Section Ins 2701.09 - Standards for Waiting Times for Appointments and Access to After-Hours Care(a) Standard waiting times for appointments shall be measured from the initial request for an appointment.(b) For behavioral health services, the carrier shall ensure that covered persons may obtain an initial appointment with an in-network provider within: (1) Six hours for a non-life-threatening emergency;(2) Forty-eight hours for urgent care; and(3) Ten business days for an initial or evaluation visit.(c) For primary care provider services, the carrier shall ensure that covered persons may obtain an initial appointment with an in-network provider within: (1) Forty-eight hours for urgent care; and(2) Thirty days for other routine care, including an initial or evaluation visit.(d) For substance use disorder services for which prior authorization requirements are governed by RSA 420-J:17, health carriers shall comply with the requirements of that section.(e) For services not governed by RSA 420-J:17, health carriers shall ensure that all covered persons have access to a utilization reviewer to make prior approval or pre-authorization decisions if required under the terms of the coverage.N.H. Admin. Code § Ins 2701.09
#9722, eff 8-1-10 (from Ins 2701.07 )
Amended by Volume XXXVIII Number 28, Filed July 12, 2018, Proposed by #12565, Effective 8/1/2018, Expires 8/1/2028.