Member Access Standards

Ensuring Members Have Access to Care

Our behavioral health staff is available 24 hours a day, seven days a week to facilitate inpatient admissions. For non-life threatening behavioral health emergencies, CDPHP directs network practitioners to refer members to the emergency department. 

CDPHP network providers are required to ensure that members have access to care within the following standards:

  • Emergency—Immediate access (may be referred to the ER)

  • Urgent appointment—within 48 hours

  • Initial routine appointments—within 10 business days

  • Follow-up routine appointment within 20 business days

  • Ambulatory appointment post-inpatient discharge—within 7 days of discharge

The behavioral health utilization management (UM) process includes triage and referral as well as prospective, concurrent, and retrospective review of the services delivered to our members.

Call the Behavioral Health Access Center at 1-888-320-9584, Monday through Friday, 8 a.m. to 6 p.m. to verify eligibility and benefit information prior to rendering care for your patients.

Participating providers can log into the secure provider portal at any time to view the Provider Office Administration Manual and CDPHP policies.