Timely Access to Care

Notice of Language Assistance and Accessibility

CCH offers a no-cost telephonic interpreter service to our members, both directly and through your providers’ offices, to provide language assistance to members with limited English proficiency To get an interpreter, or to ask about written translation of information in a non-English language, please contact CCH’s Customer Service department by phone at 1 (855) 343-2247. CCH members are entitled to full and equal access to covered services, including members with disabilities, as required under the Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973. CCH’s Customer Service Representatives are accessible by phone at 1 (855) 343-2247, and are available to assist the speech – and hearing – impaired. Further, the speech – and hearing – impaired may use the California Relay Service’s toll-free telephone number 1 (800) 735-2929 or 1 (888) 877-5378 (TTY).

Timely Access to Care

Medical and Mental Health Appointments and Timely Access to Care Health Plans in California must ensure that members have timely access to their physicians and other providers when seeking care. This means that there are limits on how long members have to wait to get an appointment and telephone triage or screening. The wait times are shown in the chart below. Some exceptions to the wait times apply. If you or a CCH member are having difficulty in obtaining a timely referral to an appropriate provider, please call CCH Customer Service at 1 (855) 343-2247. Providers and members can also file a complaint with the Department of Managed Health Care at www.HealthHelp.ca.gov or by calling 1 (888) 466-2219.

Appointment Type	Standard
Emergency Care (life threatening)	Seek immediate care at the nearest hospital
Urgent Care (non-life threatening) – no prior authorization required	Appointment is offered within 48 hours from time of the request
Urgent Care (non-life threatening) – prior authorization required	Appointment is offered within 96 hours from time of the request
Non-urgent appointments with a primary care physician (PCP) for regular and routine primary care services	Appointment is offered within 10 business days from time of the request
Non-urgent care appointments with a specialist	Appointment is offered within 15 business days from time of the request
Non-urgent appointment with a mental health provider (who is not a physician)	Appointment is offered within 10 business days from time of request
Non-urgent appointments for ancillary services for the diagnosis or treatment of an injury, illness or other heath condition	Appointment is offered within 15 business days from time of request
Telephone triage and advice	No greater than 30 minutes

Behavioral Health Emergent & Non-Emergent Appointment Access Standards

Appointment Type	Standard
Non-urgent appointments with a physician mental health care provider	Must offer the appointment within 10 business days of request
Non-Urgent Care appointments with a non-physician mental health care provider	Must offer the appointment within 10 business days of request
Urgent Care appointments	Must offer the appointment within 48 hours of request
Access to Life-Threatening Emergency Care	Immediately
Access to Follow Up Care After Hospitalization for mental illness	Must Provide Both: One follow-up encounter with a mental health provider within 7 calendar days after discharge Plus One follow-up encounter with a mental health provider within 30 calendar days after discharge

Other Regulatory Requirements:

After Hours Care: You should be able to reach a recorded message or live voice response providing emergency instructions and for non-emergent (urgent) matters information when to expect to receive a call back.

Emergency Care: Providers should instruct their after-hours answering service staff that if the caller is experiencing an emergency, the caller should be instructed to dial 911 or to go directly to the nearest emergency room. Answering machine instructions must also direct the member to call 911 or go the nearest emergency room if the caller is experiencing an emergency.

Non-Discrimination Notice

Community Care Health does not exclude, deny covered benefits to, or otherwise discriminate on the basis of race, color, or national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability. If you have a concern of discrimination based on race, color, national origin, age, disability or sex, you can file a civil rights complaint with the United States Department of Health and Human Services Office of Civil Rights electronically through the Office of Civil Rights Complaint Portal, available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

Or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue SW., Room 509F, HHH Building
Washington, DC 20201

1-800-368-1019
1-800-537-7697 (TDD).

Complaint forms are available at: https://www.hhs.gov/ocr/office/file/index.html

This statement is in accordance with the provisions of Health and Safety Code Section 1367.042, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Regulations of the U.S. Department of Health and Human Services issued pursuant to these statutes at Title 45 Code of Federal Regulations Parts 80, 84, and 91.