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Data Verification

Medical Mutual updates directory information about physicians and other office-based providers when new information is supplied by a provider. The directory is typically updated on a daily basis. Hospital accreditation information updates are received monthly. Certain information about physician training, such as medical school, accreditations, board certification and licensure, are verified through a credentialing process that includes confirmation with the issuing body or the state that issued the license. Credentialing occurs when a provider joins the network and then every three years.

Name

This information is self-reported by the provider and updated upon notification. It is not verified by Medical Mutual.

Gender

This information is self-reported by the provider and updated upon notification. It is not verified by Medical Mutual.

Specialty

This indicates the provider’s self -reported field of expertise. A provider's specialty listing in the directory is at the discretion of Medical Mutual using various external accrediting bodies. Factors considered include, but are not limited to: board certification, graduation from an accredited professional school, advanced professional training post-licensure (e.g., residency, fellowship) and professional experience. Where applicable, Medical Mutual or its designee obtains verification of this information directly from the appropriate entity.

Hospital Affiliations

Where applicable, hospital affiliations indicate medical facilities at which the provider has obtained privileges. This information is self-reported by the provider and updated upon notification. Admitting privileges at the provider's primary admitting facility are verified with the facility by Medical Mutual or its designee when a hospital joins the network and then every three years.

Medical Group Affiliations

This indicates medical groups with whom the provider is affiliated. This information is self-reported by the provider and updated upon notification. It is not verified by Medical Mutual.

Board Certification

Where applicable, this information indicates the American Board of Medical Specialties board through which the provider has obtained certification and the expiration date of the certification. The information is updated upon notification by the provider and verified by Medical Mutual or its designee directly with the American Board of Medical Specialties or the pertinent board prior to inclusion of the data in this directory. Furthermore, board certification information is re-verified at least every three years or semi-annually if the certification has expired since it was last verified. This website can be found at https://www.abms.org/WC/login.aspx.

Acceptance of new patients

If the directory indicates “Yes,” the provider is accepting appointments for new patients to his/her practice. If “No” is indicated, the provider has restricted his/her practice to existing patients only. This information is self-reported by the provider and updated upon notification. It is not verified by Medical Mutual.

Languages spoken by the practitioner or clinical staff

Medical Mutual asks providers to report if the provider or his or her staff speak any languages other than English. The languages displayed in a provider directory are self-reported by the provider and updated upon notification. This information is not verified by Medical Mutual.

Office Locations

This information indicates the location(s) at which the provider furnishes services. This information is self-reported by the provider and updated upon notification. It is not verified by Medical Mutual.

Facility Name

This information is self-reported by the provider and updated upon notification. It is not verified by Medical Mutual.

Facility Location

This information indicates the location(s) at which the provider furnishes services. This information is self-reported by the provider and updated upon notification. It is not verified by Medical Mutual.

Accreditation

Accreditation indicates whether a hospital has applied for and met certain criteria relative to quality of care performance from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the DNV National Integrated Accreditation for Healthcare Organizations (NIAHO) or the Healthcare Facilities Accreditation Program (HFAP). To earn and maintain accreditation, organizations must have an extensive on-site review at least once every three years to evaluate performance in areas that impact a patient's care. Accreditation shows that an organization is committed to ongoing efforts to improve the quality of care provided to patients. The accreditation is verified directly with the accrediting organization prior to inclusion in this directory and at least every three years thereafter.

Provider data last updated on: 9/23/2017
Page last updated on: 4/7/2017
Y0121_WSr2_2016_May 16 CMS Approved

The information on this Web site and any links are for your information only and does not take the place of, or is intended to be a substitute for professional medical advice, diagnosis or treatment from your doctor. Any services recommended or provided by your doctor may not be covered under the terms of your benefit plan. Eligibility and coverage are subject to the specific terms of your benefit plan.