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 All Plan Letter, issued February 14, 2017 are posted below.

2017 Annual Timely Access Compliance Report Templates and Tools

Health Plans are required to submit a Timely Access Compliance Report by March 31 of each year. The items required to be submitted as part of this annual report are set forth in the Timely Access Compliance Report Instructions below. The DMHC has two standardized methodologies, the Provider Appointment Availability Survey Methodology and the Audit Methodology, for measuring and reporting rates of compliance with appointment time-elapsed standards, pursuant to Health and Safety Code section 1367.03, subd. (f)(3).

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

1. Read the MY 2017 Timely Access Compliance Report Instructions. (Rev. 09/15/17)

2. Read the MY 2017 Provider Appointment Availability Survey Methodology. (Issued 04/04/17)

3. Conduct the survey utilizing the DMHC's tools and reporting templates for MY 2017. The following reporting templates are in a "locked" Excel format. All health plans utilizing the survey methodology must submit Raw Data and Provider Contact List for each provider type using these templates in section B.2: "Raw Data and Provider Contact List" in the DMHC's web portal.

MY 2017 Provider Appointment Availability Survey - Survey Tool: (Issued 04/04/17)

MY 2017 Provider Appointment Availability Survey - Provider Contact List Templates: (Issued 06/02/2017)

MY 2017 Provider Appointment Availability Survey - Raw Data Templates: (Issued 06/30/17)

4. Use the MY 2017 Results Templates by relevant provider type when reporting results for section B.3: "Rate of Compliance with the Time-Elapsed Standards" in the DMHC's web portal. (Issued 06/30/17)

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

Audit Templates

Pursuant to Health and Safety Code section 1367.03, subd. (f)(3), DMHC has adopted two standardized methodologies that health plans may use to report compliance with the required appointment wait time standards for Measurement Year 2017. Health plans have not elected to use the manual audit methodology for MY 2017. As a result, the DMHC has not selected the dates in each calendar quarter to collect the data. The Provider Appointment Audit Methodology for MY 2017 will be published in June of 2017.

DMHC MY 2017 Provider Appointment Audit Methodology (Issued 06/19/17)

DMHC MY 2017 Electronic Audit Worksheet (Issued 06/30/17)

Annual Provider Network Report Forms, Grievance Report Forms and Annual Out-of-Network Payment Report Form for Measurement Year 2017

Pursuant to California Code of Regulations, title 28, section 1300.67.2.2, subd. (g)(2)(G) and Health and Safety Code sections 1367.03, subd. (f)(2), 1367.035 & 1371.31, subd. (a)(4), by March 31, 2012 and by March 31 of each year thereafter, all full service and mental health plans are required to submit provider network reports, timely access and network adequacy grievance reports, and out-of-network payment reports to the DMHC.

2017 Annual Provider Network Report Forms

The DMHC has made changes to the Annual Provider Network Report Forms (previously known as "Timely Access Report Forms") for Measurement Year 2017 (MY 2017).

Links to the Annual Provider Network Report Forms for MY 2017 are provided below. The following Report Forms are in a "locked" Excel format. Health plans must use these Forms to compile data for each network, as of December 31, 2017. As a reminder, Report Forms are due to the Department no later than March 31, 2018.

Please refer to the instructions within each MY 2017 Report Form template for directions on completion of the template. Please contact the Department with any reporting questions prior to the date for submission. The Department will host a series of Webinars in 2017 to review instructions for reporting in detail, and to answer health plan reporting questions. The Department also discussed changes to the MY 2017 instructions during health plan workgroup meetings in 2017. As in past years, the Department will be releasing further background instructions which will address Frequently Asked Questions, list changes to the Report form templates from previous measurement years  and provide example reporting scenarios. A Measurement Year 2017 Manual with this background information is forthcoming. Additionally, instructions and background documents from prior measurement years remain available in the Archive section of this Web Page.

2017 Timely Access and Network Adequacy Grievance Report Form

The link to the Timely Access and Network Adequacy Grievance Report Form for MY 2017 is provided below. The following Report Form is provided for informational purposes only. This Report Form cannot be populated and it is only intended to provide health plans with notice of the data fields required and requested for 2017.

2017 Out-of-Network Report Form

The link to the Out-of-Network Payment Report Form for MY 2017 is provided below.

Timely Access and Annual Network Report Form Archive

To view previously issued report forms, methodologies, instructions, and other reference material for timely access compliance and annual network review reports, please see the

Timely Access Archive

Related Timely Access and Annual Network Report Form Links

Sections 1367.03 and 1367.035 of the California Health and Safety Code

Section 1300.67.2.2 in Title 28 of the California Code of Regulations

List of Licensed Health Plans

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