The most effective strategies for handling difficult or upset patients include:

1. Active Listening: Show empathy and listen attentively to understand the patient's concerns fully.
2. Calm and Respectful Communication: Maintain a calm demeanor and speak respectfully, regardless of the patient's tone or volume.
3. Clear Explanations: Provide clear, concise information to clarify misunderstandings or confusion about their care or billing.
4. Solution Orientation: Focus on finding a solution that addresses the patient's concerns, offering alternatives if necessary.
5. Follow-Up: Ensure that any promises made are kept, and follow up with the patient to confirm that their issue has been resolved satisfactorily.

Using these strategies helps to de-escalate tense situations and improve patient satisfaction.