Ensuring timely access to care is a priority of the Alliance, our providers, and the Department of Health Care Services (DHCS). Timely access standards require that members are offered access to urgent and routine appointments as follows:
| Urgent Appointments | Wait Times |
|---|---|
| For services that do not require prior authorization | 48 hours |
| For services that do require prior authorization | 96 hours |
| Non-Urgent Appointments | Wait Times |
| Primary care (including first pre-natal visit and preventive visits) | 10 business days |
| Mental health care (with a non-physician provider) | 10 business days |
| Specialist/Specialty care (including Psychiatrists) | 15 business days |
| Ancillary service for the diagnosis or treatment of injury, illness, or other health condition | 15 business days |
Beginning in 2018, DHCS engaged an external consultant to survey provider appointment times. This survey includes calling a subset of Alliance providers and verifying their status with the Alliance, recording wait time on the phone, and collecting first, second, and third next available appointment times. DHCS will conduct this survey on a quarterly basis, focusing on select provider types each quarter. The Quarter 2, 2019 survey will start on May 17, 2019 and will include a sample of the following provider types:
| Timely Access Survey Phase | Call Date Range | Provider Specialties Surveyed |
|---|---|---|
| Phase 2 | May 17, 2019 to June 28, 2019 | Endocrinologists, Gastroenterologists, Indian Health Facilities, Free Standing Birthing Centers, Certified Nurse Midwives, Licensed Midwives |
How You Can Help
In order to ensure that the Alliance and our providers are reporting accurate information to DHCS, please make sure that your staff are prepared to receive these phone calls and to answer all questions asked by the DHCS survey vendor. Accurate contact information is important, as the phone number which the Alliance has on file for your practice is what DHCS will use during survey administration. To verify your contact information, please visit the Alliance website and review your information listed in the Provider Directory. After you have completed your review, submit your information updates at
www.ccah-alliance.org/aspnetforms/ProviderDirectoryInfoForm.aspx
Thank you for your assistance and for your commitment to provide Alliance members with timely access to care. Please contact Provider Relations at (800) 700-3874, ext. 5504 with any questions.
