Appointment Accessibility Standards
Date: 08/02/22
Arkansas Health & Wellness is committed to making sure members have timely access to healthcare in accordance with accessibility requirements set forth by regulatory and accrediting agencies. We monitor compliance with these standards annually to ensure adequate appointment availability and reduce unnecessary emergency room visits.
Arkansas Health & Wellness offers a comprehensive network of PCPs, specialist physicians, hospitals, behavioral healthcare providers, and diagnostic and ancillary services providers to ensure every member has access to covered services. The travel distance and access standards that Ambetter utilizes to monitor its network adequacy are in line with both state and federal regulations.
The charts below outline Ambetter and Wellcare by Allwell appointment accessibility standards.* If you have questions about these requirements, or if you would like to speak to a provider representative, reach out to us at 1-800-294-3557 or by email at Providers@ARHealthWellness.com.
*The charts below do not outline every accessibility and wait time requirement for Ambetter and Wellcare by Allwell. To view the complete lists, visit our 2022 Provider and Billing Manuals for Ambetter (PDF) and Wellcare by Allwell (PDF).
| Appointment Type | Access Standard |
|---|---|
| PCPs – Routine visits | 30 calendar days |
| PCPs – Adult Sick Visit | 48 hours |
| PCPs – Pediatric Sick Visit | 24 hours |
| Behavioral Health – Non-life Threating Emergency | 6 hours |
| Specialist | Within 30 calendar days |
| Urgent Care Providers | 24 hours |
| Behavioral Health Urgent Care | 48 hours |
| Behavioral Health Routine Care Initial Visit | 10 business days |
| After Hours Care | Office number answered 24 hours/7 days a week by answering service or instructions on how to reach a physician |
| Emergency Providers | 24 hours a day, 7 days a week |
| Type of Care | Accessibility Standard* |
| PRIMARY CARE | |
| Emergency | Same day or within 24 hours of member’s call |
| Urgent care | Within 2 days of request |
| Routine | Within 21 days of request |
| SPECIALTY REFERRAL | |
| Emergency | Within 24 hours of referral |
| Urgent care | Within 3 days of referral |
| Routine | Within 45 days of referral |
| MATERNITY | |
| 1st trimester | Within 14 days of request |
| 2nd trimester | Within 7 days of request |
| 3rd trimester | Within 3 days of request |
| High-risk pregnancies | Within 3 days of identification or immediately if an emergency exists |
| DENTAL | |
| Emergency | Within 24 hours of request |
| Urgent care | Within 3 days of request |
| Routine | Within 45 days of request |
For the standard specific to your specialty and county, please reach out to a provider representative. The availability of our network practitioners is key to member care and treatment outcomes. Please ensure your information is up to date with our Provider Relations Representatives so our members can reach your office to schedule appointments without difficulty. You can update your information by visiting the provider portal on our website at ARHealthWellness.com or calling us at 1-800-294-3557.