Providers must comply with access-to-care appointment standards established by regulatory agencies, including DHCS, DMHC, and NCQA, to ensure timely delivery of health care services to members. Primary Care Providers (PCPs), or their designees, are required to maintain availability 24 hours a day, seven days a week.
All providers who oversee the member’s health care are responsible for providing the following appointments to Molina Healthcare of California members in the timeframes noted:
Timely access standards are based on regulatory and accreditation standards. Molina monitors compliance with these standards and will implement corrective actions for access to healthcare services that do not meet the performance standards.
If you are unable to obtain a timely referral to an appropriate provider, please contact the DMHC Provider Complaint line toll-free at (877) 525-1295 or through their website.
For additional information on appointment access standards, contact your local Molina Quality functional area at (888) 562-5442.