The EmblemHealth Access, Availability, and After-Hours Coverage Standards are monitored using random audits. We want you to pass if you are selected for one. It’s important to us that our members get the care they need in a timely manner.
One common mistake providers make is not adhering to the office waiting time standard. Members with appointments should be seen within 15 minutes, but no later than 30 minutes, of their scheduled appointment time or arrival time, whichever is later. If a delay is unavoidable, the member should be informed and offered alternatives.
Please take the time to periodically review the standards and make sure all staff who answer your phone and schedule appointments have a copy of — and are familiar with — those standards and requirements for scheduling patient appointments.
JP 67177 10/2024