Item |
Description |
Source |
Frequency of Validation |
Limitations |
Practitioner Name |
|
Credentialing application and NYS License Registration certificate. |
At initial credentialing |
|
Gender |
|
Credentialing application |
Self-reported |
|
Specialty |
The medical specialty or sub-specialty area in which the practitioner provides care. |
Credentialing application and practitioner data change forms and surveys. |
Appropriate training is verified by Independent Health with the specialty boards established by the ABMS and AOA. If the practitioner is not board certified, training is verified by the institution where the training occurred or through the AMA physician master file.
This occurs at credentialing and re-credentialing and when a change in specialties is requested by the practitioner.
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Hospital Affiliations |
The hospital(s) where practitioner has admitting privileges. |
Credentialing and re-credentialing application and practitioner data change notifications. |
Self-reported and verified at initial credentialing and re-credentialing. |
Dependent on notification from the practitioner. |
Medical Group Affiliations |
The medical group(s) the practitioner is employed by or otherwise associated with. |
Credentialing application, practitioner data change notifications. |
At initial credentialing, re-credentialing and at other times when we are notified a practitioner has changed medical group affiliations. |
Dependent on notification from the practitioner. |
Acceptance of New Patients |
Applies to primary care physicians (PCP's) and specialists only. Indicates if the practitioner is accepting new patients in his/her practice. |
Credentialing application, practitioner data change notifications and surveys. |
Self-reported by the physician on the application form at credentialing and verified with the office quarterly. |
Dependent on notification from the practitioner. |
Languages Spoken by the Practitioner or Clinical Staff |
The languages (besides English) the practitioner speaks with sufficient fluency to treat patients who speak only that language. |
Credentialing and re-credentialing application and practitioner surveys. |
Self-reported |
Dependent on notification from the practitioner. |
Office Locations |
The location of all offices the practitioner works. |
Credentialing and re-credentialing application, practitioner data change notifications and surveys. |
At initial credentialing, re-credentialing and at other times when we are notified a practitioner has changed office locations. |
Dependent on practitioner notification. |
Hospital Name |
Marketing name of the hospital |
Contract upon initial association with Independent Health and verified with the state operating certificate..Changes after initial contracting are submitted by the hospital via written notification. |
At initial contracting and at other times when we are notified a hospital’s name changes. |
Dependent on notification from the hospital. |
Address |
Street address of the hospital. |
Contract upon initial association with Independent Health. Changes after initial contracting are submitted by the hospital via written notification. |
At initial contracting and at other times when we are notified a hospital’s address is changing. |
Dependent on notification from hospital. |
Accreditation |
Accreditation is a voluntary process through which a hospital is able to measure the quality of its services against nationally recognized standards. |
Upon initial credentialing with Independent Health, credentialing staff requests information regarding the current status of the hospital’s accreditation. A copy of the most recent accreditation certificate is obtained from The Accreditation organization. |
At initial credentialing and every three years, thereafter, Independent Health confirms the hospital continues to be in good standing with the accrediting body. |
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Board Certification |
Board Certification is awarded to a physician who has satisfied the requirements and standards of a nationally recognized specialty board. |
Independent Health verifies Board Certification through CertiFACTS, an official ABMS agent or through the American Osteopathic Association if applicable at initial credentialing. |
At initial credentialing, quarterly and every 3 years at recredentialing. |
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