Disclosure Statement

This provides background information on data in the physician and hospital provider search, as required by the National Committee for Quality Assurance (NCQA).

Physician

Name and Gender

• Data is from the HMSA Provider Eligibility and Certification Application form.
• Information is validated during the initial application and credentialing process.
• Limitation: Information is self-reported.

Specialty

• Definition: The physician's area of practice, such as a certain branch of medicine, specific procedures, certain age categories of patients, specific body systems, or certain types of diseases.
• Data is from the HMSA Provider Eligibility and Certification Application form and is validated during the initial application and credentialing process.
• Information is re-credentialed every two years by the Hawaii Credential Verification Service, Inc., and validated by sources approved by the American Board of Medical Specialties (www.ABMS.org).
• Limitations: None.

Health Centers

• Definition: A group of physicians from which all health care services are provided or arranged.
• Data is from the health center's letter of verification and is validated during the initial application and credentialing process.
• Information is updated when the provider or health center notifies HMSA.
• Limitation: Information is self-reported.

Board Certified

• Definition: Physician's area of training or area where physician has passed a medical specialty examination.
• Data is from the HMSA Provider Eligibility and Certification Application form and is validated during the initial application and credentialing process.
• Information is re-credentialed every two years by the Hawaii Credential Verification Service, Inc., and validated by sources approved by the American Board of Medical Specialties.
• Limitations: None.

Accepting New Patients

• Definition: Indicates whether or not the physician is currently accepting new patients.
• Data is from the HMSA Provider Eligibility and Certification Application form and is validated during the initial application and credentialing process.
• Information is updated when the provider notifies HMSA.
• Limitations: Information is self-reported.

Language

• Definition: Languages other than English spoken by the physician or the clinical staff.
• Data is from the HMSA Provider Eligibility and Certification Application form and is validated during the initial application and credentialing process.
• Information is updated when the provider notifies HMSA.
• Limitations: Information is self-reported.

Address, City, ZIP Code and Island

• Data is from the HMSA Provider Eligibility and Certification Application form and is validated during the initial application and credentialing process.
• Information is updated from the HMSA Address Change/Closed Location/Additional Location form and office site visits.
• New and additional locations are re-credentialed every two years.
• Limitation: Information is self-reported. Office site visits are conducted for primary care physicians and high-volume behavioral health practitioners only.

Hospitals

Facility Name

• Data is from the HMSA Provider Application for Business/Facility form.
• Information is validated during the initial application and credentialing process.
• Limitations: Information is self-reported.

Address, City, ZIP Code and Island

• Data is from the HMSA Provider Application for Business/Facility form.
• Information is validated during the initial application and credentialing process and re-credentialed every two years.
• Limitations: Information is self-reported.

Accreditation

• Definition: Accreditation is a formal process where a health care organization undergoes an examination of its operating procedures to determine if procedures meet designated criteria and to ensure that the organization meets a specified level of quality.
• Data is from The Joint Commission (www.jointcommission.org) and the Commission on Accreditation of Rehabilitation Facilities (www.carf.org).
• Information is validated during the initial application and credentialing process and re-credentialed every three years.
• Limitations: None.