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Each year we survey network providers to assess how long members have to wait for an appointment. The great news – you’re doing a fantastic job! Most providers are well ahead of the contractually mandated timeframes for urgent, non-urgent and follow-up care appointments as well as timely telephone guidance. Thanks for all you do to ensure our members get the care they need, when they need it.
Access to urgent appointments with psychiatrists continue to lag a bit behind. That’s likely due to the continued high demand for medication management and specialty care for severe mental illness. We encourage our network psychiatrists to continue to find ways to see members quickly in urgent situations.
Here’s a snapshot of the results:
The MY2024 Provider Appointment Availability Survey was sent to more than 32,000 OptumHealth Behavioral Solutions of California Commercial (non-physician mental health providers and psychiatrists) network providers. Of those surveyed, 52% of psychiatrists and 66% of non-physician mental health providers responded. The survey was conducted on a county level. All providers were surveyed within the majority of counties while a random sampling was conducted for providers in the remaining counties.
Appointment Availability Standards
Urgent Care* | |
---|---|
Prior authorization of service(s) not required by the health plan | 2 days (48 hours) |
Prior authorization of services(s) required by the health plan | 4 days (96 hours) |
Non-Urgent Care* | |
Specialty Care Appointment (Psychiatrist) | 15 business days |
Mental Health Appointment (non-physician) | 10 business days |
Follow-up Care | |
Mental Health/Substance Use Disorder Follow-Up Appointment (non-physician) | 10 business days from prior appointment |
*The survey asks for the next available urgent and non-urgent appointment date and time, which can be a telehealth appointment (phone or video). If same day appointments or walk‐ins are available, that should be indicated in the survey.
What’s ahead
Provider surveys for 2025 will begin in August by QMetrics, our third-party survey vendor. Remember, if you’re contacted, you must complete the survey as required by California Department of Managed Health Care regulations and your participation agreement with Optum. Providers cannot opt out of the survey.
California Department of Managed Health Care law requires health plans to provide timely access to care. As an OptumHealth Behavioral Solutions of California network provider, you are required to adhere to contractual standards on how long members have to wait to get urgent, non-urgent and follow-up care appointments as well as timely telephone guidance.
Need more information?
Visit the California Department of Managed Health Care website for additional details on timely appointment regulatory requirements.
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