Specialty Care Provider Orientation - MetroPlus Health Plan
Specialty Care Provider Orientation - MetroPlus Health Plan
Specialty Care Provider Orientation - MetroPlus Health Plan
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Access to <strong>Care</strong>• <strong>MetroPlus</strong> Members must secure appointments within the followingtime guidelinesEmergency <strong>Care</strong>Urgent Medical or Behavioral ProblemNon-Urgent “Sick” VisitWell-Child <strong>Care</strong> VisitsRoutine Non-Urgent, Preventive or Well Child VisitAdult Baseline and Routine PhysicalAdult Baseline and Routine Physical for HIV SNP MembersInitial Family <strong>Plan</strong>ning VisitIn-plan Behavioral <strong>Health</strong> or Substance Abuse Follow-up Visit(Pursuant to Emergency or Hospital Discharge)In-plan Non-urgent Behavioral <strong>Health</strong> VisitSpecialist Referrals (Non-urgent)<strong>Health</strong> Assessment of Ability to WorkImmediately upon presentationWithin 24 hours of requestWithin 48-72 hours of request, asclinically indicatedWithin 4 weeks of requestWithin 4 weeks of requestWithin 12 weeks of enrollmentWithin 4 weeks of enrollmentWithin 2 weeks of requestWithin 5 calendar days of request, oras clinically indicatedWithin 2 weeks of requestWithin 4-6 weeks of requestWithin 10 calendar days of request12
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