What’s the difference between nurse triage call centers and medical answering services? Are they the same thing? How should a medical provider determine which one is right for their organization?
In this blog, we’ll take a closer look at both services and review some considerations for selecting the appropriate call center vendor.
First, What is Triage?
First, we should define the term triage. According to MedicineNet, triage is “the process of sorting people based on their need for immediate medical treatment as compared to their chance of benefiting from such care. Triage is done in emergency rooms, disasters, and wars when limited medical resources must be allocated to maximize the number of survivors.”
Another definition from Wikipedia states that triage is “the process of determining the priority of patients’ treatments by the severity of their condition or likelihood of recovery with and without treatment. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately; influencing the order and priority of emergency treatment, emergency transport, or transport destination for the patient.
In the most basic sense, triage is the process of screening, sorting, and guiding people for the purpose of delivering appropriate medical care. In this article, we are primarily discussing triage done over the phone for doctor’s offices, hospitals, and other healthcare organizations.
Types of Telephone Triage Services
Triage is performed in a variety of settings and circumstances but for the purpose of this article, we are examining triage services performed over the phone. For many healthcare organizations, this is done by their own providers or office staff. However, in order to provide 24/7 service or better support patients after-hours, it’s often more cost-effective to contract with a third party.
These third-party companies take calls on behalf of a medical practice or healthcare organization and provide some degree of triage support. But the degree of support varies, and it’s important to understand the differences in order to choose the medical call center solution that makes sense for your organization.
There are two primary types of services used for triaging calls:
- Nurse Triage Service: These services are staffed by registered nurses or medical professionals with clinical expertise. They are able to provide medical advice and determine the appropriate level of care.
- Medical Answering Service: These services are staffed by call center operators without medical training. They help screen calls and provide professional telephone customer service, but they’re unable to provide medical guidance and will dispatch calls to on-call nurses or physicians whenever there is a need for additional triage.
Pros and Cons of a Nurse Triage Call Center
A nurse triage service uses licensed nurses and thus can provide more in-depth triage services than a basic answering service. As a result, more calls will be resolved without escalation to a physician or on-call staff members. The nurses are specially trained in triage, undergoing rigorous quality assurance programs and using guidelines and documentation that ensure consistent care.
However, that expertise comes at a substantial cost — as much as $40 a call or more. And that expertise is paid for on every call, whether it is required or not. Most practices can identify a variety of call-types that can be immediately resolved without the assistance of a licensed professional — including appointment or billing inquiries or after-hours requests that must wait for office hours or be referred to an emergency room.
Pros and Cons of a Medical Answering Service
Basic triage can also be performed by call center operators without medical training when they are supported by on-call nurses or physicians, or when they aren’t expected to provide medical guidance. These medical answering services are structured to achieve similar outcomes as a nurse triage line — determining the nature of a call and the appropriate disposition. However, the key difference is that, because answering service operators aren’t licensed medical professionals, they aren’t able to give medical advice and are more reliant on call scripting and on-call support.
Medical answering services can provide triage in the sense that they can guide callers through a script in order to determine their general needs, but they are dependent on on-call nurses or physicians to handle the more intensive medical inquiries.
For example, whereas a licensed triage nurse may be able to probe specific symptoms in an effort to make a determination about a patient’s condition and the appropriate level of treatment, and even advise on specific actions a caller should take or things to check, a medical answering service may only be able to determine whether the caller should wait for regular office hours, go to the emergency room, or speak to the doctor-on-call.
Because medical answering services can’t provide the same level of medical support as a nurse triage service, they are more dependent on their client (the healthcare organization or medical practice) for resolving calls they are uncertain about or that meet the criteria to be escalated. This results in on-call providers being paged to speak with the patient, make an assessment, and determine the treatment plan. And if you use an answering service that doesn’t utilize intelligent call scripting and on-call procedures, the on-call may end up being bothered more than they need to be.
The cost difference between nurse triage services and medical answering services are substantial. Medical answering services are available at a fraction of the cost, with many calls being resolved for a couple of dollars or less. Automated pre-screening can further reduce the cost by limiting how much time a live operator spends on each call.
Are You Already Paying Your Providers for Triage?
Another consideration is whether or not your organization is already paying providers for triage. If you already have on-call physicians who are responsible for responding to calls after-hours, then a nurse triage service may be a redundant expense. In this instance, a medical answering service or automated solution may be the most cost-effective way to answer and screen calls.
Scripting and Customization Can Make The Difference
When deciding which option is right for your organization, it is helpful to examine the types of calls you expect to receive and how you would like those calls to be resolved. Many practices determine that they can effectively script out their calls and work with a customizable medical answering service like CMS to achieve their needs for a fraction of what it would cost to deploy a full-fledged nurse triage service.
Using Both Services Together
Medical answering services and nurse triage call centers can also work together to support your patients. The answering service can be the first line of support, screening each call to determine which patients need to speak with the nurse and which do not. Routine office calls and other matters that the triage service can’t or shouldn’t handle, like questions about an appointment, can be handled by the answering service. The triage service would then be used to provide medical guidance and direct patients to the appropriate level of care.
How Do I Decide Which Solution Is Right For Me?
If you are looking for medical professionals to replace your staff and resolve calls on their own, especially calls that require referencing detailed clinical documentation or making judgment calls that can’t be set up in a call script, a nurse triage service is probably what you are looking for. However, because of the cost, you may also want to supplement this service with a medical answering service that can handle more routine calls.
If you need a vendor to help answer your calls when you are unavailable, provide a professional telephone presence, and handle call screening and on-call dispatching, a medical answering service is likely what you are looking for. They can provide limited triage services per your specifications, asking the right set of questions to determine the nature of the call and then relaying your instructions to the caller for the given scenario. This could include a referral to the emergency room, a request to call back during office hours, or taking a message that is then relayed to an on-call nurse or physician.
Discuss Your Medical Call Center Needs with a Pro
Need help making a decision? CMS can evaluate your call center needs and propose a solution that makes sense for your organization. To get started, view our plans and pricing.