Living Healthy 6 Timely access to care As an Alliance member, it is your right to have timely access to network providers, but sometimes a provider can’t 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 must follow rules to make sure you can get care when you need it. These rules are called the “Timely Access to NonEmergency Health Care Services” standards. This chart shows the different waiting times for different types of appointments. If the provider thinks that waiting longer will not harm your health, the wait time might be longer, and they must note it in your medical record. If you feel you are not getting care when you need it, call Member Services at 800-700-3874 (TTY: 800-735-2929; 800-855-3000 for Spanish or 711). 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) mental health provider (non-doctor) follow-up care appointments. 10 business days of last appointment 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)
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