure phone settings, such as the number of rings, roll over of calls from one extension to another, voicemail on/off, etc., which can profoundly impact your new patient volume.  A poorly set up phone tree can cost you hundreds of thousands of dollars– or more– in lost revenue each year. Meanwhile, an optimized phone tree can help you book new patients even when the practice is closed, and while you sleep.

Taking a closer look at your phone tree can help you capture new patients and revenue.

The High Cost of a Sub-optimal Phone Tree

Let’s assume that your phone tree is not working at its full potential. Let’s also assume that as a result, you miss ~2 new patient calls each day. This could be because your scheduler is busy with another call, or because the office is closed for lunch, or the office closes before the patient gets off of work, etc. Maybe your patient was routed to voicemail. Maybe they got annoyed with being put on hold and hung up.

Annual missed new patient calls:  (260 business days per year x 2 missed calls per day) = 520 missed calls.

Now let’s assume that your average patient comes to your clinic 3 times per year—once as a new patient, and two more times as an established patient.

The rates below are Medicare 2020 reimbursement rates for the “Rest of Florida” MAC:

  • HCPCS code 99204, new patient visit:  $166.38
  • HCPCS code 99214 established patient visit:  $109.18

The Medicare reimbursement for those 3 visits (1 new patient visit + 2 established patient visits) adds up to $384.75 for the year. (This does not include any other office revenue such as ultrasounds, EKGs, vaccinations, in-office procedures, etc.!)

If you multiply $384.75 per patient in lost office visit revenue by 520 missed new patient calls to schedule, the total  lost revenue from office visits alone is $200,000! Even if you assume that half of those missed calls do eventually call back…you’ve still lost $100,000!

What if you’re a specialist and have an ambulatory surgery center? Let’s assume that approximately one third of your new patients end up having an outpatient procedure in your ambulatory surgery center. This could be a colonoscopy, a cataract procedure, or various urological procedures… To keep it simple, let’s just  assume your practice gets an average of $1,000 per ASC procedure performed in your ASC.

That’s 173 patients ( 1/3 of the 520 missed new patients) x $1,000, which equals another $173,000 in lost revenue

The cost of missing 2 new patient calls per day has now increased to $373,000! Do you see why even minor tweaks to your practice’s phone tree can have a profound financial impact on your organization?

Tips to Fix Your Phone Tree and Get More New Patients In The Door

#1 – Eliminate voicemail on your scheduling line.

80 percent of callers who wind up in voicemail do not leave a message.


When your patient is routed to voicemail and hangs up, only two things can happen:

  • The patient, now annoyed, will call the next practice on their internet search results or on their insurance plan’s provider directory, and one of your competitors will get their business.
  • Even if the patient is willing to leave a message, your schedulers are now playing “phone tag” with the patient. When this patient and others have to call the practice back multiple times, the phones lines are that much busier, and you risk losing other new patient calls. Your staff feel busier (and often stressed out), but they are not productive.

One practice decided to send all new patient calls to voicemail. The result was that they lost about 20 to 40 percent of their new patient volume. This was a specialty practice that performed a lot of procedures, so the impact of this decision in terms of lost revenue was potentially millions. Their phone lines were jammed with frustrated patients who kept calling back over and over again, trying to reach a live person. Each time a patient called back, they were forced to leave more voicemails. The schedulers quickly became overwhelmed, and calls went unreturned. This resulted in a months-long backlog of untouched referrals.

So how do you avoid sending patients to voicemail?

Consider disabling the voicemail feature for scheduling calls. Note: This does not mean you should just let the phones ring! Instead, utilize simultaneous ringing and rollover features to maximize the likelihood of a timely, live response. (More on this below…)

New patients are the lifeblood of practices. Promptly answering new patient calls and converting them into billable encounters is even more critical for surgeons and certain specialties, like orthopedics, where the patient’s problem is fixed (e.g. with surgery), and then the patient exits the practice. Surgeons must constantly recruit a steady stream of new patients in order to survive.

In certain situations, it makes sense to encourage patients leave a voicemail message. For example, a vendor who is trying to sell you something can be routed to voicemail. Prescription refill requests can also be routed to voicemail. This frees your staff to prioritize revenue-generating calls.

To make sure new patient scheduling calls are answered, you can:

  • Stagger lunches and breaks so that someone is always answering inbound scheduling calls.
  • Configure phones to simultaneously ring multiple staff.

You can also configure your phones to roll over scheduling calls to a manager if no one answers within three rings. (I have used this tactic to create accountability when schedulers were not answering calls. This tactic has the added benefit of keeping the practice manager informed— If too many calls are being forwarded to the manager, and all of the schedulers are busy scheduling other patients, then your practice may be understaffed.)

  • Remove outbound calling from your schedulers’ work load. If your schedulers are making outbound calls to insurance companies, they are tying up the phone line for long periods of time. Do you think your scheduler, who has already been waiting for 30 minutes on hold with the insurance company, wants to hang up to answer a new patient call? Perform benefits verification automatically through your EMR system, or divide scheduling and verification duties so that the phone line remains free for inbound new patient calls.

#2 – Use your phone tree to promote online self-scheduling. Most EMR/PM systems now give you the opportunity to make your phone system work for you after hours. Enable self-scheduling and registration options in your EMR system, then put a link on your website. Instead of just telling callers that the offcie is closed, you can record an after hours message inviting callers to use your online self-scheduling capabilities any time, day or night. You can also record instructions on how to schedule online and set up the recording to play during hold times, giving your patients an alternative to waiting on hold.

By enabling and promoting online scheduling, you will capture patients who are ready to schedule when your office is closed. You’ll also minimize overall call volume to your practice, increasing your staff’s productivity.

#3 – Find other ways to “declutter” your calls. Take a look at your practice’s work flows– including clinical workflows– and assess how they might be contributing to unnecessary calls by patients. To do this, categorize the types of calls that you get, as well as the volume by type. Look for opportunities to head off inbound calls. For example:

  • Do patients forget to ask for refills during their appointment, then call your office later? Make sure all patients are asked if they need any refills.
  • Do you get a lot of calls with the same questions about common procedures? Hand patients an FAQ about their procedure to proactively answer questions.
  • Give patients an after-visit summary to refer to (most EMRs have this capability.)
  • Are your physicians causing a flurry of rescheduling? Create a process to proactively ask about days off, vacations, CME dates, etc. to minimize the need to move patient appointments.

For a free 15 minute consult to discuss how we have helped practices like yours increase their volume and patient satisfaction, click “Work With Me: on home page, or email .

Our Call Center Roadmap Course (available July 31, 2020) is jam-packed with proprietary tools and templates, such as phoen trees, staffing calculators, job descriptions, and much more. In this course we provide a highly detailed, step-by-step blueprint of our proven system for overhauling your patient access functions to increase patient satisfaction and revenue.