2024 Provider Appointment Availability Survey (PAAS)
| Date: | September 27, 2024 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) |
| To: | Health Plan Primary Care Providers, Specialists, Behavioral Health Providers, and Ancillary Providers |
| Type: | Regulatory |
| Subject: | 2024 Provider Appointment Availability Survey (PAAS) |
| Business: | Medi-Cal Managed Care |
Health Plan is required by the Department of Health Care Services (DHCS) to monitor providers for appointment wait times. In addition, the Department of Managed Health Care (DMHC) requires Health Plan to perform an annual Provider Appointment Availability Survey (PAAS).
The PAAS survey will begin in October and conclude in December 2024. The survey will be conducted by our survey vendor, Forvis Mazars via email and phone calls with a tight turnaround time.
Providers are contractually obligated 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.
Non-compliant results of the survey will be provided to the respective providers with a remediation request or a corrective action.
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 |
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
