Providers

Practice Standards

Access and Availability

Total Health Care is committed to ensuring our members have access to the right care at the right place and in a timely manner.  To ensure optimal health for our membership, access standards have been developed to help offices deliver timely medical care based on the severity of a patient’s health condition.  Total Health Care monitors the ease with which members can access services based on the following timeframe expectations:

Primary Care Physician Response Standards

Regular and Routine Care Appointments (i.e. preventive/well-care, routine non-symptomatic, physical, annual GYN exam)

Within thirty (30) days

Routine Non-Urgent (i.e. symptomatic )

Within seven (7) days

Urgent Care Appointments (i.e. persistent diarrhea/vomiting, high fever)

Within twenty-four (24) hours

Emergency Care (i.e. life-threatening conditions)

Twenty-four (24) hours/ seven (7) days a week at any hospital

Office Visit Wait Time for Scheduled Appointments

Within 15 minutes, members should be taken to the exam room.

Within 30 minutes, members should be seen by their doctor

Behavioral Health Care Response Standards
Urgent Care appointments

Within forty-eight (48) hours

Routine office visit

Within ten (10) business days