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Appointment Accessibility Standards

Date: 08/02/22

Arkansas Health & Wellness is committed to making sure members have timely access to healthcare in accordance with accessibility requirements set forth by regulatory and accrediting agencies. We monitor compliance with these standards annually to ensure adequate appointment availability and reduce unnecessary emergency room visits.

Arkansas Health & Wellness offers a comprehensive network of PCPs, specialist physicians, hospitals, behavioral healthcare providers, and diagnostic and ancillary services providers to ensure every member has access to covered services. The travel distance and access standards that Ambetter utilizes to monitor its network adequacy are in line with both state and federal regulations.

The charts below outline Ambetter and Wellcare by Allwell appointment accessibility standards.* If you have questions about these requirements, or if you would like to speak to a provider representative, reach out to us at 1-800-294-3557 or by email at Providers@ARHealthWellness.com.

*The charts below do not outline every accessibility and wait time requirement for Ambetter and Wellcare by Allwell. To view the complete lists, visit our 2022 Provider and Billing Manuals for Ambetter (PDF) and Wellcare by Allwell (PDF).

Ambetter Appointment Availability and Wait Times
Appointment Type Access Standard
PCPs – Routine visits 30 calendar days
PCPs – Adult Sick Visit 48 hours
PCPs – Pediatric Sick Visit 24 hours
Behavioral Health – Non-life Threating Emergency 6 hours
Specialist Within 30 calendar days
Urgent Care Providers 24 hours
Behavioral Health Urgent Care 48 hours
Behavioral Health Routine Care Initial Visit 10 business days
After Hours Care Office number answered 24 hours/7 days a week by answering service or instructions on how to reach a physician
Emergency Providers 24 hours a day, 7 days a week
Wellcare by Allwell Appointment Availability
Type of Care Accessibility Standard*
PRIMARY CARE
Emergency Same day or within 24 hours of member’s call
Urgent care Within 2 days of request
Routine Within 21 days of request
SPECIALTY REFERRAL
Emergency Within 24 hours of referral
Urgent care Within 3 days of referral
Routine Within 45 days of referral
MATERNITY
1st trimester Within 14 days of request
2nd trimester Within 7  days of request
3rd trimester Within 3 days of request
High-risk pregnancies Within 3 days of identification or immediately if an emergency exists
DENTAL
Emergency Within 24 hours of request
Urgent care Within 3 days of request
Routine Within 45 days of request

For the standard specific to your specialty and county, please reach out to a provider representative. The availability of our network practitioners is key to member care and treatment outcomes. Please ensure your information is up to date with our Provider Relations Representatives so our members can reach your office to schedule appointments without difficulty. You can update your information by visiting the provider portal on our website at ARHealthWellness.com or calling us at 1-800-294-3557.