Contra Costa | Health Sense | Summer 2024

Visit us at 3 member news Your right to timely care and services NON-URGENT CARE APPOINTMENTS WAIT TIME LIMIT Primary care provider 10 business days Specialist 15 business days Mental health with a non-doctor (first visit)—this includes therapists, substance use counselors and qualified autism service providers 10 business days Follow-up mental health 10 business days from prior visit Ancillary care (includes lab work, diagnostic tests like a mammogram or MRI, and physical therapy) 15 business days First prenatal visit 14 days Exceptions ●Sometimes you need a visit sooner than the law requires. In this case, your doctor can ask for a sooner appointment. ● Sometimes waiting longer for care is not a problem. If so, your provider must note in your record that a longer wait time will not harm your health. Telephone wait times ●You can call 24 hours a day, 7 days a week, to talk to a qualified health professional. They can help you decide if your health problem is urgent. If they need to call you back, they must call you within 30 minutes. ●If you call Contra Costa Health Plan’s (CCHP) Member Services phone number, someone should answer the phone within 10 minutes during normal business hours. In-office wait times ●You should be taken to an exam room within 45 minutes of your scheduled visit. We can help. If you have a problem getting timely access to care, call CCHP Member Services at 877-661-6230. All health plan members have the right to timely appointments. The purpose of California’s timely access law is to make sure you get the care you need. URGENT CARE APPOINTMENTS WAIT TIME LIMIT Prior authorization or approval not required 48 hours Prior authorization or approval required by health plan 96 hours