Timely patient scheduling

Kaiser Permanente works with network providers to ensure that WAC, OIC, CMS, and NCQA regulations and standards are met regarding patient care. Contracted providers are responsible for providing members with medically necessary services and following all applicable regulations and standards regarding timely member access to care.

Physicians are responsible for the following:

• Ensuring that physician services are available 24 hours per day in order to advise members about how and where to obtain necessary care.
• Consulting with emergency department providers about the most appropriate setting for the level of care.
• Authorizing coverage for urgent care in emergency departments, when appropriate.
• Confirming with members their financial responsibility for any non-covered services.
• Identifying, assessing, and establishing treatment plans for members.
• Ensuring that members with special health care needs receive appropriate case management.
• Cooperating with Kaiser Permanente periodic requests for detailed reports pertaining to member access to care.
• Ensuring that notes back to referring providers are timely
• Providing interpretive services as necessary. Please see our Interpretive Services policy for more information.