Cox HealthPlans (CHP) is committed to ensuring that members have access to and receive primary care and behavioral health services in a timely manner. Standards are also in place for telephone access to member services. CHP monitors access through a variety of measures, including appointment and office wait times, complaints, and responses from our member satisfaction surveys.
Access and availability standards are shared with members and providers through Provider Manuals and Member Handbooks. CHP monitors access and availability performance and completes a thorough analysis to check for concerns or opportunities for improvement each year, taking action as needed to improve access to care.
CHP’s access standards and measures are outlined in the table below with results from the 2025 CAHPS, Marketplace CAHPS, and CAHPS-like surveys.
| Practitioner Type | Goal | Result |
| Medical Care | ||
| Regular and routine care | CAHPS-like survey Q5, QHP Enrollee Survey “getting needed care”: 75% of members reported that they “always” or “usually” get an appointment for a check-up or routine care at a doctor’s office or clinic as soon as they needed it.
Review of Member Complaints |
CAHPS: 83% of members reported that they “always” or “usually”
Marketplace CAHPS: 72.4% of members reported that they “always” or “usually”
CAHPS-like: 80.7% of members reported that they “always” or “usually”
No member complaints
|
| Routine, symptomatic care | CAHPS Q3, QHP Enrollee Survey “getting care quickly”: 75% of members reported they “always” or “usually” get an appointment for health care at a doctor’s office or clinic as soon as they needed it.
Review of Member Complaints |
CAHPS: 85% of members reported that they “always” or “usually”
Marketplace CAHPS: 75.6% of members reported that they “always” or “usually”
CAHPS-like: 78.7% of members reported that they “always” or “usually”
No member complaints |
| Urgent care | CAHPS Q3, QHP Enrollee Survey “getting care quickly”: 75% of members reported they “always” or “usually” get an appointment for health care at a doctor’s office or clinic as soon as they needed it.
Review of Member Complaints |
CAHPS: 85% of members reported that they “always” or “usually”
Marketplace CAHPS: 75.6% of members reported that they “always” or “usually”
CAHPS-like: 78.7% of members reported that they “always” or “usually”
No member complaints |
| Obstetrical care | Review of member complaints | No member complaints |
| After-hours care | 90% on after-hours call audit
Review of member complaints |
100% through walk-in clinics and through CoxHealth Virtual Visits, No member complaints |
| Behavioral Health | ||
| Routine care | Review of hours for behavioral health, review of member complaints | No member complaints |
| Screening / Triage | Review of member complaints | 100% through same day screening at Burrell Access Center, no member complaints |
| Urgent care | Review of hours for behavioral health and urgent care, review of member complaints | 100% through urgent care open 24/7, no member complaints |
| Non-life-threatening emergency care | Immediate ER Access, review of member complaints | 100% though any ED |
| Life-threatening emergency care | Immediate ER access | Yes, available through any ED |
| CHP Member Services | ||
| Telephone access to member services | Call answered within 60 seconds;
Call abandonment less than 5% |
Average calls answered within 11 seconds for MA
Abandonment Rate .74%
Average calls answered within 25 seconds for Marketplace. Abandonment Rate for Marketplace 0.40%.
Average calls answered within 23 seconds for Commercial. Abandonment Rate of 3.42% for Commercial |