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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.

PCA-1-22-03077-C&S-News
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