Timely access to care
Blue Shield of California wants to make sure you receive timely access to medical care and services. These guidelines can help you understand what to expect when you schedule medical appointments or use other health care services. If you need help making an appointment, please call us at the customer service number on the back of your Blue Shield of California member ID card.
|Urgent Care||Access to Care|
|For services that don’t need prior approval||Within 48 hours|
|For services that do need prior approval||Within 96 hours|
|Non-urgent Care||Access to Care|
|Primary care appointment||Within 10 business days|
|Specialist appointment||Within 15 business days|
|Preventive care appointment||Within 30 business days|
|Appointment for other services to diagnose or treat a health condition||Within 15 business days|
|Behavioral Health||Access to Care|
|Emergency care||Call 911|
|Non-life-threatening emergency||Within 6 hours|
|Urgent care||Within 48 hours|
|Routine office visit for non-urgent appointment with a psychiatrist||Within 15 business days|
|Non-urgent appointment with a non-physician mental health care provider||Within 10 business days|
|Follow-up routine care appointment with prescriber||Within 15 business days|
|Follow-up routine care appointment with non-prescriber||Within 10 business days|
|Telephone Inquiries||Access to Service|
|Access to a health professional for telephone screenings||24 hours/day, 7 days/week|
PCP: Family Medicine (General Practice & Family Practice), Internal Medicine, and Pediatrics for non-Medicare
One PCP of each primary type within 15 miles or 30 minutes (or an approved/pending Alternate Access Standard) from each member’s residence or workplace in the approved service area as appropriate by age.
OB/GYN: One OB/GYN within 30 miles of each member.
Time standards for appointments:
The time standards for appointments may be extended when the referring, treating, or health professional providing triage services determines that a longer wait time will not have a detrimental effect on the health of the patient.
For availability of interpreter services at the time of your appointment, consult the provider directories available at blueshieldca.com or call the customer service number on the back of your Blue Shield of California member ID card.
BSC - Y0118_22_224A_C 05252022
CMC - H0148_22_029_C_060622
Medi-Cal - Medi_22_71_LS_060622
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