Provider Access Standards
Sharp Community Medical Group (SCMG) is committed to ensure access to appropriate medical services within our network. Access to health care must be provided in a timely manner as identified by the situation. Basic health care services and specialized health care services will be readily accessible and available to each patient.
Normal Working Hours
Except in an emergency, physicians and patients are encouraged to make and keep appointments. Each physician office has a policy to see patients within 30 minutes of their scheduled appointments. Sharp Community Medical Group physicians maintain reasonable hours of operation and the provision of after-hours services.
Primary Care appointments should be made within the following time frames:
- Emergency: Immediate
- Urgent: Within 24 hours
- Routine Primary Care: Within seven calendar days
- Preventive Care: Within 30 calendar days (20 days for Senior members)
Specialty Care appointments that require Prior Authorization should be made within the following time frames:
- Routine Referrals: Reviewed within five business days
- Urgent Referrals: Reviewed within 72 hours
After-hours coverage (nights and weekends) may be accessed by calling your doctor's office. Their answering service will tell you what to do next. You may be directed to Urgent Care or an Emergency Room if your doctor finds it necessary. Also, consider doing a search on a health topic website, such as www.webmd.com.
If you believe you need emergency care, contact your primary care physician (PCP), who will determine what treatment is required.
If you believe a delay could seriously jeopardize your health, seek treatment first, then notify your PCP as soon as possible. Your PCP is responsible for follow-up and coordination of your care after the emergency has been resolved.
If you someone else's health is in immediate danger, call 911. The following includes some, but certainly not all of the symptoms and conditions that may mean someone needs emergency care:
- Difficulty breathing or shortness of breath
- Pain or discomfort in your chest
- Severe stomach ache, calf pain
- Fainting or sudden dizziness, weakness, or changes in vision
- Change in mental status, including confusion or difficulty awakening
- Sudden or severe pain anywhere in the body
- Bleeding that won't stop
- Severe vomiting, nausea
- Coughing up blood
Many people feel they will be embarrassed if they call 911 and they are not in fact having a
heart attack or stroke. But don't be embarrassed to death - heart attacks are the leading cause of death in both men and women. It's better to be safe than sorry.
If you call 911 from a cell phone, your call is directed to the 911 dispatch center for the California Highway Patrol (CHP). The CHP will forward your call to the appropriate agency. Be aware, when you call on your cell phone, the CHP cannot detect your location as with a residential or business 911 call. It's important to know your location when calling from a cell phone. Talk to your kids about using 911.
Insurance typically covers you for the care needed to stabilize your condition. Your PCP should be seen if more care is needed. Please notify your PCP within 48 hours of a visit to an emergency room or trauma center.
If you go to an emergency room without being directed there by your doctor, your condition will be evaluated to determine whether emergency care was required. If it is determined that emergency care was not required, you will be financially responsible for these services.
SCMG provides service locations that are accessible to and usable by physically handicapped persons in accordance with Section 504 of the Rehabilitation Act of 1973.
Mental Health, Alcohol and Drug Addiction
Outpatient mental health services are provided by Psychiatric Centers of San Diego 1-877-257-7273. Patients may call directly.