Mandatory Appointment Availability Standard
- After-Hours
- Routine Care
- Urgent Care
聖華金健康計劃 (HPSJ) 負責維持我們會員的護理質量。 我們必須監控網絡內的訪問和可用性,確保簽約提供商遵守訪問標準並解決任何缺陷。 這些訪問標準由衛生保健服務部 (DHCS) 和管理型衛生保健部 (DMHC) 制定,但辦公室等待時間除外——這些辦公室等待時間由 HPSJ 設置和監控.
Medi-Cal 健康計劃需要對我們簽約的提供者辦公室進行年度非工作時間訪問調查。 它旨在通過測試提供者辦公室通過應答服務或語音郵件/消息設備和軟件使用的消息內容,幫助確定我們的 Medi-Cal 成員在整個網絡中對緊急/緊急下班後護理的訪問級別。
下一個調查期定於每年 11 月。 請確保您的消息已更新以符合要求。
After- Hours Access Survey Questions | Y/N |
1) Is the practitioner’s answering system for after-hours urgent care/emergent physician coverage available 24 hours, 7 days a week? | |
2) Does the answering service or voice mail state the length of when a return call can be expected from the provider? | |
3) Are after-hours emergency instructions provided via answering machine and/ or direct communication via answering service? | |
4) Does the answering service or voice message specify a time in which the member should expect a return call? |
會員有權在以下時間範圍內安排約會:
Types 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 non-urgent appointments for mental health (non-physician) | 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 | Wait time not to exceed 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 |
Access to preventive health services within 30 business days of request | Access to preventive health services within 30 business days of request |
Non-urgent appointments for ancillary services for the diagnosis or treatment of injury | Within 15 business days of request |
In-office wait time for scheduled appointments (PCP) | Not to exceed 45 minutes |
In-office wait time for scheduled appointments (Specialists) | Not to exceed 60 minutes |
根據 DMHC,非醫師心理健康提供者包括諮詢專業人員、藥物濫用專業人員和合格的自閉症服務提供者。 通過訪問以下 URL 訪問及時訪問護理情況說明書:https://dmhc.ca.gov/Portals/0/Docs/DO/TAC_accessible.pdf
如果您有任何疑問,請聯繫我們的提供者服務部209.942.6340.
Posted on November 15th, 2021 and last modified on January 11th, 2023.
頂