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Residency clinics should give patients the option to choose a care team that is under the direction of a staff or supervising physician. The personal clinician would not be a resident because the resident will no longer be associated with the clinic when their residency ends.
The intent of AC 01 is to assess the access needs and preferences of the practice’s patient population. To identify the best way to obtain this information, practices may need to review how they are currently collecting patient feedback on access needs. For example, a patient survey may ask patients if they are able to get an appointment when needed; however, that question doesn't tell you when patients want to access the practice. The practice may be offering access when the majority of patients don't or aren't able to utilize it.
Practices should collect and assess the feedback from patients to see if there's a need to adjust the access provided to patients. Some questions to consider include:
Yes. The requirement is met if the response time is documented when a patient submits an electronic request for clinical advice and the practice communicates to patients that an on-call provider is available to address urgent issues by telephone after hours. Practices must have a documented process for addressing electronic advice and telephone advice; for this criterion, practices may submit a report tracking response times to electronic requests for at least seven days during operating hours and after hours.
No. AC 03 requires practices to offer appointments outside regular business hours for both routine and urgent care. Using the ED for after-hours care does not meet the requirement since patients cannot schedule and access routine appointments at the ED.
Yes. NCQA accepts telepsychiatry visits as an alternative clinical encounter if the behavioral healthcare practitioner is at least partially integrated with the practice site (i.e., sharing at least partial access to the same systems and patient records).
Yes. Practices may use nonphysician members of the clinical care team, such as nurse practitioners or physician assistants (PA) who have their own panel of patients, for same-day appointments. There is no requirement for all clinicians to have same-day appointment slots available every day.
Practices are expected to show both availability (i.e., open appointment slots at the beginning of the day) and use of same-day appointments for a period of five consecutive days. Practices should also monitor the availability of same-day appointments against their documented process. Practices may use utilization of same-day appointment access as an indication of patient need.
“Alternative clinical encounters” are scheduled clinical encounters between patient and clinician in lieu of a traditional, one-on-one, in-person office visit; for example:
No. Walk-in appointments are different from scheduled same-day appointments. Same-day appointments offer patients the opportunity to schedule a routine or urgent visit at a specific time to enable more patient-centered and convenient access; this prevents the need to wait for the next available clinician at the clinic.
