Provider Appointment Availability Survey is Here -UPDATED
| Date: | October 05, 2023 |
| To: | Health Plan of San Joaquin (HPSJ) Primary Care Providers, Specialists, Behavioral Health Providers, Hospitals and Ancillary Providers |
| Type: | Regulatory |
| Subject: | Provider Appointment Availability Survey is Here |
| Business: | Medi-Cal Managed Care |
Health Plan of San Joaquin (HPSJ) is required by the California Department of Health Care Services (DHCS) to monitor providers for appointment wait times. In addition, the California Department of Managed Health Care (DMHC) requires HPSJ to perform an annual Provider Appointment Availability Survey (PAAS) annually.
The PAAS survey will begin on October 9, 2023 and will conclude in November 2023. The survey will be conducted through email and phone calls and will be completed in one wave.
The success of the survey depends on your responses. 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.
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 Service
| 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 | Within 10 business days of request | |
| Follow-up non-urgent appointments with a non-physician mental health care provider |
Within 10 business days of request | |
| 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 of San Joaquin and our services is always available on our website https://www.hpsj.com/.