CMS secret shopper survey assessing appointment wait times launches soon

Beginning soon, we’re partnering with Press Ganey to conduct a secret shopper survey designed to evaluate both in-person and virtual appointment-scheduling wait times for provider offices who accept our ACA/marketplace plans. In compliance with the Centers for Medicare and Medicaid Services (CMS), the following requirements must be met:

• Behavioral health offices: Patients must be able to see a provider within ten business days of contacting the office to schedule an appointment
• Primary care offices: Patients must be able to see a provider within 15 business days of contacting the office to schedule an appointment

This survey is a requirement by CMS and works to ensure patients have timely access to behavioral health and primary care. It runs from January through mid-May. 

How will this impact providers?

• Press Ganey, our authorized vendor, will make unannounced calls during normal business hours to randomly selected offices
• Callers will pose as new patients and check appointment availability, acceptance of new patients, office hours and provider directory accuracy
• No personal health information will be requested

What can providers do to prepare?

Ensure staff is aware of the secret shopper survey and that your office contact information is up to date in Find A Doc.  

Learn how to update your Find A Doc information