New vendor administering behavioral health access survey

The annual behavioral health access studies will see a change in 2024 as a new vendor, Center for the Study of Services (CSS) in Washington, D.C., will be performing the office level survey and making calls during the first through third quarters. The survey will be conducted in the same manner as in the past and your cooperation is expected and appreciated. The purpose is to assess adequate appointment wait times for our members with an urgent condition or for routine services.

Consequently, we ask that you update office information using the PDM application on Availity Essentials or follow processes if assigned to Carelon Behavioral Health, Inc., and that you participate in quality programs, such as this critical survey, as a condition of your contract. The main challenges the vendor encounters are incorrect or non-working phone numbers; practitioner moved, retired, or is deceased; the practice has left their Anthem Blue Cross and Blue Shield (Anthem) contract, accepts private pay only, or is no longer in practice; and staff refusing to participate in the survey. Please take time to update information for each practitioner associated with the practice phone number(s), past or present.

Your contract compels access for all covered individuals to obtain timely needed appointments. The leading timeframes are below. See your Anthem Provider Manual for details. And don’t forget your compliant after-hours emergency or urgent messaging 24/7, by a recording or a live person, instructing the caller/patient to hang up and call 911 or 24-hour crisis services, or go to urgent care or ER; or directly connecting with practitioner or on-call practitioner.

Missouri behavioral healthcare appointment access

We are committed to helping patients more easily access the care they need.