Timely access to care

Having timely access to care is extremely important to us. Take a look at the tables below so you can plan ahead for services.

Appointment wait times

Urgent appointments	Maximum wait time after request
No prior authorization required	48 hours
Prior authorization required	96 hours

Non-urgent appointments	Maximum wait time after request
Primary care physician (excludes preventive care appointments)	10 business days
Non-physician behavioral health care or substance use disorder providers (includes follow-up appointments)	10 business days
Specialist (excludes routine follow-up appointments)	15 business days
Ancillary services (for example, X-rays, lab tests, etc. for the diagnosis and treatment of injury, illness, or other health conditions)	15 business days

Rescheduling appointments

If your appointment requires rescheduling, it shall be promptly rescheduled in a manner that is appropriate to your health care needs and continuity of care, consistent with good professional practice.

Extended wait times

Your wait time for an appointment may be extended if your health care provider has determined and noted in your record that the longer wait time will not be detrimental for your health.

Advance scheduling

Your appointments for preventive and periodic follow-up care services (e.g. standing referrals to specialists for chronic conditions, periodic visits to monitor and treat pregnancy, cardiac, or mental health conditions, and laboratory and radiological monitoring for recurrence of disease) may be scheduled in advance, consistent with professionally recognized standards of practice, and exceed the listed wait times.

Telephone wait times

Service	Maximum wait time
Sharp Health Plan Customer Care (Monday to Friday, 8 am to 6 pm)	10 minutes
Triage or screening services (24 hours/day and 7 days/week)	30 minutes

After-Hours triage services

Your PCP, mental health providers and substance use disorder provider are required to have an answering service or a telephone answering machine during nonbusiness hours. These services must provide direction telling you how to obtain urgent or emergency care and, if applicable, how you can contact an on-call provider for screening or urgent or emergency care as appropriate.

Interpreter services at scheduled appointments

We provide free interpreter services at scheduled appointments for members whose primary language is not English. For language interpreter services, please call Customer Care at 1-800-359-2002. The hearing and speech impaired may dial 7-1-1 or use California’s Relay Service’s toll-free numbers to contact us:

1-800-735-2922 Voice
1-800-735-2929 TTY
1-800-855-3000 Voz en español y TTY (teléfono de texto)

You must make requests for face-to-face interpreting services at least five (5) business days prior to the appointment date. Coordination of interpreter services shall not impose delays on the scheduling of your appointment. In the event that an interpreter is unavailable for face-to-face interpreting, Customer Care can arrange for telephone interpreting services.

Concerns about timely referral to an appropriate provider

You can contact Customer Care at 1-800-359-2002 for assistance if you are unable to obtain a timely referral to an appropriate provider. You can also contact the California Department of Managed Health Care at 1-888-466-2219 to file a complaint.