Checking on Appointments
You may have noticed that Cenpatico/Managed Health Services (MHS) is ramping up its process to verify that you have an appointment available in 10 calendar days for routine care and within 24 hours for urgent care. When we call to check your availability, if you do not meet either one of the standards, we send a letter reminding you of the contractual obligation that needs to be met and that we will follow up in the next quarter. If we find continued lack of appointments within the timeframes requested, we ask for a Corrective Action Plan. Once submitted, we review and contact you if it is not acceptable. Once we reach an agreement, Cenpatico/MHS accepts it and will contact you after actions have been made to determine if you now meet the requirements. This process has prompted many providers to call us and we appreciate the opportunity to work with you. Cenpatico/MHS also expects you to tell Members, or to have a message on your phone that directs members, who have a non-life threatening emergency to the nearest emergency center.
Cenpatico/MHS has found that while those meeting appointment availability standards have improved, it is still not meeting our goal to have 90% of our provider offices be available within 24 hours for urgent appointments and 10 calendar days for routine appointments. To ensure that your office meets these directives, it is important to provide education on these standards to the front office staff. Another is to allow time each day at lunch or before/after normal office hours to see those patients in crisis. Your front office staff needs to know you can be available during these hours if needed. If you are a solo practitioner and do not have front office staffs to rely on for making appointments, you could change the message that patients receive while you’re in session to reflect that you will return their call within two hours or whatever you see as possible.
Our quality department and network management staff are available to brainstorm ideas to help you meet standards that will work for you and your practice. Thank you to those of you who have been called and met the standards. We appreciate your commitment to our members.