Access To Care

Access to Care Standards

Acute Appointment Definition

An urgent (acute) care appointment is reserved for non-emergent, urgent care that is typically delivered by an Medical Treatment Facility or network Primary Care Manager. Acute care services for Active Duty and TRICARE Prime enrollees shall be scheduled no greater than 24 hours from the time the need for this appointment is determined.

Exception: Beneficiaries may waive the 24-hour access standard.

Future Appointment Definition

A Future primary care (routine) appointment is designated for patients who require a visit with their PCM for a new healthcare problem that is not considered urgent. Future (routine) care for Active Duty and TRICARE Prime enrollees shall be scheduled within seven calendar days from the time the need for this appointment is determined. Exception: Beneficiaries may waive the seven day access standard.

Specialty Appointment Definition

A specialty care appointment is designated for patients who require an initial consult, referral, or initial self-referral. Specialty care for Active Duty and TRICARE Prime enrollees shall be scheduled within 28 calendar days from the time the need for this appointment is determined. A specialty care appointment also includes procedures designated for patients in need of medical procedures.

Future Appointment Definition

A future appointment for all other clinics is designated for patients who require follow-up care. Established care for Active Duty and TRICARE Prime enrollees shall be scheduled in accordance with the provider designated time frame.

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