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Timely access to scheduled appointments
Your health is our top priority. We're committed to offering you a timely appointment when you need care.
The following standards for appointment availability were developed by the California Department of Managed Health Care (DMHC). This information can help you know what to expect when you request an appointment.
Type of care |
Appointment offered |
|---|---|
| Urgent care appointment | Within 48 hours |
| Routine (nonurgent) primary care appointment (including adult/internal medicine, pediatrics, and family medicine) | Within 10 business days |
| Routine (nonurgent) mental health care or substance use disorder treatment with a practitioner other than a physician | Within 10 business days |
| Routine (nonurgent) follow-up mental health care or substance use disorder treatment with a practitioner other than a physician | Within 10 business days of the prior appointment |
| Routine (nonurgent) specialty care appointment with a physician | Within 15 business days |
If you prefer to wait for a later appointment that will better fit your schedule or to see the practitioner of your choice, we'll respect your preference. In some cases, your wait may be longer than the time listed if a licensed health care professional decides that a later appointment won't have a negative effect on your health.
The standards for appointment availability do not apply to preventive care services. Your practitioner may recommend a specific schedule for these types of services, depending on your needs. Preventive care services may include physical exams, vision and hearing tests, immunizations, health education, and prenatal care. The standards also do not apply to periodic follow-up care for ongoing conditions or standing referrals to specialists.
Timely access to telephone assistance
In addition, the following standards for answering telephone inquiries were developed by the DMHC. These standards require health plans to answer the following telephone inquiries within specified time frames.
- For telephone advice about whether you need to get care and where to get care, plans must answer within 30 minutes, 24 hours a day, 7 days a week.
- For customer service inquiries, plans must answer within 10 minutes during normal business hours.
Interpreter services at no cost to you
When you call or come in for an appointment or call for advice, we want to speak with you in the language you're most comfortable using. For more about our interpreter services in Northern California and Southern California, call our Member Services Contact Center:
1-800-464-4000 (toll free for English and more than 150 languages using interpreter services)
1-800-788-0616 (toll free for Spanish)
1-800-757-7585 (toll free for Chinese dialects)
711 (TTY for the deaf/hard of hearing/speech impaired)