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Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.

Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.

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The Right Care at the Right Time

Date: 12/17/24

Use this guide to ensure your Marketplace patients get the appointments they need, when they need them.

Appointment Availability and Standards

Passing requirements – All Marketplace

Appointment TypeAccess Standard
PCP - Urgent <24 hours
PCP - Sick<1 week
PCP - Routine/Well Care<30 days
Specialist (Specialist, Oncologist, OB/GYN)<30 days
Wait Times - Scheduled<15 minutes
BH - Non-Life-Threatening Emergency<6 hours
BH - Urgent<48 hours
BH - Routine<10 business days
BH – Routine Follow-up
<30 days


After Hours (Passing Standards) – All Marketplace

  • Advice nurse with access to physician
  • Answering service or system that will page physician
  • Answering system with option to page physician
  • Answering service that will page the provider after a message is left
  • Answering service or system that provides number to access physician

Quality care is a team effort. We are here to help. If you have any questions about this information, please contact your Provider Network Specialist or your Quality Practice Advisor.