Care that already knows the protocol.

An answering service takes a message. The person on the phone is not a clinician, cannot assess a symptom, and cannot make a care decision, so every call that matters gets forwarded to whoever is on call, at whatever hour it comes in.

Nurse triage puts a licensed registered nurse on the first call. The nurse assesses the caller against physician-authored protocols, makes a disposition, documents the encounter, and escalates to your on-call clinician only when the protocol calls for it. The clinical difference is the disposition; the operational difference is how many times your staff gets woken up.

Most agencies underestimate it, because the cost is spread across line items that never get added up: on-call differentials and stipends, overtime when a night call runs long, the next-day productivity lost by a nurse who was up at 3 a.m., and the recruiting cost of replacing clinicians who leave over call burden.

The avoided-cost side is easier to size. The Peterson-KFF Health System Tracker puts the average emergency department visit at roughly $2,453, of which about $1,134 is the evaluation-and-management portion. A single avoided, genuinely unnecessary ED visit covers a meaningful share of a month of coverage.

Yes, and most independent practices never bill it. Chronic Care Management pays roughly $66 for the first twenty tracked minutes in a calendar month. Advanced Primary Care Management pays a flat monthly amount by patient complexity, about $16, $54, or $117, with no time threshold at all.

The obstacle is never the software. It is that twenty minutes per patient per month, at 200 enrolled patients, is roughly 67 hours of licensed clinical time nobody on your staff has spare. That is the part we supply.

You bill, always. TULQ never submits a claim to Medicare and is not a billing company; we invoice your practice a flat fee. Care management runs under general supervision, so you direct the care without needing to be present while we work, and you review and sign the care plan.

Our nurses introduce themselves as your care team, because under these programs that is exactly what they are. No vendor branding, no separate number, no offshore handoff.

For established patients, yes. The annual wellness visit is largely history and structured questioning rather than examination, and audio-only delivery is permitted under the telehealth flexibilities that the Consolidated Appropriations Act of 2026 extended through 31 December 2027. New patients generally still need to be seen in person.

That is what lets a nurse complete the visit without occupying one of your examination rooms, which is the real reason the visit never gets scheduled.

Yes. CMS launched Advanced Primary Care Management (APCM) on January 1, 2025 under the CY2025 Physician Fee Schedule, with three codes stratified by patient complexity: G0556, G0557, and G0558. FQHCs, RHCs, and critical access hospitals billing through an outpatient primary-care billing practitioner can all participate.

APCM includes an expectation of 24/7 access to care and continuity with the care team. A nurse triage line is one way a health center satisfies that access element without putting its own clinicians on overnight call. Rates are set annually; check the current fee schedule and your MAC's guidance before you build a financial model on them.

U.S. state-licensed registered nurses, working Schmitt-Thompson telephone triage protocols, the physician-authored standard used across the telephone triage industry. Our clinical practice is aligned with the American Academy of Ambulatory Care Nursing's scope and standards for professional telehealth nursing.

Every encounter is documented and returned to you for your clinical and compliance record.

Your practice is, and we will not blur this. Medicare covers the annual wellness visit when it is furnished by a physician, a qualified non-physician practitioner, or by a medical professional or team working under the direct supervision of a physician, meaning the physician is in the office suite and immediately available.

TULQ's nurses perform the visit and produce the documentation. The supervision obligation and the claim stay with you. Note that care management is different: it runs under general supervision. Any vendor implying an outsourced nurse can simply bill a Medicare wellness visit for you is describing something other than the benefit.