Clinician Rights & Responsibilities
- You should expect to be treated with courtesy and fairness.
- You should expect to be rewarded on the basis of merit and skill.
- You should expect to receive fair and reasonable fees for your work, and receive them promptly.
- You should expect your paperwork and telephone calls to be kept to a minimum.
- You should expect to receive clear and understandable communications from you third party administrator.
- You should expect to have a source of consultation and referral for your patients who need this.
- You should expect any system of which you are a part to hear and welcome your suggestions.
- You should expect change if change will solve a problem rather than create a new one.
BHCP's Accessibility Standards:
BHCP providers should direct members to the ER for emergent care needs.
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Accessibility Standard
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Performance Goal
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Average speed of telephone answer.
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30 seconds or less.
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Telephone call abandonment rate.
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5% or less.
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Percentage of telephone calls handles within 30 seconds.
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85%
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Appointment offered with non- life threatening emergency care needs
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99% within 6 hours
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Prescriber behavioral health urgent appointments
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60% of offices report a first available urgent appointment is open for a patient within 48 hours of patient request
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Prescriber behavioral health new patient routine appointments
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60% of offices report a third available routine appointment is open for a new patient within 10 business days of patient request
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Prescriber behavioral health established patient routine follow-up appointments
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60% of offices report a third available routine appointment is open for a established patient within 60 days of patient request
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Non prescriber behavioral health urgent appointments
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85% of offices report a first available urgent appointment is open for a patient within 48 hours of patient request
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Non prescriber behavioral health new patient routine appointments
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85% of offices report a third available routine appointment is open for a new patient within 10 business days of patient request
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Non prescriber behavioral health established patient routine follow-up appointments
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85% of offices report a third available routine appointment is open for a established patient within 60 days of patient request
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Grievances:
As a network BHCP provider, should you become aware of a member concern or complaint that cannot be resolved quickly or satisfactorily, or which involves a health plan, you will advise the member that a formal grievance may be filed by calling the applicable member services or grievances contact number for the relevant health plan.
Serious Reportable Event:
Immediately upon becoming aware of a Sentinel or SeriousReportable Event, as a BHCP network provider you will notify the relevant health plan of the event by contacting such plan’s risk management department (or other department as instructed by such health plan). Sentinel Events are those events defined by The Joint Commission as Sentinel Events. Serious Reportable Events are those events defined by the National Quality Forum as Serious Reportable Events.