Verifying Provider Information
The online Provider Search tool is populated from an Intermountain Healthcare database of physicians and other healthcare practitioners who meet both conditions below:
- Completion of the Intermountain Healthcare credentialing verification process that is repeated every three years. Not all types of healthcare practitioners are required to go through the Intermountain Healthcare credentialing process. Healthcare practitioners who are not credentialed by Intermountain Healthcare do not show up in the online provider directory.
- Contractual participation with one or more SelectHealth insurance plans OR medical staff membership at the one or more Intermountain Healthcare hospitals.
Intermountain and SelectHealth reserve the right to exclude certain medical specialities and certain medical provider for the online directory, for example, providers who choose not to be listed, providers who see patients on a walk-in basis only (such as InstaCare, KidsCare or WorkMed providers), hospitalist physicians who see hospital inpatients only.
Information about providers in the directory changes frequently and often without notice. Intermountain Healthcare and SelectHealth have formal policies and procedures that address the collection and validation of directory information. However, responsibility falls on providers to report changes to their information so the database can be updated accordingly.
The information listed below is verified by Intermountain Healthcare when a provider is initially credentialed. Updates to this information are also subsequently verified every three years thereafter.
- Foreign language fluencies means and languages besides English in which a provider or clinical staff is able to speak with and understand patients. Member Advocates verify annually which languages are spoken by providers. This information can be obtained by calling the provider's offices and verifying that the information we have on file is accurate.
- Medical education and post-graduate residency and fellowship training.
- Accepting new patients refers to wether a provider's practice is open or closed to new patients or certain patient types. Member Advocates verify annually whether providers are accepting new patients. This information may vary by office location or SelectHealth insurance plan. It can be obtained by calling the provider's offices and verifying that the information we have on file is accurate.
- Medical speciality, meaning the speciality or specialities recognized by the American Board of Medical Specialities (ABMS) in which a provider was formally trained.
- Board certification, meaning the process whereby a licensed physician has elected to undergo an examination before a board of professional peers to establish expertise beyond regular medical licensure in an ABMS specialty or sub-specialty. This information applies to physicians only and not other types of healthcare practitioners. You may visit the ABMS website to verify a physician's board certifications.
- Hospital affiliations, meaning the Intermountain Healthcare hospitals at which a provider holds active or courtesy medical staff privileges. Only providers who treat patients in a hospital setting will show hospital affiliations in the online directory. The listing is limited to Intermountain Healthcare hospitals and may not be a comprehensive list of hospitals with which provider is affiliated, nor a comprehensive list of hospitals offered in the area.
- Office addresses, phone numbers, and medical group affiliations, meaning the name of a multi-specialty clinic that is associated with a provider's office address. SelectHealth has a policy and procedure to verify office locations and phone numbers when a provider joins a SelectHealth plan or network. Changes to a provider's office information is usually verified by SelectHealth upon notification of the change by a provider. Due to the frequency of changes to the office information among several thousand providers, not all changes are verified.
- SelectHealth plan participation, meaning the insurance plans or networks administrated by SelectHealth for which a provider has an active contract to treat members of the plan according the plan's fee schedule and polices. The list of plans is limited to those offered by SelectHealth and may not be a comprehensive list of plans accepted by a provider, nor comprehensive list of health insurers offered in the area.
The information listed below is self-reported by providers and is not verified or reviewed in the Intermountain Healthcare credentialing process. Not all providers listed in the directory have supplied this information. Efforts to collect this information have be focused on physicians but will expand to other practitioner types in 2007.
- Professional memberships, meaning a provider's memberships in organized medical professional societies.
- Office hours, meaning the days of the week and the hours that a provider is open for seeing patients. Days and hours may vary by office location for providers with multiple offices.
- After-hours instructions, meaning the instructions a provider lists in the directory on how to get access to care after a provider's office is closed for the day.
- Practice focus, meaning any specific treatments, conditions, areas of the body, or patient types that a provider specifically focuses on or excludes from his or her practice. Providers are asked not to list anything that is outside of their formal training or conflicts with their hospital privileges.
- Patient education material, meaning general health or medical education documents that a provider chooses to make available to the public through the online directory.
Inclusion of a provider in the online directory is not guarantee of coverage for any health insurance plan. Before receiving medical services, it is recommended that patients consult their health insurance plan to verify provider participation, referral and authorization requirements, and benefits including limitations and exclusions.
The online directory is not intended as a recommendation, referral, or endorsement of any particular provider, as a tool for verifying the credentials, qualifications, abilities, or availability of any such provider.
The online directory and any of the data, listings or other information contained therein may not be republished, sold, or re-purposed, in whole or in part, in any medium, for use in any other list of providers or for any purpose whatsoever, except for express use as a directory of Intermountain Healthcare credentialed providers who contract with one or more SelectHealth insurance plans.
We regularly monitor the location of our contracted networks against where our members live and work to ensure that the members have primary care physicians, behavioral health physicians, specialty physicians and hospitals within reasonable traveling distance. We evaluate these providers based on member complaints, member experience, clinical quality measures and appropriate use of healthcare resources. This helps us determine whether to add the provider or hospital to one or more of our networks.