Appointments & Getting Care

At the Alliance, we are your partner in health. As your partner in health, we are here to help you stay healthy, active, and strong by helping you get the care you need. The first step to getting the care you need is selecting your Primary Care Provider (PCP) doctor and making an appointment to see them.

Primary Care Provider (PCP)

Your Primary Care Provider (PCP) is your personal doctor who is most familiar with you and your health history.

Your PCP will:

  • Give you all your routine care, including regular checkups, shots, treatment, prescriptions and medical advice
  • Keep your health records
  • Refer (send) you to specialists if needed
  • Order X-rays, mammograms or lab work if you need them

When you need routine care, you will call your PCP for an appointment.
Be sure to call your PCP before you get medical care, unless it is an emergency.

For an emergency, call 911 or go to the nearest emergency room.

Appointments

When you need health care:

  • Call your PCP
  • Have your Alliance member ID number ready on the call
  • Leave a message with your name and phone number if the office is closed
  • Take your BIC and Alliance member ID card to your appointment
  • Be on time for your appointment
  • Call right away if you cannot keep your appointment or will be late
  • Have your questions and medication information ready in case you need them

If you have an emergency, call 911 or go to the nearest emergency room.

How Long Should I Wait For My Appointment?

Your health is our top priority. We want to make sure you can get care when you need it. Here’s what to expect when you request an appointment.

Please remember to call your doctor’s office if you can’t make it to your appointment.

If you are having trouble making an appointment or if you have questions, please call:

 

Other Services

  • Nurse Advice Line: You may also call the Alliance Nurse Advice Line 24 hours a day, 7 days a week.
  • ​Help Getting to Your Appointment: We work with a transportation vendor to help those who need a ride get to and from the doctor’s office.
  • Member Services: For help with any of these services, or to find an urgent care clinic close to you, please call:

Routine Care

Appointment Type: Checkup or follow-up

Appointment offered within: 10 business days or less

Urgent Care

Appointment Type: For conditions that need attention quickly but are not life-threatening

Appointment offered within: 96 hours or less

Emergency Care

Appointment Type: For life-threatening conditions that need care right away

Appointment offered within: Immediate, 24 hours a day, 7 days a week

First Prenatal Visit

Appointment Type: Checkup for pregnant women (You don’t need a referral)

Appointment offered within: 2 weeks of request

Routine Specialty Care

Appointment Type: When your Primary Care Provider (PCP) doctor wants you to see an expert in one part of the body, or a particular type of illness, (called a Specialist). Your PCP must ask the Alliance for approval before you see a specialist (this is called a referral)

Appointment offered within: 15 business days or less

Non-Urgent Behavioral Health

Prior authorization (approval) is not required for routine outpatient behavioral health care services.

Appointment offered within: 10 Business Days of Request

Do You Need Help Finding Primary Care Provider (PCP) Doctor, or a Specialty Care Doctor, Closest to Where You Live?

The Alliance works to ensure timely access to care for all of our members. In certain parts of Alameda County, members may need assistance in locating the nearest provider for certain services.

We are here to help. Please call:

Timely Access Standards

The California Department of Healthcare Services (DHCS) has standards that the Alliance has to meet for members to see providers within a certain amount of time and distance from the member’s home.

If the Alliance does not have a provider in your zip code who meets the time and distance standards listed in the table below, we will help you find a provider who meets the Medi-Cal approved alternative access standards.

 

Appointment Travel Time and Distance Standards

 Provider Type

 Time and Distance from Member’s Residence
Primary Care (Adult and Pediatric) 30 minutes and 10 miles
Specialty Care (Adult and Pediatric) 30 minutes and 15 miles
OB/GYN Specialty Care 30 minutes and 15 miles
Hospitals 30 minutes and 15 miles
Pharmacy 30 minutes and 10 miles
Mental and Behavioral Health (non-psychiatry)

Outpatient Services (Adult and Pediatric)

 30 minutes and 15 miles
Long Term Services and Supports (LTSS) Time and distance standards are not established for Multipurpose Senior Services Program (MSSP), Skilled Nursing Facilities (SNF), or Intermediate Care Facilities (ICF) providers as these providers either travel to the member to provide services or the member resides at the facility for care.
Ancillary Services Not Applicable

 

Table 2: Adult and Pediatric Core Specialists
Cardiology/Interventional Cardiology Nephrology
Dermatology Neurology
Endocrinology Oncology
ENT/Otolaryngology Ophthalmology
Gastroenterology Orthopedic Surgery
General Surgery Physical Medicine and Rehabilitation
Hematology Psychiatry
HIV/AIDS Specialists/Infectious Diseases Pulmonology

 

Alternative Access Standards

 
County Zip Code Approved Provider Type Population Served (Adult, Pediatric, or Both) Approved Max Time (Minutes) Approved Max Distance (Miles)
Alameda 94550 ENT/Otolaryngology Pediatric 80 50
Alameda 94550 Hematology Pediatric 120 50
Alameda 94550 HIV/AIDS Specialists/Infectious Diseases Pediatric 115 65
Alameda 94550 Oncology Pediatric 120 50

 

If your zip code and provider type are listed, the Alliance must help you find an appointment. You have a right to call the Alliance Member Services Department to get help with finding an appointment with a specialist who is closer to where you live. If the Alliance cannot find you an appointment with a closer specialist, we will arrange transportation to see the specialist.

We are here to help. Please call:

 

Language Services

The Alliance offers interpreter services in your language at no cost to Alliance members, 24 hours a day, 7 days a week.

We will make sure you get services and member materials that you understand. Our staff can help you find a doctor who speaks your language or make sure you have an interpreter when you need one.

To learn more, please click here.