[California] Access surveys for primary care practitioners, specialty care practitioners, and behavioral health practitioners

By August 1, 2026: All scheduling and clinical staff must implement and maintain compliance with the following access standards: (1) PCP urgent care (24 hours), routine preventive (30 calendar days), routine check-up (10 business days); (2) SCP (OB/GYN, oncology) urgent care (48 hours), routine (15 business days); (3) BHP non-life-threatening emergency (6 hours), urgent (48 hours), initial routine (10 business days), follow-up routine (30 calendar days), post-discharge psychiatric (7 calendar days). Front desk and scheduling teams must enforce these timeframes in the appointment system. Clinical staff must configure after-hours call coverage with live operators or compliant recorded messages directing members to urgent care, 911, ER, or on-call physician callback—telephone-only voicemail/answering machines are not acceptable. Update telehealth status in Availity by July 1, 2028 (directory requirement effective that date). Document all instances where standards cannot be met due to seasonal or practice-specific constraints. Billing team should not schedule claims denials, but prepare for compliance audits via phone/email surveys and member grievance monitoring by Anthem's designated vendor. Non-compliance may result in contractual penalties or plan participation issues.