MHS WI > For Providers > Access Standards

Access Standards

MHS strives to provide its members timely access to health care.  Therefore, adherence to healthcare quality standards as promoted by URAC, a non-profit health care accreditation organization, are fully anticipated from our Providers.  We want to ensure our members that once they contact you for an appointment that they will be seen within a medically responsibly amount of time for specified services.

MHS expected commitment from its providers is to adhere to these member access standards for Medical (PCP), Specialty and Dental appointments:

Medical (PCP) Appointments

Appointment Type: Access Standard:
Routine visit Within 30 calendar days
Non-Urgent visit Within 7 calendar days
Urgent Care visit Within 24 hours
Emergency visit Immediately, 24 hours a day, 7 days a week and without prior authorization
Initial high-risk prenatal care Within 2-3 weeks
After hours coverage 24 hours per day, 7 days per week
Office wait times Within 30 minutes of scheduled appointment

 

Specialty Appointments

Appointment Category: Access Standard:
Routine referral visit Within 60 calendar days
After hours coverage 24 hours per day, 7 days per week
Office wait times Within 30 minutes of scheduled appointment

 

Dental Appointments

Appointment Category: Access Standard:
Routine visit Within 90 calendar days
Emergency visit Immediately

 

Services made available by provides to patients:

  • Twenty-four (24) hour answering service or a telephone recording instructing members how they can access care after regular office hours
  • Hours of operation that do not discriminate against BadgerCare Plus and /or Medicaid SSI members
  • Information regarding overall results is communicated via physician newsletter articles, Health Plan web site and/or other written communications