Common use of Timely Access to Care Clause in Contracts

Timely Access to Care. Participating Providers agree to provide timely access to care. This means that when you call for an appointment, you will see your provider within a reasonable timeframe. Blue Shield’s access standards are listed below. Services that do not require prior authorization Within 48 hours Services that do require prior authorization Within 96 hours Primary Care Physician office visit Within 10 business days Specialist office visit Within 15 business days Mental or substance use disorder health provider (who is not a Physician) office visit Within 10 business days When your appointment will occur Follow-up appointments with a mental or substance use disorder health provider (who is not a Physician) Within 10 business days of the prior appointment for those undergoing a course of treatment for an ongoing mental health or substance use disorder condition Other services to diagnose or treat a health condition Within 15 business days Access to a health care professional for phone triage or screening services by calling Shield Concierge 24 hours a day, seven days a week Call Shield Concierge if you need help finding a Participating Provider or if a Participating Provider is not available. Please see the If you cannot find a Participating Provider section for more information. Contact Shield Concierge to schedule interpreter services for your appointment. For more information about interpreter services, see the Language access services notice.

Appears in 1 contract

Sources: Group Health Service Contract

Timely Access to Care. Participating Providers agree to provide timely access to care. This means that when you call for an appointment, you will see your provider within a reasonable timeframe. Blue Shield’s access standards are listed below. Services that do not require prior authorization Within 48 hours Services that do require prior authorization Within 96 hours Primary Care Physician office visit Within 10 business days Specialist office visit Within 15 business days Mental or substance use disorder health provider (who is not a Physician) office visit Within 10 business days When your appointment will occur Follow-up appointments with a mental or substance use disorder health provider (who is not a Physician) Within 10 business days of the prior appointment for those undergoing a course of treatment for an ongoing mental health or substance use disorder condition Other services to diagnose or treat a health condition Within 15 business days Access to a health care professional for phone triage or screening services by calling Shield Concierge Customer Service 24 hours a day, seven days a week Call Shield Concierge Customer Service if you need help finding a Participating Provider or if a Participating Provider is not available. Please see the If you cannot find a Participating Provider section for more information. Contact Shield Concierge Customer Service to schedule interpreter services for your appointment. For more information about interpreter services, see the Language access services notice.

Appears in 1 contract

Sources: Group Health Service Contract

Timely Access to Care. Participating Providers agree to provide timely access to care. This means that when you call for an appointment, you will see your provider within a reasonable timeframe. Blue Shield’s access standards are listed below. Services that do not require prior authorization Within 48 hours Services that do require prior authorization Within 96 hours Primary Care Physician office visit Within 10 business days Specialist office visit Within 15 business days Mental or substance use disorder health provider (who is not a Physician) office visit Within 10 business days When your appointment will occur Follow-up appointments with a mental or substance use disorder health provider (who is not a Physician) Within 10 business days of the prior appointment for those undergoing a course of treatment for an ongoing mental health or substance use disorder condition Other services to diagnose or treat a health condition Within 15 business days Access to a health care professional for phone triage or screening services by calling Shield Concierge Customer Service 24 hours a day, seven days a week Call Shield Concierge Customer Service if you need help finding a Participating Provider or if a Participating Provider is not available. Please see the If you cannot find a Participating Provider section for more information. Contact Shield Concierge Customer Service to schedule interpreter services for your appointment. For more information about interpreter services, see the Language access services notice.

Appears in 1 contract

Sources: Group Health Service Contract