Submit the filled-out form by ensuring it is appropriately customized with relevant doctor and contact information. Email the form to the designated recipient or upload it through the online submission portal if available. You may also fax the completed form to the provided fax number or mail it to the specified physical address following the submission guidelines.

The purpose of this form is to provide physicians and medical groups with sample scripts for ensuring Medi-Cal patients have timely access to medical care after business hours. Effective after-hours telephone service is critical in directing patients to appropriate emergency resources or connecting them with on-call physicians. This form includes instructions and templates for handling calls answered by a live voice or an answering machine.

• 1. Live Voice Script: Template script for handling calls answered by a live voice, including emergency instructions and options for connecting with an on-call physician.
• 2. Answering Machine Script: Template script for handling calls answered by an answering machine, including emergency instructions and options for reaching an on-call physician or urgent care center.

Failure to submit this form can result in patients not receiving timely medical care after business hours. It may also lead to non-compliance with Medi-Cal regulations.

• Patient Risk: Patients may not receive appropriate emergency instructions or timely connection to on-call physicians.
• Non-Compliance: Non-submission may result in non-compliance with Medi-Cal regulations, which could have legal and financial implications.

• 1. After-Hours Calls: Use this form to handle after-hours calls effectively and ensure patients receive appropriate instructions.
• 2. Emergency Situations: Use this form to provide clear emergency instructions to patients after business hours.
• 3. On-Call Physician Connection: Use this form to facilitate timely connection between patients and on-call physicians.