Your provider must offer you an appointment within the time frames listed below.
Sometimes waiting longer for care is not a problem. Your provider may give you a longer wait time if it would not be harmful to your health.
It must be noted in your record that a longer wait time will not be harmful to your health.
| APPOINTMENT TYPE | ABLE TO GET AN APPOINTMENT WITHIN |
|---|---|
| Urgent care appointments that do not require pre-approval (prior authorization) | 48 hours |
| Urgent care appointments that do require pre-approval (prior authorization) | 96 hours |
| Non-urgent (routine) primary care appointments | 10 business days |
| Non-urgent (routine) specialist care appointments | 15 business days |
| Non-urgent (routine) mental health provider (non-doctor) care appointments | 10 business days |
| Non-urgent (routine) appointments for ancillary (supporting) services for the diagnosis or treatment of injury, illness, or other health condition | 15 business days |
| Telephone wait times during normal business hours | 10 minutes |
| OTHER WAIT TIME STANDARDS | ABLE TO GET CONNECTED WITHIN |
|---|---|
| Member Services telephone wait times during normal business hours | 10 minutes |
| Telephone wait times for Nurse Advice Line | 30 minutes (connected to nurse) |