We understand the challenges Health Plans face everyday. Rising healthcare costs, increasing competition, client retention and the growing costs of treatment all place tremendous strains on your plan’s overall strategy and bottom line.

Today, Nurse Line services play a pivotal role in educating members and supporting confidence in their health plans, while at the same time encouraging the best use of hospital and physician resources. For health plans, it is a demanding and sensitive role, where success hinges on building trust by delivering value and providing a sense of security.

IntelliCare has the experienced staff, clinical expertise, flexible technology and industry experience to provide your plan with the tools to:

• Empower members to use healthcare resources more appropriately
• Provide members with the information they need to make better health decisions
• Increase member satisfaction
• Lower your healthcare costs

IntelliCare Health Plan Services
IntelliCare currently offers the following services to Health Plans:

IntelliNurse®: 24 x 7 Nurse Line and Information Services

• 24 x 7 Nurse Line - Triage and Health Information
  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. Read more.
  
  
• Health Coaching
  IntelliCare’s Health Coaching service provides members with access to a trusted advisor who can help to weigh the pros and cons of treatment options while helping members to navigate an increasing complex healthcare system. Read more.
  
  
• Health Assessments
  Whether we provide initial assessments as a part of a Customized Care Management program, or a health risk assessment to assist in garnering important information about a population quickly, IntelliCare has the capability to meet your assessment needs.
  
  
• Enrollment Services
  Enrollment for health plans and disease management programs is one of IntelliCare’s fastest growing services. Based on client-defined criteria, IntelliCare can identify candidates for program intervention, explain the program and its benefits, and perform an initial enrollment survey if the patient agrees to participate.
  
  
• Audio Health Library
  Client’s can provide access to an audio library of health information from an industry-leading vendor, Healthwise®. Available 24 x 7, callers can learn about a condition or diagnosis and gain a better understanding of appropriate care, with the option to speak with a nurse to discuss any remaining questions.
  
  
• Automated Voice Services
  As a full-service call center, IntelliCare employs a variety of technologies that complement our more traditional service methodologies. We use Automated Voice Services to provide a lower-cost but professional solution for programs where this technology makes good sense. Appointment reminders; Initial Welcome Calls; Drug Compliance Calls.
  
  
• Web Portal
  IntelliCare offers access to a health information portal that assists members in becoming more empowered in their healthcare decisions. The site provides convenient links to federal health resources, such as MEDLINEplus and www.clinicaltrials.gov, with up-to-date, reliable information about specific diagnosis and procedures, drug information, clinical trials, senior health, and women’s health.

Marketing Services:

• Physician Referral
  Our agents assist members in finding appropriate physicians to meet their specific needs. We often provide our clients with a web-based self-service application.
  
  
• Class and Event Registration
  Registering members for screenings, educational programs, or other events is a service that IntelliCare has been providing clients for a long time. In many cases, we complement this telephonic service with a web-based self-service application as well.
  
  
• Custom Outbound Calling Programs
  IntelliCare has the experienced staff and flexible application technology to support a wide variety of customized clinical and non-clinical outbound calling programs. From new member welcome calls to telephonic health risk assessments, IntelliCare can manage all aspects of the outbound campaign. Our data driven environment allows for detailed reporting and call monitoring capabilities.
  
  
• Member Services
  IntelliCare provides a variety of 24 x 7 member services functions in support of multiple client programs that improve participant satisfaction and operational efficiencies. Specially trained Medical Service Representatives can address common questions related to available services, provide directions and contact information, and direct members to other resources as appropriate. By integrating with our client’s benefit applications, our agents can provide eligibility verification; respond to benefit inquiries, and distribute member materials as needed.
  
  
• Member & Patient Satisfaction
  As a normal course of business, IntelliCare conducts satisfactions studies on the core services that we provide our clients. In some cases we are contracted to conduct similar patient / member satisfaction studies on services that we are not running.
  
  
• Member Communication Services
  IntelliCare supports our clients with complete member communication services. From concept to design, to print and fulfillment, IntelliCare takes an “ad agency” approach to producing member communications, consulting with each client to ensure that the materials produced drive appropriate utilization of the service and reflect the corporate culture, identity, and goals of your organization.

Coordination and Integration:

• Staffing and Infrastructure Solutions
  Providing support to members around the clock can be challenging. To assist health plans in providing a broad spectrum of services on a 24 x 7 basis, IntelliCare provides after hours and overflow support for member services and other functions. Our flexible application technology allows agents to process a call as though it were being processed within the walls of the health plan, and our distributed call center model allows the services to be provided in a cost effective way.
  
  
• Program Integration
  Every interaction with a member counts. When a member calls with a health concern, there is an opportunity to maximize that interaction by educating the member about programs or services they may be eligible for. Using existing member demographics and other client-provided data, combined with data compiled during the call, IntelliCare’s proprietary logic engine “DidUKno” provides information in real time about additional programs and services that might benefit the member.