Skip to Main Content
Stay Connected on the Go! Download our Health Insurance Portal mobile app to search for care, view benefits and access your Member ID card. LEARN MORE AND DOWNLOAD THE APP
Stay Connected on the Go! Download our Health Insurance Portal mobile app to search for care, view benefits and access your Member ID card. LEARN MORE AND DOWNLOAD THE APP

Are You Following Ambetter Health’s Appointment Standards?

Date: 10/10/25

Do you know how long it should take for your practice to schedule a routine visit for a patient? What if it’s an emergency?

Ambetter Health reminds providers that they must adhere to the health plan’s standards for scheduling appointments with their patients, our members.

There are also standards for answering patients’ calls; different standards for primary care physicians (PCPs), obstetrician-gynecologists (OBGYNs), specialists and behavioral health providers; and specific time frames for everything from sick visits to after-hours calls to emergencies.

To review those standards, visit and bookmark Ambetter Health Provider Standards for Appointment Scheduling.

Providers can also use telehealth resources to help them meet appointment standards. Visit the Sunshine Health Telehealth Guide & Best Practices resource to learn more about these services and how they can help your patients.

You can also review the Ambetter Health appointment standards here:

Ambetter Health Provider Standards for Appointment Scheduling

  • After Hours Availability
    • All Providers (from 5 p.m. to 8 a.m. and all weekends and holidays).
  • After Hours Passing Standards
    • Answering service or system that can contact a physician. Member should receive a response within 30 minutes.
    • Advice nurse with access to physician.
    • Office telephone that transfers calls to a cell phone; or any method that ensures 24-hour phone access for members.
  • Provider Office Wait Times
    • 30 minutes maximum
  • Primary Care Physician (PCP)
    • Urgent Visit: 24 hours
    • Pediatric Sick Visit: 24 hours
    • Adult Sick Visit: 48 hours
    • Routine Visit: 15 business days
  • Obstetrician-Gynecologist (OBGYN)
    • Urgent Care: 24 hours
    • Routine: Within 30 business days
  • Specialist (includes Ancillary Providers)
    • Routine Visit: 30 business days
  • Behavioral Health (BH)
    • Non-life-threatening emergency: 6 hours
    •  Urgent Visit: 48 hours
    • Routine Visit: 10 business days

Questions

Ambetter Health has a wealth of resources available to help answer your questions and address your concerns:

AMB_10827