Nurse Advice Line for Health Plans

With IntellaTriage, your patients will speak with a licensed nurse quickly – on average, our calls are answered in under one minute. We can address up to 80% of all concerns over the phone, meaning that your patients receive the appropriate treatment and medical advice at the right time, day or night.

Reducing unnecessary costs for members is the top priority of health plans. We help you accomplish this by ensuring that your patient receives the proper level of care, no matter what time it is. Instead of heading to the ER with no information in hopes of a diagnosis, your patients can speak with a licensed nurse 24 hours per day. At IntellaTriage, we have found that up to 90% of ER visits are unnecessary and can be resolved by speaking with a telephone triage nurse.

Uncover direct cost savings by outsourcing your call center function. Health plans save $150,000 annually by switching to IntellaTriage from a self-staffed call center. Make the switch and save yourself (and your customers) money.

Common Questions

What is a nurse advice line? A nurse advice line is a 24/7 telephonic service that connects health plan members with licensed, triage-trained nurses who can assess symptoms, provide clinical guidance, and direct members to the appropriate level of care, urgent care, ER, or home management. It’s one of the most cost-effective tools available to health plans for reducing avoidable emergency department visits while improving member experience.

What is the difference between a nurse advice line and a call center? A nurse advice line is staffed by licensed nurses performing clinical triage: assessing symptoms, applying evidence-based protocols, and making care routing recommendations. A call center is staffed by non-clinical agents performing service and administrative functions. The distinction is critical: only a licensed nurse can safely advise a member whether a symptom warrants an ER visit. Routing clinical calls to non-clinical staff creates both safety and liability risk.

How can health plans reduce avoidable ER visits? The most direct intervention is giving members fast, easy access to a clinical voice when they’re uncertain about a symptom. When a member can reach a nurse in minutes rather than defaulting to “when in doubt, call 911,” a significant percentage of those potential ER visits are safely redirected to lower-acuity settings. Studies consistently show that nurse advice lines reduce ED utilization by 30-50% among engaged users.

How can health plans provide 24/7 clinical support? The most scalable approach is a purpose-built telephonic triage operation staffed by experienced nurses, supported by evidence-based protocols, and integrated with the plan’s care management systems. Building this internally is possible but costly. Partnering with a specialized triage organization is typically faster to deploy, more consistent, and more cost-effective at scale.

How can nurse triage improve member experience? When members know they can reach a real nurse quickly – day or night – their confidence in their health plan increases. They feel supported, not just insured. That confidence translates into higher satisfaction scores, better health engagement, and stronger retention. Speed-to-nurse and disposition are the two metrics that matter most for member experience in telephonic triage.

What is telephonic care management? Telephonic care management is the delivery of clinical support, health coaching, and care coordination over the phone without requiring an in-person visit. For health plans, it’s a scalable way to support high-risk members, manage chronic conditions, and close care gaps. When combined with triage, it creates a continuous clinical touchpoint that improves outcomes and member satisfaction.

Can nurse-first triage improve HEDIS performance? Yes, in several ways. Nurse triage interactions are opportunities to identify care gaps such as missed screenings, overdue follow-ups, and lapsed medications, and connect members with resources to close them. Triage nurses can also support medication adherence conversations and facilitate transitions of care. When triage data is integrated with care management systems, it becomes a powerful tool for proactive HEDIS gap closure.

Can nurse triage support the Medicare Advantage members in my health plan? Absolutely. Medicare Advantage members tend to have higher acuity, more complex medication regimens, and greater caregiver dependence than commercial populations, all of which drive after-hours call volume. A nurse advice line tailored to your MA population, with nurses experienced in geriatric assessment and complex chronic conditions, can meaningfully reduce ED utilization, support care coordination, and improve Star ratings.