Provider Validation

Provider Validation – sources of information in the directory, how frequently the information is validated and limitations of the information.


Helpful Descriptions:  


Specialty
A “specialty” is an area of medicine that a doctor practices in. This means the doctor gets more training in this area. This usually happens after a doctor graduates from medical school. Your primary care doctor will help you find a specialist when you need one. Providers tell us about their specialty when they join MDwise. We check this information with the American Board of Medical Specialties (ABMS). We also check with the school in which the provider got the specialty training. The information is checked every 3 years. This information is also updated if the doctor tells us about changes. You may not see changes that happen in-between the 3-year cycles. This can happen if the doctor did not tell MDwise about the change.

Hospital Affiliations
This is the hospital(s) where a doctor can admit patients when they need care. Doctors provide MDwise with this information when they join MDwise. We check this information every 3 years. You may not see changes that happen in-between the 3-year cycles. This can happen if the doctor did not tell MDwise about the change.

Medical Group Affiliations
Doctors may belong to a group that has more than one doctor. It is called a medical group. Doctors tell us this information when they join MDwise. Every 3 years, we ask the doctor about their medical group connection. We then update this information. This information is also updated if the medical group or doctor lets us know about changes. You may not see changes that happen in-between the 3-year checks. This can happen if the doctor did not tell MDwise about the change.

Board Certification
Board certification means that a doctor has completed training in an area of medicine. They have also passed national exams and other things that they need for certification. Doctors give MDwise this information when they join MDwise. MDwise then checks this information every 3 years. We check with the American Board of Medical Specialties (ABMS) or the American Osteopathic Association. You may not see changes that happen in-between the 3-year checks. This can happen if the doctor did not tell MDwise about the change. You can find the most up-to-date board certification information about a doctor at http://www.abms.org. Check on the “Is Your Doctor Certified?” link.

Accepting New Patients
Some doctors may not be able to see new patients in their practice. You may have to already be a patient to get an appointment. Doctors tell us if they are taking new patients when they join MDwise. We update the Provider Directory when the doctor gives us new information. Changes to this information may not be up-to-date. This could happen if the doctor does not tell MDwise about the change.

Practitioner Office Location
This is the place where the doctor sees patients. The street address and phone number are listed. Doctors tell MDwise about their office locations when they join MDwise. We change this information when the doctor moves or changes their phone number or office hours. MDwise updates this information every 3 years. Changes to this information may not be up-to-date. This could happen if the doctor does not tell MDwise about the change.

Name, Gender, Languages spoken by the Doctor’s Office
When doctors join MDwise, they tell us their name and whether they are male or female. They also tell us the languages spoken in the office. This is checked every 3 years. You may not see changes to this information between 3-year checks. This could happen if the doctor does not report changes.

Hospital Name, Location, Phone Number
When a hospital joins MDwise, they give us their name, location(s) and phone number. We check with the hospital to make sure the information is correct. We do this when they join and at least every 3 years after that. You may not see changes to hospital information. This could happen if the hospital did not tell us about the change. Not every hospital joins the MDwise network. Please check with MDwise Customer Service to find out if a hospital is in our network.

Hospital Accreditations
There are certain organizations that check for hospital quality. If a hospital is accredited, it means that they have met quality and safety standards. These standards are set by the outside organization. Each hospital tells MDwise about their accreditation when they join MDwise. We get a copy of the hospitals’ accreditation certificate to be sure. Hospitals are reviewed at least every 3 years. At the time of the review, we check to see if they are still accredited. You may not see changes to this information between 3-year checks. This could happen if the hospital doesn’t tell us about the change.

Hospital Quality Data
When searching for a hospital (Filter Results for “Hospital”), our directory gives a link with each hospital listing: View Quality Information. We link to the quality data landing pages for “Hospital Compare” and “mycareINsight” (which uses data from Hospital Compare) as our sources of information. You can search quality data by hospital from either site. Information/validation on these sites is managed by the site and information on frequency and collection methods is stated on the sites.


Request a Directory

If you would like to request a printed Provider Directory, please create a myMDwise account and select "Find a Doctor" under the "My Benefits" menu.