calendar days of first request or immediately in an emergency
Specialty Care Appointments
Routine / Preventative Appointment for Established Patients
Urgent Care
Emergent Care
Definition A problem requiring care or evaluation by a specialist but not considered urgent or emergent by the PCP Problems requiring evaluation by a specialist
Problem requiring immediate specialty physician consultation for treatment and diagnosis
Standard 95 % of appointments can be scheduled within 14 days from date of referral
95 % of appointments can be scheduled within three days based on the PCP ’ s assessment Providers will direct member to call 911 or go to the nearest emergency room . If request is received during nonbusiness hours , the provider ’ s voicemail will direct the member to call 911 or go to the nearest emergency room .
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