Timeframes for Access Requirements. INSURER must have sufficient network of providers and must establish procedures to ensure beneficiaries have access to routine, urgent, and emergency services; telephone appointments; advice and Beneficiaries service lines. These services must be accessible to beneficiaries within the following timeframes: - Urgent Care within 24 hours of request; - Routine care within 2 weeks of request; - Physical/Wellness Exams for adults must be provided within 8 to 10 weeks of the request; - Referrals: Appointments of referrals must be delivered and notified to beneficiaries within five (5) days from the date prescribed by the provider.
Appears in 3 contracts
Sources: Health Insurance Contract (Triple-S Management Corp), Health Insurance Contract (Triple-S Management Corp), Health Insurance Contract (Triple-S Management Corp)