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Date:	July 15, 2016
To:	Health Plan of San Joaquin (HPSJ) Providers
From:	Provider Services Department
Subject:	Access Standards for Appointments
Business:	Medi-Cal, MCAP (Medi-Cal Access Program, previously known as AIM)

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Recently, Health Plan of San Joaquin (HPSJ) sponsored a survey on the subject of timely access for appointments. Our results revealed that not all of our providers are aware of the current standards for appointment access mandated by the Department of Health Care Services (DHCS). Following are the compliance results by category.

Category	Urgent within 48 hrs.	Urgent with Prior authorization 96 rs.	Routine
PCP (Primary Care Provider)	54.6%	33%	93.9%
Specialists	36.4%	44.4%	70.5%
Behavioral Health	37.5%	25%	100%
Ancillary, MRI, Mammogram, PT	61.9%	38.1%	100%

Please review and post the table below as a reminder for your practice scheduling staff and/or include the table in your clinic workflow.

Appointment Access Standards for Medical Services
Type of Services	Standard
Access to non-urgent appointments or primary care-regular and routine care (with a PCP)	Within 10 business days of request
Access to urgent care services that do not require prior authorization	Wait time not to exceed 48 hours of request
Access to urgent care (specialist and other) services that require prior authorization	Within 96 hours of request
Access to non-urgent appointments with a specialist	Within 15 business days of request
Access to after-hours care (with a PCP)	Ability to contact on-call physician after hours within 30 minutes for urgent issues
In-office wait time for scheduled appointments (PCP and specialist)	Not to exceed 15 minutes
Access to preventive health services	Within 30 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

If you have questions, please contact our Provider Services Department at (209) 942-6340.