DMHC/DHCS Timely Access Standards for Wait Times, Urgent Care and After-Hours

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Date: July 13,2021
To: Health Plan of San Joaquin (HPSJ) –All Contracted and Non-Contracted Providers
From: Health Plan of San Joaquin
Subject: DMHC/DHCS Timely Access Standards for Wait Times, Urgent Care and After-Hours – In-OfficeWait Times Set/Monitored by HPSJ
Business: Medi-Cal

Health Plan of San Joaquin(HPSJ)is charged with maintaining the quality of care for our members. As such we must monitor access and availability within the network, making sure access standards are observed by contracted providers and any deficiencies are addressed. These access standards are set forth by both theDepartment of Health Care Services (DHCS) and theDepartment of ManagedHealth Care (DMHC), with the exception of in-office wait times—those in-office wait times are set by and monitored by the ManagedCarePlans (MCPs) like HPSJ.

Please review and post the table below as a reminder for your practice scheduling staff and/or include the table in your clinic workflow. Also, please take note of in-office wait times for scheduled appointments.

Appointment Access Standards for Medical Services

In these tough times during the pandemic – If providers are only able to offer limited services due to physical distancing, they always have an option to offer Telehealth services to our members.

Please contact our Customer Service Department with questions: 209.942.6320.
For more information about the access standards, please refer to our Provider Manual on
www.hpsj.com/provider-manual.

1 PerDMHC, non-physician mental health providers include counseling professionals, substance abuse professionals, and qualified autism service providers
(https://www.dmhc.ca.gov/Portals/0/Docs/DO/TAC_accessible.pdf).

Posted on July 13th, 2021

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