Appointment Availability Standards. The Contractor shall comply with the following appointment availability standards(1).
a) For emergency care: immediately upon presentation at a service delivery site.
b) For urgent care: within twenty-four (24) hours of request.
c) Non-urgent "sick" visit: within forty-eight (48) to seventy-two (72) hours of request, as clinically indicated.
d) Xxxxxxx non-urgent, preventive appointments: within four (4) weeks of request.
e) Specialist referrals (not urgent): within four (4) to six (6) weeks of request.
f) Initial prenatal visit: within three (3) weeks during first trimester, within two (2) weeks during the second trimester and within one (1) week during the third trimester.
g) Adult Baseline and routine physicals: within twelve (12) weeks from enrollment. (Adults >21).
h) Well child care: within four (4) weeks of request.
i) Initial family planning visits: within two (2) weeks of request.
j) In-plan mental health or substance abuse follow-up visits (pursuant to an emergency or hospital discharge): within five (5) days of request, or as clinically indicated.
k) In-plan, non-urgent mental health or substance abuse visits: within two (2) weeks of request.
1) Initial PCP office visit for newborns: within two (2) weeks of hospital discharge.
Appointment Availability Standards a) The Contractor shall comply with the following minimum appointment availability standards, as applicable(1).
i) For emergency care: immediately upon presentation at a service delivery site.
ii) For urgent care: within twenty-four (24) hours of request.
iii) Non-urgent "sick" visit: within forty-eight (48) to seventy-two (72) hours of request, as clinically indicated.
iv) Routine non-urgent, preventive appointments: within four (4) weeks of request.
v) Specialist referrals (not urgent): within four (4) to six (6) weeks of request.
vi) Initial prenatal visit: within three (3) weeks during first trimester, within two (2) weeks during the second trimester and within one (1) week during the third trimester.
vii) Adult Baseline and routine physicals: within twelve (12) weeks from enrollment. (Adults >21 years),
viii) Well child care: within four (4) weeks of request.
ix) Initial family planning visits: within two (2) weeks of request.
x) Pursuant to an emergency or hospital discharge, mental health or chemical dependence follow-up visits with a Participating Provider (as included in the Benefit Package): within five (5) days of request, or as clinically indicated.
xi) Non-urgent mental health or chemical dependence visits with a Participating Provider (as included in the Benefit Package): within two (2) weeks of request.
xii) Initial PCP office visit for newborns: within two (2) weeks of hospital discharge.
(1) These are general standards and are not intended to supersede sound clinical judgement as to the necessity for care and services on a more expedient basis, when judged clinically necessary and appropriate.
xiii) Provider visits to make health, mental health and chemical dependence assessments for the purpose of making recommendations regarding a recipient's ability to perform work when requested by a LDSS: within ten (10) days of request by an MMC Enrollee, in accordance with Section 10.7 of this Agreement.
