TIMELY ACCESS TO CARE
Health plans in California shall provide care and services to patients seeking treatment in a timely manner appropriate for the nature of the patient’s condition and consistent with good professional practice.
These services may include, but are not limited to:
- Initial examinations and non-urgent visits shall be available within thirty (30) days.
- Urgent vision care appointments shall be available within seven (7) days. Urgent vision care appointments are limited to replacement of broken or lost eyewear, which are only covered if the eyewear benefit has not been used in the current benefit period.
- When it is necessary for a participating provider or patient to reschedule an appointment, the appointment shall be promptly rescheduled in a manner that is appropriate for the patient’s vision care needs and ensures continuity of care.
- The panel of participating providers includes offices with bilingual doctors and staff, as indicated on the website and directory. A patient’s need for interpreter services shall be coordinated when scheduling the appointment with the participating provider’s office.
- During normal business hours, the waiting time for a patient to speak by telephone with a Customer Service Representative shall not exceed ten (10) minutes.