After Hours Survey is Here
| Date: | November 6, 2023 |
| To: | Health Plan of San Joaquin (HPSJ) Primary Care Providers (PCP)s and Behavioral Health Providers |
| Type: | Regulatory |
| Subject: | After Hours Survey is Here |
| Business: | Medi-Cal Managed Care |
HPSJ monitors after-hours access for our members on an ongoing basis, as required by the Department of Health Care Services (DHCS) and the Department of Managed Health Care (DMHC). A key goal for HPSJ is to ensure that our members have instructions on how to obtain care after-hours.
To monitor providers for compliance with after-hours emergency instructions and access to providers for HPSJ members, HPSJ has contracted a vendor to conduct an After-Hours Survey. The telephonic survey will begin in the next week and will conclude by the end of December 2023.
In order to ensure that providers are compliant with the required access standards, all four requirements listed below should be met. Please review your after-hours messaging, and if applicable, make necessary updates to ensure it meets the requirements.
| After-Hours Access Survey Requirements |
|---|
| 1. Is the practitioner’s recorded message or live attendant available 24-hours, 7 days a week? |
| 2. Are emergency instructions to call 911 or go to the nearest emergency room provided on a recorded message or live person? |
| 3. Is there an on-call provider available for urgent care by transferring the call or providing information on how to reach an on-call provider to triage or screen by phone? |
| 4. If the member is required to leave a message, does the recorded message or live attendant state the return call would be within 30 minutes? Note: Return call to triage or screen by phone should be within 30 minutes. |
We thank you for ensuring that HPSJ members have access to after-hours care. If you have any questions, you may request to speak to a Provider Services Representative.
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 of San Joaquin and our services is always available on our website https://www.hpsj.com/