Appointment type You should be 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 Other wait time standards You should be 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) If you feel you are not getting care when you need it, call Member Services at 800-700-3874 (TTY: 800-735-2929 or 711). How long should you have to wait? As a member of the Alliance, it is your right to have timely access to network providers, but sometimes it is not possible for a doctor to see you right away. Some appointments might take longer to schedule than others. We work with the providers and clinics in our network to make sure you can get care when you need it. 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. The chart at right lists 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 they feel a longer wait time would not be harmful to your health, they must note it in your medical record. GETTING AN APPOINTMENT: Living Healthy 7
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