Connecting, communicating, and empowering health plan members to make more informed healthcare decisions.
In trying to contain rising healthcare costs, health plans face challenges at every turn. People are living longer, with more costly illness burdens per patient. Advances in medical treatment coupled with the growing expense of prescription drugs are further accelerating costs. The trend toward consumer driven health plans places additional responsibility on payors and their clients to provide services that assist members in understanding complex healthcare decisions while navigating the healthcare system.
Health plans have an opportunity in their healthcare call centers and nurse line programs. Whether they are outsourcing these services or managing their own internal call centers, health plans can make more strategic use of these member touchpoints to do more for their members at the same time they reduce their spending on call center services.
Nurse Line Service Components
Our nurse line service provides members with a toll free telephone
number that they can call 24 hours a day 7 days a week to speak
with a registered nurse about health or medical concerns. IntelliCare
nurses use industry standard guidelines to determine the most appropriate
level of care for the member. Whether it’s a case of the flu,
a sprained ankle or something more serious, our nurse line service
can relax members and help them to determine the most appropriate
plan for care.
The following are standard components of the IntelliNurse program:
- Dedicated toll-free number
- 24 x 7 access to RNs for medical triage and health questions
- 24 x 7 access to MSRs for non-clinical concerns and administrative assistance
- On-line and printed educational materials
- Integrated referrals to disease management, case management, or other programs based on clinical triggers
- Access to IntelliCare's audio library of recorded health topics
- Notification of appropriate members of the care team and health plan
- Annual member satisfaction survey
- Access to IntelliCare's online health information portal
- Standard reporting package, delivered electronically
Our nurses average 19 years of varied clinical experience and we handle approximately 400,000 triage calls per year. Our experience has produced great results – 95% of our callers say that they are satisfied or very satisfied with the triage service and 96% would recommend the service to another health plan member.
IntelliCare: Facilitating Access to Appropriate Care
IntelliCare's full suite of nurse line and health call center services delivers high-value, intelligent solutions for patient and provider communications. With IntelliCare, health plans can:
- Create more informed members. Research has shown repeatedly that access to healthcare information helps health consumers make more conservative decisions about their care and use resources more judiciously. Through IntelliCare's nurse line services, members receive world-class clinical content and decision support via phone, fax, Web, email or print, so interactions can be tailored to individual communication preferences.
- Maximize the impact of each nurse line call. Each encounter is an opportunity to learn more about members, build relationships and ensure that members get precisely the care they need. When members are most open to hearing about health improvement programs, they receive this information, improving enrollment efforts. The result is healthier, more satisfied members and decreased healthcare costs.
- Help members understand what resources are available to them and how best to access them. IntelliCare supports health plans in addressing the growing consumerism trend by ensuring members find the physicians, facilities and programs that can make a difference in their health status.
- Privately label IntelliCare's solutions. Marketing the contact center as a member service and branding it with the health plan's identity sends members the message that their health plan understands how complex the healthcare system is, and how their plan can help. With IntelliCare, members have one intelligent point of access to the health system - anytime they need it.
- Choose the implementation approach that makes sense. Health plans have vastly increased flexibility with IntelliCare, from in-house technology implementation to complete outsourcing of operations. Because IntelliCare uses the same software we sell, members can be migrated transparently should outsourcing become the preferred option. Conversely, health plans can outsource to IntelliCare, confident in the knowledge that transitioning to in-house deployment at a later point will be smooth and seamless. Sharing the IntelliCare platform also means that we can step in to provide back-up support after hours, during peak periods or as part of an organization's disaster recovery plan.
The IntelliCare Difference
- Healthcare expertise -- Our registered nurses average 19 years of clinical experience, and their superior customer service skills are responsible for IntelliCare's unmatched quality track record. We have helped hundreds of integrated delivery systems, hospitals, managed care organizations, group practices and employer groups across the United States increase the efficiency of their call center operations, saving them money while enhancing their reputations in the communities they serve.
- Distributed contact center network -- IntelliCare manages both inbound and outbound calls via 5 URAC accredited health call centers as well as an extensive network of telecommuting nurses. Calls are distributed to the most appropriate agent within our nationwide network based on skills, training and availability for enhanced access at the best price.
- Intelligent technology -- With our proprietary, fully secure architecture, IntelliView, health plans can promote personalized clinical and marketing programs while accommodating their unique policies and practices. The result: more satisfied, loyal members in an increasingly competitive market.
- Flexible, integrated solutions -- Health plans can design the contact center solution that meets their specific needs, whether outsource, in-source or a combination of the two. And because IntelliCare takes an application-and content-neutral approach, health plans can use their preferred applications and content in conjunction with IntelliCare's solutions.
Interested in finding out more?
If you would like more information about IntelliCare and our Nurse Line services for health plans, please contact our sales department today!
