Last update: October 16, 2020
UnitedHealthcare Community Plan has appointment availability requirements for primary care providers (PCPs) and specialists. The requirements apply to routine, urgent and after-hours care. Your practice may have received a call from a third-party surveyor asking for appointment scheduling information availability that your practice has available for your patients. These calls are made to care provider offices on a random basis to confirm if a practice meets the access and availability standards set by the Division of Medical Assistance and Health Services (DMAHS). Please help ensure that your practice meets the following appointment availability scheduling timeframes.
Primary care and OB-GYN care providers are required to have after-hours access to speak directly with a live person outside normal business hours if contacted for any urgent medical matters by a patient. Care provider offices may be able to coordinate after-hours coverage with their affiliated hospital or provide coverage through an answering service.
For more information about access and availability guidelines, go to the Provider Administrative Manual at UHCprovider.com > Menu > Choose Your State: New Jersey > Go to UHCCommunityPlan.com > Provider Administrative Manual under Chapter 12: Participating Provider Responsibilities.