New Claims System Update

4.4 Nurse Help Line

Provider Manual
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4 ACCESS TO CARE

4.4 Nurse Help Line

Health plans provide a nurse help line, which is a service designed to support the provider by offering information and education about medical conditions, health care and prevention to members after normal physician practice hours. A nurse help line provides triage services and helps direct members to appropriate levels of care.

The nurse help line telephone number is listed on the member’s ID card. This ensures members have an additional avenue of access to health care information when needed. Features of the nurse help line include:

  • Availability 24 hours a day, 7 days a week for crisis and triage serivces
  • Information based upon nationally recognized and accepted guidelines
  • Free translation services for 150 different languages and for members with difficulty hearing
  • Education for members about appropriate alternatives for handling nonemergent medical conditions
  • Member assessment reports faxed to providers' offices within 24 hours of the call