Definitions/Glossary

Provider: A person, group, or facility that provides health care services and/or products (e.g. doctor, specialist, hospital or pharmacy).

Primary Care Provider (PCP): A PCP is the person or provider that you select (or that has been selected for you) to be the medical professional who takes care of your healthcare needs or problems and helps you get any needed specialty services.

Gender: The sex of the provider; male or female.

Office Location: The physical address for the provider.

Office Phone Number: The telephone number at which the provider can be contacted.

Specialty: The area of medicine in which the provider specializes. Examples of types of specialty include Internal Medicine, Pediatric Medicine, and Obstetrics and Gynecology. The provider self-reports their specialty on their credentialing application and this information is verified by the provider at least annually and by Jai Medical Systems every three years.

Board Certification: An official provider certification in an area of specialty by the American Board of Medical Specialties or other certifying board. For the most up-to-date information regarding a provider’s Board Certification, please visit the American Board of Medical Specialties website at www.ABMS.org. Board Certification is verified by the provider at least annually and by Jai Medical Systems every three years.

Group Name: The name of the group practice for the provider. The Group Name is verified by the provider at least annually and by Jai Medical Systems every three years.

Hospital Affiliation: These are the hospitals for which the provider has admitting privileges. The provider must apply for privileges to each hospital individually and meet the hospital’s admitting privileges standards. Hospital Affiliation(s) is self-reported by the provider annually and verified by Jai Medical Systems every three years.

Hospital Accreditation: There are specific organizations that accredit hospitals. This section includes the name of the accrediting body and the status of accreditation. Hospital Accreditation is self-reported by each hospital annually and verified through the accreditation organization’s website.

Accepting New Patients: This explains whether a provider is currently accepting new patients. This information is only identified for Primary Care Providers, Obstetricians and Gynecologists, and Substance Abuse Providers. This information is verified by the provider at least annually.

Languages: These are the language(s) that are spoken by providers participating in our network. Provider language is verified by the provider at least annually and by Jai Medical Systems every three years.