Access to quality health care is essential to the health of a community. When experiencing a health issue, patients want to know that they can see their provider/doctor within an appropriate time frame. CDPHP has established access standards to make sure members can access the health care they need when they need it.
CDPHP appreciates your compliance with the following standards. As a reminder, the New York State Department of Health (NYS DOH) monitors all PCP and OB-GYN practices annually to ensure that availability standards are met. During past audits, NYS DOH noted that in some cases, patients were not allowed to make an appointment before producing their past medical records. To ensure your office is compliant, please grant appointments before requesting a patient’s medical records.
Don’t forget that PCP and OB-GYN offices must also provide 24-hour phone coverage for after-hours calls.
Type of Visit | Appointment Time Frame |
Urgent care | Within 24 hours |
Non-urgent “sick” visit | Within 48 hours |
Emergency care | Immediately |
Routine primary care; preventive care appointments | Within 4 weeks |
Initial prenatal visit within first trimester | Within 3 weeks |
Initial prenatal visit within second and third trimester | Within 1 week |
Initial family planning | Within 2 weeks |
Initial newborn visit | Within 2 weeks of hospital discharge |
Oncology | New patient: 7 days |
Established patient: 5 days | |
Urgent or urgent care follow-up: same or next day | |
Behavioral health – Emergent | Within 6 hours (may be referred to the ER) |
Behavioral health – Urgent appointment | Within 48 hours |
Behavioral health – Initial routine appointment | Within 10 business days |
Behavioral health – Ambulatory appointment after inpatient stay | Within 7 days of discharge |
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