Timely Access Standards for Appointments
We work with our providers to make sure our members get timely, appropriate care for health needs.
Receive Timely Care
Sutter Health Plan and our participating provider groups follow these timely appointment access standards.
| Access Type | Standard |
|---|---|
| Access to nonurgent appointments with a primary care physician (PCP) for regular and routine primary care services | Appointment is offered within 10 business days of the request |
| Access to urgent care services with a PCP that do not require prior authorization (includes appointments with a physician, nurse practitioner or physician's assistant in office) | Appointment is offered within 48 hours of the request |
| Access to after-hours care with a PCP | Ability for members to contact an on-call physician after-hours; return call within 30 minutes for urgent issues |
| PCP provides appropriate after-hours emergency instructions | |
| Access to non-urgent care appointments with a specialist, including a specialist for mental health and substance use disorder services | Appointment is offered within 15 business days from the time of the request |
| Access to urgent care services that require prior authorization from a specialist or other provider | Appointment is offered within 96 hours from the time of the request |
| Access to nonurgent appointments with a mental health or substance use disorder provider who isn’t a physician | Appointment is offered within 10 business days from the time of the request |
| Access to nonurgent follow-up appointments with a mental health or substance use disorder provider who isn’t a physician | Appointment is offered within 10 business days from the prior appointment |
| Nonurgent appointments for ancillary services used to diagnose or treat injuries, illnesses or other health conditions | Appointment is offered within 15 business days from the time of the request |