Is the Health Information Hotline available
24 hours a day, 7 days a week,
365 days of the year
Staffed by highly qualified and experienced Registered Nurses, with the assistance of the most advanced technology. Teleconsulta’s nurses will gladly answer your questions about any health topic that may concern or interest you. If you are sick, hurt or need health related advice, the nursing professionals will offer you guidance to help you decide whether you should:
- make a doctor’s appointment,
- visit an emergency room,
- or they will offer you self-care instructions to help alleviate your symptoms safely, in the comfort of your home.
Teleconsulta gives you an additional benefit if the nursing professional recommends a visit to the Emergency Room (ER); in such case you will be given a number that eliminates or lowers your deductible for that visit to the ER (available only in Puerto Rico and it depends on contract stipulations).
Your call to Teleconsulta is toll free through a 1-800 number. You can call from anywhere in Puerto Rico or the United States. Look for the number on the back of your Triple-S Salud ID card; and remember, when you call Teleconsulta you must have your Triple-S Salud ID card close at hand.
What is Triple-S Salud Teleconsulta?
Teleconsulta is an exclusive telephone-based service offering health related advice and information. It is available 24 hours a day, 365 days of the week. When you call Teleconsulta, it is important that you have your Triple-S Salud Plan ID card on hand. Teleconsulta is a service Triple-S Salud provides exclusively for its insureds. This service is managed by Axis Point Health, an independent contractor that renders health orientation and information via telephone.
Who is eligible to receive Teleconsulta services?
Most of our members are eligible to receive this service, except for some that are subscribed to employer self insured policies. If you are a member of an employer group policy, please check with the Benefits Administrator of your employer for eligibility to the service.
How does Teleconsulta benefit TRIPLE-S Salud plan members?
Through Teleconsulta, our plan members have access to health information and advice when they need it the most, and they are unsure about what they should do. At Teleconsulta, we evaluate the member’s symptoms, offer advice and direct the member to the most appropriate level of care, at the appropriate moment. If the member’s condition allows him/her to stay at home, we offer self-care instructions to help manage his/her condition immediately instead of having to waste long hours at the Emergency Room (ER) unnecessarily. If, however, during the evaluation process the Registered Nurse directs the plan member to the ER, the member will be given a number to either lower or eliminate the ER deductible (depending on the policy), which is another of Teleconsulta’s benefits.
At Teleconsulta, we help improve our plan members’ quality of life.
Who handles the calls at Teleconsulta?
Calls to Teleconsulta are handled by highly qualified nursing professionals with a minimum of five (5) years of clinical experience, duly licensed to practice nursing in Puerto Rico and who are fully bilingual (English-Spanish).
Before our Nurses are allowed to work at the call center, they undergo a rigorous training process of approximately six (4) weeks duration, specifically, two (2) weeks in the classroom and two (2) weeks alongside a preceptor. This way, we make sure that when they take your call, all our professionals are fully prepared to manage your situation and advise you properly.
How does Teleconsulta do clinical evaluations over the telephone?
Teleconsulta uses a computer program based on algorithms, or a series of questions used to eliminate possibilities. The questions comprising the algorithms were developed by physicians of all specialties. These questions are designed in such a way that they begin with those dealing with the most serious emergencies progressing to questions related to less serious situations, in order to evaluate and determine the urgency and the level of medical that the plan member needs.
When the evaluation process is completed, the nurse does not diagnose, but rather advises the plan member about what is the type of care that he/she needs based on the symptoms presented. The nurse can refer the member to an Emergency Room, recommend a medical visit or a call to the doctor, or simply offer self-care instructions.
Is it necessary for the plan member to be present during the call to Teleconsulta?
YES, when the call to Teleconsulta is made it is very important for the person who is experiencing the symptoms to be present during the call and talk to the nurse, including minors who can speak for themselves, in which case the nurse will want to speak to the minor. Afterwards, instructions regarding the child’s care will be given to the adult in charge.
How does Teleconsulta handle calls related to emergency services?
The nursing professional evaluates the plan member’s symptoms and directs him/her to the most appropriate level of care, with the necessary urgency, depending on the severity of the member’s condition. In some cases, this means that you should immediately go to an emergency room, while in others, the recommendation will be to visit your doctor’s office as soon as possible.
If I think that I need emergency-room care, am I required to call Teleconsulta?
No. Teleconsulta is a health advice service, and its objective is to help the plan member make decisions regarding his/her health. We offer guidance to plan member as to the most appropriate level of care that they need to seek, in accordance with the symptoms presented at the time of the call, and the plan member always has the freedom to seek professional service when he/she deems it appropriate. No plan member will be deprived of medical care. The plan member is always free to use emergency service when he/she considers it appropriate. Calling Teleconsulta is a voluntary action on the part of the plan member. TRIPLE-S Salud does not intend to make it a requirement to call Teleconsulta before using the emergency room.
What types of call does Teleconsulta handle?
The types of call received at Teleconsulta vary; you can call when:
- You feel unwell or are in pain and don’t know what to do.
- You have questions about medications.
- You want to learn more about a condition such as asthma, diabetes, hypertension, etc.
- You have doubts about a procedure or routine exam.
- Your children are sick.
- You don’t know if you should go to an emergency room (ER).
In addition, Teleconsulta represents a valuable resource for parents, offering them help in managing the symptoms of common childhood conditions. Our nursing professionals provide health guidance and advice regarding everyday situations. In many cases, parents have been spared from spending long hours in an ER waiting room in the middle of the night.
Do I have to pay for the call to Teleconsulta?
NO. The call is toll free for the plan member through a 1-800 number printed on the back of the plan member’s ID card. The call can be made from anywhere in Puerto Rico and the United States.
What resources does TRIPLE-S Salud have to be able to offer the TELECONSULTA service?
Triple-S Salud has forged a strategic alliance with Axis Point Health, the leading company in this type of service, which serves more than 25 million people in the United States. We have been serving uninterruptedly for 10 years, helping and guiding our plan members in those situations when they need it the most. We are accredited by URAC and NCQA, which are two prestigious accreditation agencies dedicated to certifying quality in the processes of health call centers.
RIGHTS AND RESPONSIBILITIES OF THE MEMBERS OF TRIPLE-S SALUD ABOUT TELECONSULTA SERVICE
The line of Teleconsulta service is voluntary and confidential to help you get answers to your questions about health care. This is a list of your rights and responsibilities about Teleconsulta Service.
- You have the right to receive information about Teleconsulta Service, if you have questions; call 787-774-6060 Customer Service of Triple-S Salud.
- You have the right to decide whether or not use Teleconsulta Service.
- You have the right to call Teleconsulta for information that will help you make decisions about health care; however, decisions about your health care should be taken with your doctor.
- You have the right to expect a free of charge call and a confidential service.
- You have the right to be treated with respect by people who provide Teleconsulta Service.
- You have the right to make known your concerns or complaints about Teleconsulta Service. If you have any complaint, call 787-774-6060 Customer Service of Triple-S Salud.
- You have the right to receive health care information in a way that is easy to understand.
- You have the right to know if the Teleconsulta Service will no longer be covered under your health plan.
- You have the right to ask questions if you do not understand what they say.
- You have the responsibility to provide accurate and complete information about diseases, medicines and other health issues in the past or present.
- You have the responsibility to ask questions if there is something you do not understand or if you need more information.