			Home \| Contact Wellmark \| Work @ Wellmark \|
			Members \| Employers \| Providers \| Brokers \| About Wellmark

Wellmark Health Plan of Iowa Access to Care Policies

Appointment Wait Time - Primary Medical/Surgical Care

WHPI has policies to assure our patients have access to covered services. These include policies for appointment wait times, including appointments with primary care providers for preventive and health maintenance, primary care, and urgent care.

Wellmark Health Plan of Iowa strives to ensure that all members have access to their primary care practitioners 24 hours a day, 7 days a week, and that members can obtain an appointment within a reasonable period of time.

Policy	Example	Measurement
Primary care offices shall schedule a preventive/health maintenance appointment within 4-8 weeks	Physicals, immunizations, well-female exam, well child visit	Based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) member satisfaction ratings, the percentage of members that report that they “always” or “usually” get care when they needed it will be at or exceed the 90 th percentile Quality Compass^®.
Primary care offices shall schedule a primary care appointment within 14 calendar days	Hypertension follow-up, joint pain/arthritis, skin rash or acne, headaches	Based on the CAHPS member satisfaction ratings, the percentage of members that report that they “always” or “usually” get care when they needed it will be at or exceed the 90 th percentile Quality Compass.
Primary care offices shall schedule an urgent care appointment within 24 hours	Conditions with sudden onset of symptoms or deterioration such as urinary tract infection, upper respiratory infection, breast lump, bloody stools, severe pain	Based on the CAHPS member satisf action ratings , the percentage of members that report that they “always” or “usually” get care when they needed it right away will be at or exceed the 90 th percentile Quality Compass.
Members will be able to receive emergency care immediately	Emergency Care	100% of members are able to receive emergency care immediately

CAHPS^® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
Quality Compass^® is a registered trademark of the National Committee for Quality Assurance.

Copyright© 2008 Wellmark, Inc. All Rights Reserved.
Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota. Blue Cross®, Blue Shield®, and the Cross® and Shield® symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.