Professional Explanation of Terms

Accepting new patients

The term accepting new patients determines whether a group or physician is accepting new patients into their practice. Assessment as to whether the physician or group is accepting new patients is done by provider relations consultants, annually or when information changes as reported by the physician or group. Accepting new patient information is self-reported.

Board certification

A board certified practitioner is one who has satisfied examination of testing requirements beyond the standard medical license and indicates a physician’s expertise in and commitment to a particular medical specialty and/or subspecialty of medical practice. Board certification is reviewed at the time of initial credentialing and every three years after that. Board certification is also reviewed at the time of the expiration date. If no expiration date is noted, the board certified physician has a lifetime certification.

Medical Doctor (MD) board certification

Learn more about board certification for MDs by visiting the American Board of Medical Specialties or by calling 866.275.2267.

  • Enter doctor's information (first name, last name, state, and specialty)
  • Click Search
  • Information about the doctor will display

Doctor of Osteopathic Medicine (DO) board certification

Learn more about board certification for DOs at American Osteopathic Association.

  • At the top of the page, click "For Patients".
  • Search for DO by city and state, and click Go.
  • Click on the Name tab to search by name.
  • Information about the doctor will display.

Hospital affiliation

Hospital affiliation indicates the network hospital(s) that a practitioner has admitting privileges. Affiliations are not noted for hospitals not participating in our network. Hospital affiliations are reviewed at the time of initial credentialing and every three years after that. Primary hospital affiliations are primary source verified with the hospital. Additional hospital affiliations are self-reported.

Language

Language spoken indicates all languages, in addition to English and including sign language, that a practitioner has stated he or she is fluent. Language spoken by the practitioner is reviewed at the time of initial credentialing and every three years after that. Languages spoken are not assessed between recredentialing cycles, but are updated if new information is reported by the practice. Language spoken by the practitioner is self-reported.

Name and gender

Name and gender are reported at the time of initial credentialing and every three years after that. Name and gender are self-reported.

Office locations and telephone numbers

This is the address and phone number(s) for the location or locations where the physician sees patients. Office location(s) and telephone number(s) are reviewed at the time of initial credentialing and every three years after that. Office location(s) and telephone number(s) are self-reported.

Practice/medical group

Medical group affiliation specifies the name of the medical group(s) that a provider is affiliated. Affiliations are not assessed between recredentialing, but are updated if new information is reported by the practice. A provider may be affiliated with more than one medical group. Medical group affiliations are reviewed at the time of initial credentialing and every three years after that. Medical group affiliations are self-reported.

Specialty

A physician specialty is any specific branch of medicine that a physician may concentrate. Specialty is reviewed at the time of initial credentialing and every three years with recredentialing. This information is not assessed between recredentialing cycles, but is updated if reported by the specialist. It is verified by primary source verification from the residency or fellowship training and/or primary source verification of board certification of specialty.