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(b) Transitional healthcare services by a home ca.re nurse, a home sare mental health professional or other behavioral health professional shall be available within seven oalendar days of discharge from inpatient or institutional care for physical or behavioral health carq if ordered by the Covered Person's PCP or as part ofthe discharge plan; (c) Non-symptomatic (i.e., preventive care) office visits shall be available from the Covered Person's PCP or another provider within 30 calendar days. A non-symptomatic visit may include, but is not limited to, welVpreventive care such as physical examinations, annual glmecological examinations, or child and adult immunizations. (d) Non-rrgerrt, symptomatic (i.e., routine care) office visits, shall be available from the Covered Person's PCP or another provider within 10 calendar days, including behavioral health services from a behavioral health provider. A non-urgent, symptomatic visit is associated with the presentation of medical signs not requiring immediate attention. (e) Urgent, symptomatic office visits shall be available from the Covered Person's primary care, behavioral health or another provider within 24 hours. An r.rgent symptomatic visit is associated with the presentation of medical or behavioral health signs tlat require immediate attention, but are not emergent. (f) Emergency medical oare shall be available 24 hours per day, 7 days per week; and (g) Seeond opinion appointments dqscribed in Subsection 16.2.I of the State Conhact must occur within 30 calendar days of the request, unless the Covered Person requests a postponement of the second opinion to a date later than 30 calendar days. Flealth Plan shall monitor Provider's conrpliance with this section. In the event Provider fails to comply with the applicable appointment wait time standards set forth in this section" Provider shall comply with Health Plan's procedures for corrective action. Nothing in this section prohibits Provider from conducting assessments in altemate settings, such as the Covered Person's home or within an institutional setting. [Source: $ 6.9 of ths 2022 Apple Health IMC Agreementl 3.21. 24/7 AvailabiliV. To the extent applicable, Provider shall make the following services available 24 hours per day, 7 days per week, 365 clays a year by a toll-free telephone number: (a) Medical and behavioral health advice for Covered Persons from licensed health care professionals; (b) Triage conoerning the emergent, urgent or routine nature of medical and behavioral health conditions by licensed health care professionals; and (c) The toll-free lino staff must be able to make a wann handoff to the regional crisis line. 3.22, Health Information Systems. Provider shall maintain a health information system that complies with the requirements of 42 C,F.R. 5438,242 and provides the infonrration necessary to meet Flealth Plan's obligations under the State Contract, Provider shall: (a) Collect, analyze, integrate, and report data. The system must provide infornation on areas that include but are not limited to utilizationn grievance and appeals, and terminations of ernollment for other than loss of Medicaicl eligibilify; and (b) Ensure clata provided to l-Iealth Plan is accurate and complete by: (a) verifying the accuracy and timeliness of reported data; (b) screening the data for completeness, logic, and consistency; and (c) collecting ssrvice information on standardizod formal;s to the extent feasible and appropriate, PPA WA - Kittitas County Public llealth - A5.Q7 .2025 - ICMProviderAgreernent_360268 Page 5 of 12