Information Validation
Medical Group/IPA Responsibility
WHA's contracted Medical Groups/IPAs are responsible for providing WHA accurate, current information
regarding their physicians and healthcare providers. They notify WHA on a daily basis as new information
becomes available. Within seven (7) business days of receiving new information, WHA's web-based Provider
Directory is updated. WHA requires that contracted Medical Groups/IPAs verify the accuracy of the Provider
Directory information on a quarterly basis.Verification of information about a physician's training, licensure, and board certification(s) is the responsibility of WHA's contracted Medical Groups/IPAs. Verification takes place when a physician initially joins a group (credentialing) and again every 36 months (recredentialing). WHA carries out oversight activities to ensure that each contracted Medical Group/IPA meets and maintains national credentialing and recredentialing standards.
WHA contracts directly with the hospitals listed in the WHA Provider Directory. Quarterly, WHA confirms the accuracy of hospital directory information, including but not limited to, licensure and accredited status.
Acceptance of New Patients
This field indicates if a physician is currently taking new patients. The Medical Group/IPA notifies WHA
when it learns a practitioner's practice is "closed" to new patients. Quarterly, WHA requires the Medical
Groups/IPAs to validate this information. Please note there are times in which Medical Groups/IPAs are not
immediately notified that a physician has limited his/her practice. Before you select a PCP, it is always
best if you contact that PCP's office to verify that he/she is accepting new patients. *Hospital Accreditation
To be accredited a hospital voluntarily submits to an ongoing evaluation process to determine if it
meets the standards that have been established by an accrediting body. A hospital that is fully accredited
by The Joint Commission is in full compliance with rigorous national healthcare quality and safety standards.
Obtaining Joint Commission accreditation is validation of an organization's ongoing performance improvement
efforts. Quarterly, WHA's contracted Medical Groups/IPAs are required to provide documents to support the
accreditation of hospitals to which they refer WHA members. WHA reviews all submitted documentation and
verifies its accuracy on a quarterly basis. You may verify a hospital's accreditation status by visiting
the following website:
http://www.qualitycheck.org/consumer/searchQCR.aspx.Board Certified Practitioner
A specialist who has successfully completed a residency program approved by the Accreditation Council for
Graduate Medical Education (ACGME) in a specialty recognized by the American Board of Medical Specialties
(ABMS) or by the American Osteopathic Association (AOA), and has been certified by an ABMS or AOA Member
Board is considered board certified. Board certification(s) is verified by each contracted Medical Group/IPA
as part of their credentialing and recredentialing process and are reported to WHA. Quarterly, the contracted
Medical Groups/IPAs must review and confirm the accuracy of information specific to their physician's, including
board certification(s). You may verify a physician's board certification(s) by visiting
http://abms.org/wc/.
Members who would like to check the certification status of a Doctor of Osteopathic Medicine can contact the
AOA Member Service Center at 1-800-621-1773 and select 1 from the menu options. All board certifications listed
are those issued by an ABMS Board except as follows: If "AOB" appears before the board certification it is issued
by, an AOA recognized board.Hospital Affiliations
This field shows the hospitals where a physician may admit or care for patients. Physician's self-report this
information to their affiliated Medical Group/IPA at the time they are credentialed and recredentialed. The
Medical Groups/IPAs report this information to WHA as well as any changes made to a physician's hospital
affiliation(s). Quarterly, the Medical Group/IPA must review and confirm the accuracy of information specific
to their physician's including their hospital affiliation(s). *Language Spoken by Practitioner
Language(s) spoken by each physician is reported to WHA by the contracted Medical Groups/IPAs. If new
information becomes known regarding a physician's ability to communicate in another language, the Medical
Groups/IPAs will notify WHA. Language assistance is available at all of WHA's provider locations. If you
have a specific language need let your physician's office know. *Medical Group Affiliations
This field designates the Medical Groups/IPAs with whom the physician is associated. When a physician joins or
leaves a WHA contracted Medical Group/IPA, the Group is required to notify WHA. Quarterly, the Medical
Groups/IPAs review and confirm the accuracy of information specific to their physician's, including their
Medical Group/IPA affiliation(s). *Specialty
A specialty is a particular branch of medicine in which a physician focuses. A specialty may be based on a
specific body system, such as the heart, a specific age group, such as pediatrics, or on a complex scientific
technique used to diagnose or treat certain types of disorders. A specialist may or may not be board certified.
WHA's contracted Medical Groups/IPAs validate specialty information during the credentialing and recredentialing
process and report all changes to WHA. Quarterly, the Medical Groups/IPAs must review and confirm the accuracy of
information specific to their physician's specialties. ** Limitations to the accuracy of information in WHA's web-based or print Provider Directory would be the result of human or computer error in requesting information, responding to a request, a data entry error or in the timeliness of reporting. WHA's print directories are limited to the information available at the time the directory is printed.