Measurement Year 2016

Survey Tools

Survey Templates

Audit Templates

Measurement Year 2015

Timely Access Report

The Measurement Year 2015 ("MY 2015") Timely Access Report, published by the DMHC pursuant to Health and Safety Code 1367.03, subd. (i), the corresponding MY 2015 Timely Access Data, the Timely Access Fact Sheet and the All Plan Letter, issued February 14, 2017, are posted below.

MY 2015 Timely Access Report

MY 2015 Timely Access Data (NOTE: As reported in the MY 2015 Timely Access Report, 90 percent of health plans' 2015 Timely Access Compliance Reports submitted to the DMHC contained one or more significant errors or data inaccuracies, making it virtually impossible for the DMHC to measure individual health plan compliance and compare health plans across the industry.)

Survey Tools

Steps for submitting Timely Access Compliance Report (A-F data):

1.  Read the MY 2015 Timely Access Compliance Report Instructions

2.  Please use the MY 2015 templates by relevant provider type when reporting results for section B.3 Data Source: Appointment Availability Audit/Survey in the DMHC's web portal.

3.  Submit documents per instructions via the DMHC's web portal (You may download the D. Advanced Access Form (optional) to report provider groups).

Audit Templates

Provider Appointment Manual Audit Dates

Rule 1300.67.2.2, subd (g)(2)(B) requires health plans to report a rate of compliance with several appointment wait time standards. Pursuant to SB 964 and Section 1367.03, subd (f)(3), DMHC has adopted two standardized methodologies that plans may use to report compliance with the required appointment wait time standards for Measurement Year 2015 (“MY2015”).

Plans conducting a manual audit using the DMHC MY2015 Provider Appointment Audit Methodology will perform appointment availability audits on four days during MY2015, one day in each calendar quarter of the year. After the close of each calendar quarter, DMHC will post on its website a notification of one date from the quarter for which data shall be collected. Data should be collected for each date soon after it is posted on DMHC’s website to allow plans to use the data for ongoing monitoring and to ensure that data systems are not purged before collection is accomplished.

For MY2015, the first two audit dates are:

First quarter: Wednesday, February 11, 2015

Second quarter: Tuesday, May 5, 2015

SPECIAL REMINDER: In the DMHC's web portal, please complete Steps 1 and 2 under the Submit tab and make sure you receive a confirmation email to identify your report has been successfully submitted to the DMHC. The Timely Access Compliance Report will not be submitted if Step 2 (Affirmation to Complete) is not completed. 

Need Help with Your Health Plan?

Call the DMHC Help Center

1-888-466-2219

or submit an Online Complaint

Need Help with Your Health Plan?

Call the DMHC Help Center

1-888-466-2219

or submit an Independent Medical Review/Complaint Form

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