Physician Access/Appointment Availability Standards General Availability Standards
Members must be able to access their PCP 24 hours a day, 7 days a week. As the member's healthcare manager, the PCP is responsible for providing or arranging healthcare services on a 24/7 basis. (An answering machine does not suffice as access to the provider.) The PCP must also have a method to inform his or her Empire BlueCross BlueShield (“Empire”) members about regular office hours and how to obtain care after office hours. PCPs must proactively notify members in their care of any of the following changes: Tax ID, location/demographic and/or mergers/acquisitions, which may impact a member's PCP assignment. This will allow member to contact Empire's member services team to mitigate any disruption in care.