Included below is an explanation of the data you are viewing when you select a provider from our Find-A-Provider feature.
We update our Find-A-Provider database on a regular basis. The left side of the page includes the detailed information on the selected provider; you will see when our database was last updated. Our providers are recredentialed every three years. During this process, all of their demographic information (name and gender), practice information, education, and malpractice information are verified.
Providers are responsible for telling us in a timely manner about changes to their address or phone number, new patient restrictions, age limitations, hospital privileges, and any additional languages that are spoken by the provider. To keep our data as updated as possible, on a quarterly basis, the provider receives the demographic information MedStar Family Choice has on file and if the information is out of date, the provider is asked to send in updated information as quickly as possible. We process changes within two weeks of receiving complete and updated information from our providers.
Specialty: The specialty is the area of medicine in which the provider practices. Examples of specialty include pediatrics, gastroenterology, and OB/GYN. The provider includes his/her specialty on the application. The MFC credentialing process includes calling all of the schools and hospitals where the provider has been trained to make sure that the provider has enough training in this area of medicine before allowing the provider to join the network. Specialty information is reviewed every three years during the recredentialing process. In addition, on a quarterly basis, the provider receives information MedStar Family Choice has on file and the provider is asked to send in any updated information. Before changes to a specialty are made, additional documentation regarding the training the provider has received would need to be received and validated.
Accepting New Patients: The provider includes on his/her application whether or not he or she is currently accepting new patients. This information is also collected during the recredentialing process every three years. If there are changes, the provider must inform us of these changes before they stop taking new patients.
Handicap Accessible: The provider includes on his/her application whether or not the office is accessible for individuals with disabilities. In addition to this, our provider relations staff performs a site audit on the office during initial credentialing and any time the office moves to ensure that the offices meets the American Disabilities Act standards. In addition, on a quarterly basis, the provider receives information MedStar Family Choice has on record and the provider is asked to send in any updated information. During this site audit process, the office location is reviewed for accessible parking and entryways as well as elevators. We also look for accessible hallways, restrooms, and handrails. If an office is not accessible, this will be noted as “No” under Handicap Accessible. In addition, there will be field called “Office Limitations” that provides the reason the office is not accessible. Some examples of not being an accessible location would include the following: no accessible parking, no handrails, no accessible restroom, or no accessible entryway or hallway.
Group Name: The group name is the name of the practice to which the provider belongs. This information is given to us by the provider when he/she joins our network. We rely on the provider to send us updates to any changes in the name of the group; however, it is also verified during the recredentialing process, which occurs every three years.
Address and Hours: The address, phone number, fax number, and hours of operation are included on the provider's application. This information is also verified during the recredentialing process, which occurs every three years. If there are changes made to the practice location or hours of operation, it is the provider's responsibility to tell us as quickly as possible. However, on a quarterly basis, the provider receives information MedStar Family Choice has on file and the provider is asked to send in any updated information.
Medical School and Residency: The medical school and residency are reported by the provider during the credentialing process. However, this information is validated through our credentialing process to ensure all training and education is accurate. We contract with an outside organization that specializes in verifying all of this information.
Board Certification: The Board Certification will tell you if the provider has additional training or expertise in a certain area of specialty. You can obtain additional and updated information regarding a provider's Board Certification by going directly to the American Board of Medical Specialties at www.ABMS.org. Or you may call 1-866-ASK-ABMS (275-2267). This information is also verified during the recredentialing process every three years.
Hospital Accreditation: For hospitals, there will be information regarding the status of the hospital accreditation. There are specific organizations that credential hospitals. The status of the hospital's accreditation and the accrediting body can be found on the website. We obtain copies of the hospital's accreditation certificate to validate the status. Hospitals are recredentialed every three years.
Hospital Affiliation: The hospital affiliations section lets you know what participating hospitals the provider is credentialed to use. The provider must apply to a hospital that he/she wishes to send his patients to. The hospital also credentials the providers to ensure that the providers are properly trained. The hospital privileges are reported to us by the provider when he/she joins our network and he/she is responsible for sending us changes. Hospital privileges are verified through the recredentialing process every three years.
Hospital Quality Data: You can view data on hospital quality data by going to the following Quality Check® site, http://www.qualitycheck.org/consumer/searchQCR.aspx. This data is provided by The Joint Commission, an independent organization that performs quality reviews of healthcare organizations.
Languages: We have also included other languages that are spoken by our doctors. This information is provided to us on the credentialing application and is verified again during the recredentialing process, which occurs every three years. The provider is responsible for telling us any changes regarding the languages he/she speaks. In addition, on a quarterly basis, the provider receives information MedStar Family Choice has on record and the provider is asked to send in any updated information.
Information current as of: