In an era where communications are dominated by instant messages, emoticons and disposable images and videos, telephone conversations might seem passé. The art of having a proper phone conversation appears to have been lost to the convenience and speed of e-mails and text messages.
Over the past decade, technologies such as e-mail, text messaging and social media have ushered in a new era of communication for most workers – particularly those under 40 – redefining standards of etiquette and introducing new tensions between generations. A 2014 Gallup poll confirmed a truth that has become self-evident: Text messages now outrank phone calls as the dominant form of communication among Gen X and millennials. Texting is the dominant form of communication for Americans under 50.
According to communications consultant Mary Jane Copps, aka the Phone Lady, some employees are simply not ready for this ‘new’ reality called “talking”:
“Business still happens on the phone, and when I deal with graduating students, they might want to get into [an industry such as] financial services, and they suddenly realize they have to talk to clients on the phone and they are not prepared. This is terrifying for them, since many of them have never spoken on the phone, and if they have, it’s only to their mom.”
But the lack of phone skills isn’t merely a generational failing, Copps adds. Many professionals have been relying on e-mail as their primary communication tool for years, leaving their phone and interpersonal communication skills rusty. This can be a problem, especially in insurance claims.
Despite the survey results and trends, a real conversation conducted over the telephone remains an important tool, if not the most important, for a disability case manager.
Every disability case manager knows that:
- Disability management must be proactive rather than reactive.
- Close communication and cooperation among all stakeholders are essential.
- A holistic, de-medicalized approach is favorable, and identifying and addressing biopsychosocial factors (BPS) and non-medical barriers early with the insured are essential to increasing the chance of a healthy, successful return to work in the shortest possible time.
By conducting an initial telephone interview with an insured, the case manager can obtain valuable information not always contained in the file and submitted written evidence, such as:
- The context in which the disability occurred
- The non-medical, BPS factors
- The insured’s perception of his/her condition and treatment
- The insured’s motivation towards an eventual return to work
- The insured’s expectations and perceptions regarding his/her own disability and abilities
This information becomes even more critical when the insured has a mental health condition or one that is subjective in nature (e.g., chronic pain, fibromyalgia, post-concussion syndrome, or post-traumatic stress disorder).
In theory, this practice seems well established in the industry. In a recent RGA survey, when asked “when a comprehensive interview was conducted on behavioral health claims,” 94% of the companies interviewed indicated performing the interview before claim approval. The breakdown between Canada and U.S. is as follows:
| CANADA (n=5) | US (n=13) | |
|---|---|---|
| Before claim approval | 100% (5) | 92% (12) |
| After claim approval | 40% (2) | 61% (8) |
| Other | 0% | 23% (3) |
Training and/or Measurement issues?
Unfortunately, the practice doesn’t always follow the theory. RGA has observed in claim reviews over the years that the quality of the phone summary content is often lacking. In many instances, the information gathered is not detailed enough or is superficial, while the real issues remain unaddressed.
Although they are done in a timely manner, the initial telephone interview is often a mere formality, either to satisfy the need of the company’s internal QA process, or because of an apparent lack of training in or a case manager’s unease with conducting a thorough telephone interview.
To remedy this, RGA proposes the following ...
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