Behavioral health accessibility standards
The Priority Health Behavioral Health Department provides information about participating behavioral health care providers to members and other providers. Members seeking services are not required to contact the Behavioral Health department to schedule initial appointments, but our clinicians can, at the member's request, assist members in securing appointments.
Here are the Priority Health standards for member telephone access to providers and appointment scheduling to ensure timely access of care for members.
Telephone access standards
- Callers reach a non-recorded voice in less than 30 seconds
- The telephone abandonment rate is less than or equal to 5%
Measurement methodology: The telephone system provides data, by telephone queue, for the average speed of answer and the abandonment rates monthly, quarterly, and year-to-date.
Appointment scheduling standards
Three appointment standards are based on the members level of risk.
- Non-life-threatening emergent care: Appt. available within 6 hours
A situation in which a member is suicidal or homicidal but not engaged in the act, or is psychotic (with violent command hallucinations or exhibiting dangerous behavior) and is not in a professional setting where they can be safely monitored.
Urgent care: Appt. available within 48 hours
A situation in which a member has suicidal ideation but no intent, or members who experience severe psychological distress which may interfere with normal functioning and/or lead to further deterioration of emotional or physical health or is actively in danger to self or other, but is being monitored by a crisis intervention or medical professional who is able to keep the member safe (i.e., PCP's office, a Behavioral Health practitioner, an emergency room or ambulance).
Routine care: Appt. available within 10 business days
A situation in which a member is seeking treatment for situational stress such as family or work related problems, with no suicidal or homicidal ideation or imminent risk of deterioration of emotional or physical health, or when a case manager arranges a transfer of an at-risk member from a medical confinement to a psychiatric or substance abuse treatment facility.