Provider Information Validation
How Often Is the Provider Directory Updated?
Every 90 days
- Practitioner Name
- Office Location and Phone Number
- Specialty
- Hospital Name
- Hospital Location and Phone Number
Every 6 months
- Hospital Safety Score
Every 3 years
- Medical Group Affiliations
- Gender
- Languages Spoken
- Hospital Affiliations
- Board Certification
- Accepting New Patients?
- Hospital Accreditation
| Item | Description | Source | Frequency of Validation | Limitations (If Any) |
|---|---|---|---|---|
| Practitioner Name | The name of the physician. | Practitioner | Every 90 days upon notification from Practitioner when changing a name. | None |
| Office Location and Phone Number | The street address and phone number of the practitioner's office. | Practitioner | Every 90 days upon notification from Practitioner when changing a location. | None |
| Medical Group Affiliations | The organizations, companies or medical groups the practitioner is employed by or associated with. An organization or group may have more than one care site. | Practitioner | Every 3 years upon notification from Practitioner when adding or changing a medical group affiliation. | None |
| Specialty | The type of care or conditions a practitioner specializes in, such as family medicine, pediatrics, cardiology, or dermatology. | Practitioner | Every 90 days upon notification from Practitioner when adding or changing a specialty. | None |
| Gender | The gender of the physician. | Practitioner | Every 3 years upon notification from Practitioner when updating information. | None |
| Languages Spoken | Languages, in addition to English, spoken by the practitioner and/or staff. | Practitioner | Every 3 years upon notification from Provider when adding or changing practice language information. | None |
| Hospital Affiliations | The hospitals where a practitioner is allowed to admit and care for patients. | Practitioner | Every 3 years upon notification from Practitioner when adding or changing a hospital affiliation. | None |
| Board Certification | Board certification involves rigorous testing by a recognized board of the American Board of Medical Specialties and is not required by most states. To verify a provider's board certification and status, visit the American Board of Medical Specialties. | ABMS or AOA | Every 3 years upon notification from Provider when renewing, adding or changing a board certification. | None |
| Accepting New Patients? | Indicates whether a primary care practitioner or personal physician is accepting new patients. A practitioner may have a full patient roster and cannot accept any new patients at this time. | Practitioner | Every 3 years upon notification from Provider when adding or changing practice information. | None |
| Hospital Name | The name of the hospital. | Provider |
Every 90 days upon notification from Provider when updating information. | None |
| Hospital Location and Phone Number | The street address and phone number of the hospital. | Provider |
Every 90 days upon notification from Provider when updating information. | None |
| Hospital Accreditation | An independent accreditation organization has recognized a hospital as meeting predetermined standards for quality of care and service. Two examples are the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) and National Integrated Accreditation for Healthcare Organizations (NIAHO). | Blue Cross and Blue Shield Association | Every 3 years upon notification from Provider when recertifying, adding or changing an accreditation. | None |
| Hospital Safety Score | The Hospital Safety Score is a public service provided by The Leapfrog Group, an independent nonprofit organization committed to driving quality, safety, and transparency in the U.S. health system. | The Leapfrog Group | Twice per year, upon reporting from The Leapfrog Group. | None |