Timely access to care
Blue Shield of California wants to make sure you receive timely access to medical care and services. These guidelines can help you understand what to expect when you schedule medical appointments or use other health care services. If you need help making an appointment, please call us at the customer service number on the back of your Blue Shield of California member ID card.
| Urgent Care | Access to Care |
|---|---|
| For services that don’t need prior approval | Within 48 hours |
| For services that do need prior approval | Within 96 hours |
| Non-urgent Care | Access to Care |
|---|---|
| Primary care appointment | Within 10 business days |
| Specialist appointment | Within 15 business days |
| Preventive care appointment | Within 30 business days |
| Appointment for other services to diagnose or treat a health condition | Within 15 business days |
| Behavioral Health | Access to Care |
|---|---|
| Emergency care | Call 911 |
| Non-life-threatening emergency | Within 6 hours |
| Urgent care | Within 48 hours |
| Routine office visit for non-urgent appointment with a psychiatrist | Within 15 business days |
| Non-urgent appointment with a non-physician mental health care provider | Within 10 business days |
| Follow-up routine care appointment with prescriber | Within 15 business days |
| Follow-up routine care appointment with non-prescriber | Within 10 business days |
| Telephone Inquiries | Access to Service |
|---|---|
| Access to a health professional for telephone screenings | 24 hours/day, 7 days/week |
Accessibility:
PCP: Family Medicine (General Practice & Family Practice), Internal Medicine, and Pediatrics for non-Medicare
One PCP of each primary type within 15 miles or 30 minutes (or an approved/pending Alternate Access Standard) from each member’s residence or workplace in the approved service area as appropriate by age.
OB/GYN: One OB/GYN within 30 miles of each member.
Time standards for appointments:
The time standards for appointments may be extended when the referring, treating, or health professional providing triage services determines that a longer wait time will not have a detrimental effect on the health of the patient.
Interpreter services:
For availability of interpreter services at the time of your appointment, consult the provider directories available at blueshieldca.com or call the customer service number on the back of your Blue Shield of California member ID card.
BSC - Y0118_22_224A_C 05252022
CMC - H0148_22_029_C_060622
Medi-Cal - Medi_22_71_LS_060622
The company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability. La compañía cumple con las leyes de derechos civiles federales y estatales aplicables, y no discrimina, ni excluye ni trata de manera diferente a las personas por su raza, color, país de origen, identificación con determinado grupo étnico, condición médica, información genética, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad, ni discapacidad física ni mental. 本公司遵守適用的州法律和聯邦民權法律，並且不會以種族、膚色、原國籍、族群認同、醫療狀況、遺傳資訊、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡、精神殘疾或身體殘疾而進行歧視、排斥或區別對待他人。
