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Ambetter Health Providers: Get Ready for the Q1 Appointment Wait Time Audit

Date: 03/18/26

Ambetter Health reminds providers that it’s time for the Quarter 1 2026 Appointment Wait Time Audit.

Providers are required to adhere to the Ambetter Health Provider Standards for Appointment Scheduling for medical and behavioral health services both during and after office hours. This applies to in-person and telehealth visits.

Ambetter Health tracks provider compliance by using secret shoppers to book appointments. The Centers for Medicare & Medicaid Services (CMS) also monitors provider compliance.

We wants to work with your practice to ensure medical and behavioral health services are available to our members, your patients, on a timely basis.

Take these steps to ensure your practice complies with the appointment standards:

  • Post Them: Download and print the Sunshine Health Provider Standards for Appointment Scheduling (PDF) and post it near your front desk.
  • Learn Them: Make sure your staff is familiar with the appointment standards so they can adhere to them when scheduling appointments for our members.
  • Troubleshoot Them: Proactively address any changes in staffing or workflow at your practice before they can impact patient scheduling.

If you have questions, contact your Provider Engagement Account Manager (PEAM).

Your continued partnership has a direct impact on the health, trust, and experience of our members. Thank you for your dedication to their wellbeing.

Standards for Appointment Scheduling

The appointment standards are available online:

Questions?

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