Provider Availability Standards

Priority Health has set standards for our members' accessibility to health care: appointments, urgent care, returning calls, and waiting to see a provider. These are set out in the chart below. Providers must ensure that their office hours for Medicare enrollees are consistent with those for other members.

Related information:

• How to provide after-hours care
• Requirements for office locations
  

Patient Request	Acceptable Time Frame
Emergency care	Immediately or within 24 hours, depending on nature of illness (Medical) Immediately (Behavioral Health, life-threatening) Within 4 hours (Behavioral Health, non-life-threatening)
Urgent care	Two days or less (Medical)* Within 24 hours (Behavioral Health)
Appointments for routine or regular care	30 business days (Medical)* 14 business days (Medical, for Medicaid members) 10 business days (Behavioral Health)
Physical exam/preventive care	90 business days or less*
Return phone calls (during business hours)	4 hours or less (Medical) Reach a non-recorded voice in 25 seconds or less (Behavioral Health only)
Return phone calls (after hours)	2 hours or less 10 minutes or less (Behavioral Health only)
Waiting time in office	20 minutes or less (average)

More about our standards for accessibility and after-hours service

• Read the Medical Accessibility Standards, including the methodology for determining acceptability.
• Read the Behavioral Health Accessibility Standards, including the methodologies for determining acceptability.
• Read the guidelines for billing after-hours services.