Timely Access to Care for Managed Health Network Behavioral Health Groups
The California Department of Managed Health Care (DMHC) has issued regulations (California Code of Regulations Title 28, Section 1300.67.2.2) with requirements for timely access to non-emergency health care services.
Please contact MHN at the number shown on your member ID card, 7 days per week, 24 hours per day to access triage or screening services. MHN provides access to covered health care services in a timely manner.
Please see the "Language Assistance Services" section, and the "Notice of Language Services" section, for information regarding the availability of no cost interpreter services.
Definitions Related to Timely Access to Care
Triage or Screening is the evaluation of a Member’s health concerns and symptoms by talking to a doctor, nurse, or other qualified health care professional to determine the member’s urgent need for care.
Triage or Screening Waiting Time is the time it takes to speak by telephone with a doctor, nurse, or other qualified health care professional who is trained to screen or triage a member who may need care, and will not exceed 30 minutes.
Business Day is every official working day of the week. Typically, a business day is Monday through Friday, and does not include weekends or holidays.
Scheduling Appointments with Your Participating Mental Health Professional
When you need to see a Participating Mental Health Professional, call his or her office for an appointment. The receptionist will make every effort to schedule an appointment at a time convenient for you. If you need to cancel an appointment, notify your provider as soon as possible.
This is a general idea of how many business days, as defined above, that you may need to wait to see a Participating Mental Health Professional:
- Non-urgent appointment with a Psychiatrist (Behavioral Health Physician) for routine care: within 15 business days of request for an appointment.
- Non-urgent appointment with a therapist or social worker, or non-Physician for routine care, including follow-up appointments: within 10 business days of request for an appointment.
- Urgent appointment that requires Prior Authorization with a behavioral health provider: within 96 hours of request for an appointment.
- Urgent appointment that does not require Prior Authorization with a behavioral health provider: within 48 hours of request for an appointment.
- Non-life threatening behavioral health emergency: within 6 hours of request for an appointment.
Your Participating Mental Health Professional may decide that it is okay to wait longer for an appointment as long as it does not harm your health.