October 20, 2022
Rhode Island Medicaid: Help your patients get timely care
The Rhode Island Department of Human Services has established appointment availability standards to help ensure Medicaid members have timely access to care.
Appointment availability standards
Please ensure you’re adhering to the following appointment availability requirements for your patients who are UnitedHealthcare Community Plan members:
| Appointment type | Access standard |
|---|---|
| After hours care – telephone | 24 hours a day, 7 days a week |
| Emergency care | Immediately or referred to an emergency facility |
| Urgent care appointment | Within 24 hours |
| Routine care appointment | Within 30 calendar days |
| Physical exam | Within 180 calendar days |
| Early and Periodic Screening, Diagnostic and Treatment (EPSDT) appointment | Within 6 weeks |
| New member appointment | Within 30 calendar days |
| Non-emergent, non-urgent mental health or substance use services | Within 10 calendar days |
Quarterly phone surveys
We conduct quarterly appointment availability surveys in accordance with state requirements and may call your practice to ask about your appointment availability for UnitedHealthcare Community Plan members. We make these calls on a random basis.
We appreciate your support in responding to these surveys and ensuring your practice meets these requirements.
Questions?
See contact information for UnitedHealthcare Community Plan of Rhode Island.
