Timely access to care

California has set standards for health plans and providers to ensure members have access to health care in a timely manner. Scripps Health Plan works with our network of providers and participating medical groups (PMGs) to help you get the health care you deserve, when you need it.

Urgent appointments

Emergency & urgent care services

  • Wait time: Immediately, 24 hours a day, 7 days a week

For services that do not require prior authorization (such as an urgent appointment with your PCP)

  • Wait time: 48 hours

For services that require prior authorization (such as an urgent appointment with a specialist)

  • Wait time: 96 hours

Non-Urgent Appointments

Primary care appointment

  • Wait time: 10 business days

Specialist appointment

  • Wait time: 15 business days

Appointment with a mental health or substance use disorder (MHSUD) provider who is not a physician 

  • Wait time: 10 business days

Follow-up appointment with a non-physician MHSUD provider for those undergoing a course of treatment

  • Wait time: 10 business days following prior appointment

Ancillary service appointments (such as X-ray, MRI or physical therapy, etc.)

  • Wait time: 15 business days

Ongoing care

Preventive care services and periodic follow-up care, including standing referrals to specialists for chronic conditions, periodic office visits to monitor and treat pregnancy, cardiac, mental health, or substance use disorder conditions and laboratory and radiological monitoring for recurrence of disease, may be scheduled in advance consistent with professionally recognized standards of practice as determined by your provider.

It is important that you understand information about your health care. If you need help talking with your provider, understanding medical information or obtaining care, we can help by providing you with free interpreter (verbal) and translation (written) services. If you need language assistance or assistance making an appointment, please call Scripps Health Plan customer service at 844-337-3700 or TTY/TDD (888) 515-4065 for the hearing and speech impaired, Monday through Friday from 8 am to 5 pm PST.

For triage or screening of an urgent condition, you may call your provider’s office 24 hours a day, 7 days a week. If you contact your provider’s office after normal business hours, a qualified clinician will return your call within 30 minutes.

For treatment of mental health and substance use disorder conditions, coverage is provided through Evernorth Behavioral Health of California, Inc. Visit well.evernorth.com, or call 888-736-7009 or TTY: 711 for the hearing and speech impaired, 24 hours a day, 7 days a week, to speak with an Evernorth Behavioral Health Representative.