1. Auditing Provider Offices
SPH measures access to care by directly contacting providers’ offices during regular operating hours. Professional phone agents contact the provider’s office to determine appointment availability for several appointment types based on the client’s provider access standards.
In addition, a separate audit is conducted by contacting provider offices after operating hours. This audit evaluates after-hours protocol and captures information about the initial phone response (e.g., live person, recording or auto-attendant) and whether it includes information on how to contact a physician or what to do in an emergency situation.
SPH provides in-depth reporting and optional provider- or office-level report cards, so health plans can follow up with providers who are not meeting standards and provider offices can make needed adjustments.