WHPI has policies to assure our patients have access to covered services. These include policies for appointment wait times, including appointments for behavioral health services.
WHPI strives to ensure that all members have access to behavioral health care services, and that members can obtain an appointment within a reasonable period of time.
| Policy |
Example |
Goal |
| A member has access to a counseling
appointment within 10 working days |
A member whose symptoms interfere
with daily living and/or significant relations, e.g. family,
work, school |
95% |
| A member has
access to a medication management appointment within 10
working days |
A member taking a
prescribed medication and is checking with the clinician
regarding side effects or other concerns |
95% |
| A member with non-life-threatening emergency needs has access to care within 6 hours
|
A member who is exhibiting erratic and/or irrational behavior and requires supervision to prevent harm to him/herself and others; hallucinations; severe mood swings; increased use of alcohol or drugs
|
100% |
| A member with life-threatening emergency needs
has access to care immediately |
A member who is threatening suicide or endangering the lives of others
|
100% |
| A member with urgent needs has access to care within 48 hours |
A member experiencing new or recent changes in symptoms resulting in significant dysfunction in activities of daily living or significant relationships, but not immediate threat to self or others. Examples: loss of employment, death in family, news of a serious illness or sudden to significant marital/relationship breakdown
|
100% |
