Timely Access to Care
California law requires health plans to provide timely access to care. This means that there are limits on how long you have to wait to get health care appointments and telephone advice.
Santa Clara Family Health Plan (SCFHP) is committed to providing timely access to care for all members. SCFHP strives to ensure that all health services are provided in a timely manner. SCFHP will continue to notify our members of any changes or updates made regarding the current policies.
If you have a problem getting timely access to care, you should call SCFHP Customer Service at 1-800-260-2055, 8:30 a.m. to 5:00 p.m., Monday – Friday (except holidays). TTY/TDD users call 1-800-735-2929 or 711.
APPOINTMENT WAIT TIMES
You have the right to appointments within the following time frames:
|APPOINTMENT TYPE||MUST GET APPOINTMENT WITHIN|
|Urgent care appointments that do not require pre-approval (prior authorization)||48 hours|
|Urgent care appointments that require pre-approval (prior authorization)||96 hours|
|Non-urgent primary care appointments||10 business days|
|Non-urgent specialist||15 business days|
|Non-urgent mental health provider (non-physician)||10 business days|
|Non-urgent appointments for ancillary services for the diagnosis or treatment of injury, illness, or other health condition||15 business days|
|Vision care appointments||15 business days|
|Urgent dental care appointments||72 hours|
|Non-urgent dental care appointments||36 business days|
|Preventive dental care appointments||40 business days|
|Telephone wait time during normal business hours||10 minutes|
|Triage – 24/7 services||24/7 services - No more than 30 minutes|