Access to Care - Appointment Wait Times
Date: 06/06/22
Heritage Health (Medicaid)
In-network providers will be available during reasonable hours. Services will be available to meet your medical needs. You should be given an appointment within these times:
| TYPE OF APPOINTMENT | SCHEDULING TIME FRAME |
|---|---|
Routine, non-urgent or preventive care | Within 4 weeks |
Routine, non-urgent behavioral health care | Within 14 days |
Non-urgent sick care (including walk in patients) | Within 72 hours. Sooner if the illness gets worse and becomes urgent or an emergency |
Urgent Care (including walk in patients) | Same day |
Urgent behavioral health care | Within 48 hours |
Emergency visits | Immediately |
Initial prenatal visits for newly enrolled pregnant women in their first trimester | Within 14 days of the postmark date on the member’s welcome packet material |
Initial prenatal visits for newly enrolled pregnant women in the second trimester | Within 7 days of the postmark date on the member’s welcome packet material |
Initial prenatal visits for newly enrolled pregnant women in the third trimester | Within 3 days of the postmark date on the member’s welcome packet material |
High risk pregnancies | Within 3 days of identification of high risk, or immediately in an emergency |
Members who become pregnant | Within 30 days |
Specialty Care Providers (Specialists) | Within 30 days of referral or sooner if needed |
ER follow-up visits | Follow discharge instructions |
In-office waiting time for scheduled appointments | Wait should not be longer than 45 minutes. If a provider is delayed, you should be told. If the wait is more than 90 minutes, you should be offered a new appointment. |
Family planning services | Within seven days |