Nurse Advice Line
When illnesses or injuries occur after hours or when the physician’s office is closed, Optima Health plan members have the After Hours Nurse Advice Line.
Calling the Nurse Advice Line puts you in contact with a professional nurse who can assess your medical situation, advise you as to where to seek care, and if possible, suggest self–care options until you can see your physician. In any life–threatening emergency situation, always go to the closest emergency room or call 911.
Steps to Care
Here are steps you can follow to help ensure your care is covered at the highest benefit level when you are faced with an illness or injury after hours:
- Call your physician.
- If your physician is unavailable, call the Nurse Advice Line — 757–552–7250 or 1–800–394–2237.
When you call, you will be connected with a nurse trained in emergency, acute, OB/GYN, and pediatric care. Please note: the After Hours nurse will not have access to your medical records, cannot diagnose medical conditions, order lab work, write prescriptions, order home health services, or initiate hospital admissions.
- You will be asked to provide the following information. Please be sure to have the following information readily available:
- The Member ID number of the person who is ill or has been injured. This number is on the front of the Member ID card.
- Detailed information regarding the illness or injury.
- Any other relevant medical information about the patient, such as other medical conditions or prescriptions. Keep in mind that After Hours nurses do not have access to medical records or other pertinent health information and are relying on you to provide them with relevant information.
- The After Hours nurse will advise you regarding whether to proceed to the nearest emergency room or urgent care center. The After Hours nurse may suggest appropriate home treatments. You may be advised to see your physician on the next business day. If a visit to the emergency room is authorized by the After Hours nurse, the visit will automatically be covered following your Plan guidelines without retrospective review.
- Your primary care physician (PCP) will receive a follow–up report about your call so your medical records can be kept up–to–date.
* This program may not be available to certain self–funded groups who are located outside of Hampton Roads. If you have the After Hours Nurse Advice Line, the phone number will appear on the back of your Member ID card. Members who are unsure if they have the After Hours Nurse Advice Line program should contact their benefits administrator or call Member Services at the number on their ID card.