Central California Alliance for Health | Living Healthy | March 2016

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Think of your Primary Care Provider
(PCP) as your gateway to the world of
health care.
He or she will be your first stop
when you’re sick and when you need
advice about staying well.
PCPs can be general practice or
family practice doctors, pediatricians,
or internists. You can also choose a
clinic or medical group to be your
PCP. Among other things, your PCP
will:
■ ■ Guide all of your health care
■ ■ Treat a wide range of health issues
■ ■ Help prevent health problems
■ ■ Refer you to other doctors as
needed
Over time, your PCP will get to
know your health history and help
you make good choices so you can
stay well.
Picking your doctor, group or
clinic. You can find a PCP by looking
in your Provider Directory in the PCP
section. Or, for the most up-to-date
information, go to our website,
.
1. Click on the Members page.
2. Then click on the “Choose or
Change Doctors” link to the left.
3. Click “Primary Care Provider
section of the Online Directory”
under “How Do I Pick a PCP?”
4. Pick your health plan (Medi-Cal,
IHSS, Healthy Kids or Medi-Cal
Access Program) from the Health
Plan drop-down box.
5. Pick “Primary Care Physician
(PCP)” from the provider category
drop-down box.
6. Make sure you look for a PCP who
is taking new patients. To find a PCP
who is taking new patients, check the
“Accepting new patients” box.
primary care providers
What is a PCP?
7. Then pick your county.
8. Then call Member Services to let
us know who you want.
If you were an established patient
of a PCP in our network before
becoming an Alliance member and
want to see if you can pick that doctor
as your Alliance PCP, call Member
Services. We will have to get approval
from the provider. Established means
that you were seeing that doctor on a
regular basis within the last year.
GETTING AN APPOINTMENT
How long should you
have to wait?
We know it is important for you to
get care when you need it. But it
is not always possible for a doctor
to see you right away. You may
have to wait longer for some types
of appointments than others. For
example, you should be able to get
an urgent care (care when you are
sick) appointment sooner than an
appointment for a regular checkup.
We work with the doctors and
clinics in our network to make sure
you can get care when you need it.
We have always done this because we
know it is important.
Health plans in California have to
meet certain standards for access
to care. The regulations to put this
law into place are called the Timely
Access to Nonemergency Health
Care Services standards. There are
different standards for different types
of appointments.
In the chart above are the
standards for different types of
appointments. The waiting times
for an appointment may be longer
if the provider feels that it will not
harm your health if you have a
longer wait.
If you feel you are not getting
care when you need it, call Member
Services at 1-800-700-3874.
Type of care you need Time to get an appointment
Urgent care Within 48 hours of when you call
Non-urgent primary care Within 10 business days of when you call
Non-urgent specialty care Within 15 business days of when you call
Non-physician, non-urgent
mental health care Within 10 business days of when you call
Non-urgent diagnostic services Within 15 business days of when you call
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