2025 Provider Appointment Availability Survey (PAAS)


Date: September 19, 2025
From: Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”)
To: Health Plan Primary Care Providers, Specialists, Behavioral Health
Type: Regulatory
Subject: 2025 Provider Appointment Availability Survey (PAAS)
Business: Medi-Cal Managed Care

The Provider Appointment Availability Survey (PAAS) has begun.

Health Plan is required by the Department of Health Care Services (DHCS) to monitor providers for appointment wait times and an annual PAAS is performed as required by the Department of Managed Health Care (DMHC).

The survey will be conducted by our survey vendor, Forvis Mazars via email and phone calls with a tight turnaround time and the survey will conclude in November 2025. In accordance with your contract agreement, you are required to complete the survey. Please make every effort to respond.

This short survey will collect wait times for urgent and non-urgent appointments. If your clinic offers telehealth appointments, you may include telehealth timeslots when answering the survey questions.

As a reminder, the table below demonstrates the Appointment Access Standards that providers must adhere to in order to be compliant with the regulatory requirements.

Appointment Access Standards for Medical Services
Non-urgent appointments for primary care Within 10 business days of request
Non-urgent appointments with a non-physician mental health care provider Within 10 business days of request
Follow-up non-urgent appointments with a non-physician mental health care provider Within 10 business days of the prior appointment
Urgent care appointments for services that do not require prior authorization (most primary care) Wait time not to exceed 48 hours of request

 

 

 

Urgent care appointments for services that require prior authorization (most specialty services) Wait time not to exceed 96 hours of request
Non-urgent appointments with specialist physicians Within 15 business days of request
Non-urgent appointments for ancillary services for the diagnosis or treatment of injury, illness, or other health condition Within 15 business days of request

Providers with non-compliant results of the survey will be notified by Health Plan with a request for remediation or a corrective action.

Please use the following link to access the DMHC “Know Your Health Care Rights Timely Access to Care” and post accordingly: https://www.dmhc.ca.gov/Portals/0/Docs/DO/TAC_accessible.pdf


If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org

Virtual Look and Learn

Posted on September 19th, 2025

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