California timely access requirements
As a network health care professional, you’re essential in helping patients get the primary, urgent, preventive and specialty care they need, when they need it. The following appointment access standards are aligned with the state of California’s access requirements.
Please ensure you’re adhering to these appointment availability requirements for your patients who are UnitedHealthcare of California and UnitedHealthcare Benefits Plan of California plan members.
| General appointment type | Time frame |
|---|---|
| Non-urgent appointment (ancillary provider) | 15 business days |
| Non-urgent doctor appointment (primary care provider) | 10 business days |
| Non-urgent doctor appointment (specialty physician) | 15 business days |
| Urgent care (prior authorization not required by health plan) | 48 hours |
| Urgent care (prior authorization required by health plan) | 96 hours |
| Behavioral appointment type | Time frame |
|---|---|
| Care for non-life-threatening emergency | 6 hours |
| Urgent care | 48 Hours |
| Appointment for routine office visits offered | 10 business days |
| Non-urgent follow-up appointment (non-physician mental health care or substance use disorder providers) | Within 10 business days of prior appointment |
| Dental appointment type | Time frame |
|---|---|
| Emergency services | 24 hours |
| Urgent appointments | Within 72 hours of the time of request for appointment |
| Non-urgent and preventive dental care appointments | 10 business days |
New patient resources
If patients are unable to obtain a timely referral to an appropriate provider, they can file a complaint by calling the California Department of Managed Health Care (DMHC) Help Center at 888-466-2219. Patient resources are also available online through the DMHC at healthhelp.ca.gov.
Questions?
Please contact your provider advocate or visit our Contact Us page for more information.
