Quality Management
Access & Availability Standards

Independence Blue Cross (IBC) has developed the following standards to help maintain the availability of primary and specialty care providers and to ensure the accessibility of primary care, urgent care, and member services within our managed care networks. As part of these standards, IBC considers the types of providers and their geographical locations and takes into account the cultural needs, special circumstances, and preferences of members.

Access Standards

Minimum Number of Office Hours per Practice per Week

Practices are encouraged to have at least one weekend day or evening session per week included in the hours below.

Maximum Number of Patients Scheduled per Hour per Physician

Internal Office Waiting Time

• Patient's wait time should be less than 30 minutes from the time of the scheduled appointment.

Availability

• Coverage: 24 hours a day; seven days a week
• Covering physician must be a participating network provider.
• Providers who use answering machines for after-hour services are required to include:
  • Urgent/Emergent instructions (as the first point of instruction)
  • Information on contacting a covering provider
  • Telephone number for after-hours physician access

After-hours Phone Response

• Urgent/Emergency problems should be addressed within 30 minutes.

Patient No-show

• If a member does not keep a scheduled appointment (a no-show) it should be documented in his or her medical record.