HRSA Requirements – FQHC Nurse Advice Line

By March 18th, 2020No Comments

Meeting Health Resources and Services Administration (HRSA) Requirements

Meaningful Use and Healthcare Reform prompted by the Affordable Care Act (ACA) has placed increased demands on Federally Qualified Health Centers (FQHCs). ACA legislation has consequently bolstered the necessary requirements for these organizations to receive federal funding. FQHCs are organizations that receive grant funding under Section 330 of the Public Health Service Act. A FQHC qualifies for enhanced reimbursement from Medicare and Medicaid. At present, FQHCs must meet all 19 qualifications in order to receive such a designation.

In this article, we will examine the applicability of utilizing a nurse advice line service as it pertains to a critical requirement standard for FQHCs.

Fonemed is an industry leading telehealth solutions provider that has developed partnerships with numerous FQHCs to assist their organizations’ in fulfilling the HRSA requirements for FQHCs. Now that we have presented some brief background information, let’s get into some specifics about how Nurse Advice Lines (NAL) and their supporting technologies squarely meet the existing needs of FQHC providers.

HSRA Health Center Program Requirement 5:”After-Hours Coverage”

The HRSA mandates that Federally Qualified Health Centers (FQHCs) are required, as a condition of their federal grants, to provide professional coverage for their patients enabling them access to medical advice and guidance during the hours in which the FQHC is closed. Furthermore, FQHCs which received Patient Centered Medical Home (PCMH) recognition are required to provide timely medical advice by telephone. Specific arrangements for after-hours coverage (such as in a rural area) may vary by community. However, all health centers must have some type of clear arrangement(s) for after-hours coverage.

The most direct way in which Fonemed can assist in meeting the “after-hours coverage” requirement is through our nurse advice line service offering. Our nurse advice line telehealth service is distinctly qualified to meet this requirement as it provides an appropriate clinician that can exercise independent professional judgment in assessing a health center patient’s need for emergency medical care. Additionally, these nurses, whom are licensed for the state in which they deliver care, are capable of referring patients to the appropriate locations for such care, including emergency rooms, when warranted.

Applicable Legal Statute: (Section 330(k)(3)(A) of the PHS Act and 42 CFR 51c.102(h)(4))

Nurse Advice Line Services for FQHCs

At Fonemed, we offer nurse advice lines and “after-hours” call capabilities for FQHCs to help them better serve their client populations and meet the mandates established by the HRSA. All of our licensed RNs are URAC accredited and experienced in evaluating patient symptoms and offering professional medical advice based on the gold-standard Schmitt/Thompson protocols.

Inbound calls are directed through our telephony system to the appropriate nurses and they begin to document the encounter using our proprietary Population Health Management software, a secure system designed to manage and protect personal health information. It is important to note, that our registered nurses utilize the computerized triage protocols to guide their decision making versus making referral decisions for them. Fonemed’s policies and performance standards clearly govern the provision of telephone advice and the scope of advice under which guidance is provided. All calls are recorded, allowing for subsequent monitoring by our Quality Management Team.

A detailed encounter report is generated following each triage call. Reports are then forwarded to the primary care physician or HIPAA authorized entities via secure fax or a secure FTP site in XML, text or PDF formats. Such reports are reviewable by staff member as part of permanent contact history and are available for reference by caregivers in the event of future encounters with the caller.

Our services are designed to be scalable, flexible and adapt to the unique requirements of each of our clients. As a result, Fonemed’s telehealth capabilities are expansive and can also include Remote Patient Monitoring, providing patient instructions for contacting the FQHC, community referrals, emergency room referrals, or providing 911 contact information when required.

Our clients’ have come to expect excellence in our programs, therefore we offer additional services that compliment our FQHC nurse advice line service. For example, FQHC’s interested in reducing hospital readmissions may want to consider the patient outreach options for post-hospital discharge in our Care Transitions program.


