Common use of Timeframes for Access Requirements Clause in Contracts

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. The services required must be delivered or rendered within a reasonable period as medically needed by the beneficiary, in a time frame which may not exceed thirty (30) days from the time of the appointment, except in cases where the particular nature of specialist services require additional waiting time because of unavailability of a specialty service.

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. The services required must be delivered or rendered within a reasonable period as medically needed by the beneficiary, in a time frame which may not exceed thirty (30) days from the time of the appointment, except in cases where were the particular nature of specialist services require additional waiting time because of unavailability of a specialty service.