Find a doctor or other health care provider: doctor information details

Fallon Health collects and verifies all practitioner credentials in accordance with NCQA standards for primary source verification. Aperture Credentialing, Inc., a credentialing verification organization, verifies board certification. Aperture verifies the board certifications of each practitioner type (MD, DO, podiatrists, etc) through the appropriate board.

Topic Explanation Source Frequency of Validation Limitations
Acceptance of new patients Indicates if the practitioner is accepting new patients at his/her office Practitioner/office staff Self-reported/not validated Fallon may not be notified if this status changes.
Gender Credentialing application Self-reported/not validated Not all practitioners provide this information since it is optional.
Hospital affiliations The hospital or hospitals where practitioner has admitting privileges Credentialing/recredentialing application Verified directly with primary hospital at the time of credentialing
and/or recredentialing (at least once every three years)		 When practitioners change sites, their hospital affiliations may not be updated until the time of their next recredentialing (at least once every three years).
Hospital quality data Shows how hospitals compare in providing safe, high quality care Leapfrog This data is self-reported. The hospital's CEO, or their designee, completes an Affirmation of Accuracy, affirming that the information the hospital has submitted is accurate Hospitals provide this data voluntarily.
Languages spoken by practitioner The languages the practitioner speaks with sufficient fluency to treat patients who speak only that language Credentialing/recredentialing application Self-reported/not validated Not all practitioners provide this information since it is optional.
Board certification Indicates whether or not the practitioner has completed a training program in a specialty and has passed an exam to assess his or her knowledge, skills, and experience to provide quality patient care in that specialty Credentialing/recredentialing application Verified directly with each board at the time of credentialing and/or recredentialing (at least once every three years) Fallon may not always be notified when a practitioner receives a new board certification. This information will be updated at the time of the next recredentialing (at least once every three years).
Accreditation Information Verification that contracted facilities are in good standing by an accrediting body The Joint Commission; Accreditation Association of Health Care (AAAHC); Commission on Accreditation of Rehabilitation Facilities (CARF); Community Health Accreditation Program (CHAP); and Continuing Care Accreditation Commission (CCAC) Every three years  
Medical group affiliations The medical group or groups that the practitioner is employed by or otherwise associated with Credentialing/recredentialing application
  • Verified at credentialing
    and/or recredentialing (at least once every three years)
  • Verified when change form is received
 Fallon may not always be notified when a practitioner changes medical group affiliations.
Specialty The specialty or sub-specialty area in which the practitioner provides care
  • Credentialing/recredentialing application
  • Change forms submitted by office/practitioner
  • Information received from specialty boards
  • Verified at credentialing
    and/or recredentialing (at least once every three years).
  • Verified when change form is received.