Patient Appointment Access Standards

Providers are required to follow these Blue Cross and Blue Shield of Texas Patient Access Standards:

ACCESS MEASURE

PATIENT ACCESS STANDARD

Initial New Patient Visit

Within 30 days of request

Preventive Care by Primary Care Provider (Annual physical)

Within 30 days of request

Routine Primary Care

Within 5 days of request

Urgent Care

Within 24 hours of request

Emergency Care

  • During Office Hours
  • After Office Hours

Immediate

After Hours Care

  • Urgent Care
  • Alternative Care

24 Hours per day, 7 days a week

In Office Wait Time

Within 30 minutes of appointment time

High Impact* or High-Volume Specialists**

  • Urgent Care  
  • Routine Care

                                                                                    

  •  Within 5 days of request
  • Within 21 days of request                                                                                  

*High Impact Specialists: Practitioner types who treat conditions  with high mortality or morbidity rates where treatment requires significant resources comprised of, but not limited to, the following:

- Neurology
- Oncology

**High Volume Specialists: Practitioner types as determined by annual high-volume report are comprised of, but not limited to, the following:

- Obstetrics/Gynecology
- Cardiovascular Disease
- Orthopedic Surgery
- Psychiatry
- Psychology
- Licensed Professional Counselors (LPC)
- Licensed Marriage and Family Therapist (LMFT)
- Licensed Medical Social Workers- Advanced Clinical Practice (LMSW-ACP)

More Information: Refer to the Quality Improvement sections of our Provider Manuals.