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The doctor, hospital or facility information found on this online Find a Doctor search tool is submitted to Sharp Health Plan by the doctor, the doctors medical group, the hospital or facility. Sharp Health Plan (or the delegated medical group) reviews the credentials of all contracted doctors to ensure they meet specific criteria for acceptance as a Plan Provider. Sharp Health Plan works with a credential verification organization that is accredited by the National Committee for Quality Assurance (NCQA) to verify the accuracy of the information submitted by the doctors. Final credentialing status is approved by Sharp Health Plans Peer Review Committee under the guidance of the Chief Medical Officer and the Board of Directors. Doctors are required to maintain compliance with all standards as a condition for continued participation.

Our Find a Doctor search tool is updated daily with any changes received on the doctor, hospital or facility information.

Doctor, Hospital or Facility Name

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This information is reported by the doctor, hospital or facility during the initial credentialing or contracting process. It is verified during initial credentialing and at re-credentialing every three years. This information is updated when we are notified of any changes.

Practice Name (Medical Group)

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The Practice Name indicates the doctor‘s affiliated Plan Medical Group. This information is provided by the medical group during the doctor‘s initial credentialing and at re-credentialing every three years. It is updated during the year if there are any changes in the doctor‘s affiliation with the medical group.

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Location and Phone Number

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The office address and phone number is self-reported during the initial credentialing or contracting process. This information is updated when the doctor, hospital or facility reports a change.

Gender

This information is reported by the doctor on their initial application during the credentialing process. It is not verified by Sharp Health Plan.

Specialty

Specialty refers to a particular, focused field of medicine that the doctor specializes in and in which the doctor has received additional training. Specialties are reported by the doctor on the initial application and verified during credentialing and every three years during re-credentialing. Changes to a doctor‘s specialty are made upon notification. The specialties listed are limited to those recognized by Sharp Health Plan and for which the doctor has met the required education and training requirements.

Board Certification

A doctor who is board certified has received certification in a specialized area of medicine granted by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA). This information is reported by the doctor and verified through the ABMS or the AOA during credentialing and every three years during re-credentialing. Board certification is voluntary. A doctor‘s record is updated if their status changes. To obtain the most current board certification status for a doctor, visit the American Board of Medical Specialties web site at http://www.abms.org/ or the American Osteopathic Association at http://www.osteopathic.org/.

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Hospital Affiliations

This information refers to the Sharp Health Plan contracted hospital(s) where the doctor has permission to admit or care for patients. This is also referred to as 'admitting privileges'. This information is provided on the doctor‘s application. Hospital affiliations are verified at initial credentialing and at re-credentialing, every three years. A doctor‘s record is updated upon notification of any changes.

Languages

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This information indicates any language(s) spoken by the doctor, in addition to English. This information is reported by the doctor on the initial application. It is not verified by Sharp Health Plan. Changes to a doctor‘s language are updated upon notification.

Accepting New Patients

This indicates whether a doctor is available to patients that he or she has not seen before. 'Y' means that the doctor is able to accept new patients. 'N' means the doctor has limited his or her practice to existing patients only. This information is reported by the medical group or doctor and updated upon notification.

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Hospital Accreditation

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Accreditation indicates that a hospital was evaluated and met the designated standards for quality healthcare and safety by an accrediting organization such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This information is provided during the initial credentialing or contracting process. It is verified during initial credentialing and at re-credentialing every three years. For more information on accreditation, visit the JCAHO web site at http://www.jointcommission.org/.