  • Fonemed can help to ensure continuity of care for patients in your community through a proven telehealth service that is available 24 x 7, 365 days per year (this helps ensure the HRSA’s program requirement number 6: “Hospital Admitting Privileges and Continuum of Care”).
  • Each client is assigned a unique, toll-free number (with a customizable greeting) to access our team of nurses.
  • We provide our FQHC Nurse Advice Line partners detailed call demographics on a monthly basis.
  • Fonemed offers service in English and Spanish as part of our standard program with no additional fees
  • Encounter documentation for inclusion in Electronic Medical Records (EMRs)
  • Fonemed’s URAC-reviewed and accredited operating systems, management structure, personnel, recruitment and training programs, quality assurance procedures and R&D capabilities ensure the best telephone triage experience possible.
  • Gain peace of mind knowing that, for nearly two decades in business, Fonemed has never had a claim on its insurance or any threat of litigation.


As an industry leader, we naturally excel in nurse advice, managing health information and providing telehealth solutions. The primary goal of Fonemed’s Nurse Advice Line for FQHC’s service is to provide safe, high quality care by placing the patient in the most appropriate level of care at the right time. Accomplishing this goal could not be done without the dedication and commitment of our talented team of professionals that support our clients and their patients.

Fonemed employs a team of experienced Registered Nurses (our nurses have, on average, 10 years of clinical experience) and Health Care Specialists that currently serve over 10 million individuals throughout the United States. Each of our Registered Nurses are licensed in the state in which they provide telephone triage and nurse advice line services and are often located in the client communities they serve. Fonemed nurses that serve our FQHC client’s have a varied background in community and acute care settings. Our registered nurses are trusted by organizations just like yours to provide the appropriate care instructions to FQHC patients in a culturally competent, linguistically appropriate manner.


Fonemed has been accredited by URAC for Health Call Center Services since 2000. This accreditation assures that quality assurance, HIPAA compliance, credentialing and licensure, medically-safe clinical guidelines, response times and performance records all meet URAC’s rigid, widely recognized industry standards. Our organization’s URAC accreditation applies to all offices and operations including the evaluation of clinical and non-clinical staff to ensure proper credentialing, orientation, training, monitoring and supervision. We’re proud to announce that we routinely complete each URAC audit successfully.


With nearly two decades of experience in implementing FQHC Nurse Advice Lines, we have the process down to a science. Fonemed utilizes a team of professionals comprised of roles such as clinical supervisors, business development specialists, and operations personnel to ensure a seamless transition for your FQHC to implement and deploy new services.

Your account will benefit from the participation of dedicated, proactive project managers that will actively engage in its supervision, as well as address any concerns you may have along the way. We understand that each FQHC Nurse Advice Line has its own unique needs and we take pride in not only meeting our client’s requirements, but in building lasting relationships that better enable us to maintain and support our partners.


We think experience matters, and when matters of patient health and safety are involved, we’re sure you would agree. Fonemed has a 19-year track record of successfully providing nurse triage, remote patient monitoring, occupational exposure hotline and other clinical services via telehealth. In this time, Fonemed has taken over 2 million nurse advice calls with no adverse outcomes or litigation.

Our proven track record includes serving a diverse client base by providing nurse advice line services to physician practices, hospitals, community care centers, benefit providers, employer groups, government agencies, universities, insurance plans, and more.

Every day, we meet the unique needs of hundreds of clients, thousands of client groups, and provide health service coverage to over 10 million individuals. Our focus on quality of care and patient satisfaction has offered our organization the opportunity to connect with tens of thousands of patients each month, and helped us become a recognized world leader in providing telephone nurse advice services. Our telehealth services saved our clients’ over $30 million last year, and we achieved a client and patient satisfaction rating over 95%.

Do you represent an FQHC that is seeking an “after-hours” nurse advice line or another telehealth solution? We would love to hear from you, contact us today.