Ambetter Provider Standards for Appointment Scheduling
Ambetter from Sunshine Health (Marketplace) wants to ensure appointments for medical and behavioral health services are available to all our members on a timely basis. The following Appointment Availability standards can also be found in the Provider Manual. Please ensure these standards are implemented by your organization.
All Providers (from 5 p.m. to 8 a.m. and all weekends and holidays).
- 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.
30 minutes maximum
- Urgent Visit: 24 hours
- Pediatric Sick Visit: 24 hours
- Adult Sick Visit: 48 hours
- Routine Visit: 30 business days
- Routine Visit: 30 business days
- Non-life-threatening emergency: 6 hours
- Urgent Visit: 48 hours
Resources & Tips
- Call: 1-877-687-1169
- TTY: 1-800-955-8770
Non-urgent sign language and language interpreter services.
- Call Provider Services: 1-877-687-1169
- Visit Manuals, Forms and Resources
- Download the Provider Interpreter Request Form (PDF)
- Email completed form to: InterpreterRequests@centene.com
Confidential, free, 24/7/365 support from a trained counselor for mental health, substance use or suicidal crisis.
- Call or text: 988
- Chat: 988 Lifeline Chat and Text connects you with caring crisis counselors for emotional support.
Telehealth Offerings
Virtual mental health services; must be 13 years of age and up.
- Call or Text: 1-305-902-6347
- Email: referral@bebravehealth.com
- Visit: BraveHealth website
- Available to Ambetter members
Virtual healthcare; available to all ages.
- Call: 1-800-835-2362
- Visit: Teladoc
- Available to Ambetter members