Access to Care Standards

May 1, 2023, 7:26 pm

Cox HealthPlans (CHP) is committed to ensuring that members have access to and receive primary care and behavioral health services in a timely manner. Standards are also in place for telephone access to member services. CHP monitors access through a variety of measures, including appointment and office wait times, complaints, and responses from our member satisfaction surveys.

Access and availability standards are shared with members and providers through Provider Manuals and Member Handbooks. CHP monitors access and availability performance and completes a thorough analysis to check for concerns or opportunities for improvement each year, taking action as needed to improve access to care.

CHP’s access standards and measures are outlined in the table below.

Access Standards

Practitioner Type


Source of data/goal

Medical Care

Regular and routine care

An appointment within 30 days

CHP member satisfaction survey Q5,


Review of member Complaints

Routine, symptomatic care

An appointment within one (1) week or five (5) business days

CHP member satisfaction survey Q3,


Review of member Complaints

Urgent care

An appointment within 24 hours

CHP member satisfaction survey Q3,


Review of member Complaints

Obstetrical care

An appointment within one (1) week for enrollees in the first or second trimester of pregnancy and within three (3) days for enrollees in the third trimester

Review of member complaints





After-hours care

After- hours care is available to members through later clinic hours and walk-in clinics

90% on after-hours call audit,

Review of member complaints

Behavioral Health

Routine care

Within 30 days

Review of hours for behavioral health, Review of member complaints

Urgent care

Within 48 hours

Review of hours for behavioral health and urgent care,

Review of member complaints

Non-life-threatening emergency care

Within 6 hours

Immediate ER Access,

Review of member complaints

Life-threatening emergency care

24 hours / 7 days per week

Immediate ER access

Plan Member Services

Telephone access to member services

Call answered within 60 seconds,

Call abandonment less than 5%


Telephone system reports





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Phone: 417.269.4679
or 800.664.1244
Fax: 417.269.2949

Mailing Address
Cox HealthPlans
PO Box 5750
Springfield, MO 65801-5750

Or visit us at
Cox HealthPlans
Medical Mile Plaza
3200 S. National, Building B
Springfield, MO 65807

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