--- title: "Provider verification process | Sutter Health Plan" description: "Discover how Sutter Health Plan ensures trusted care by verifying provider credentials, including board certifications, medical group affiliations and more." url: "https://www.sutterhealthplan.org/providers/provider-verification-process" --- 1. [Home](https://www.sutterhealthplan.org/) / 2. [Providers](https://www.sutterhealthplan.org/providers) / 3. Provider verification process # Provider verification process Keeping you informed is our priority. We update the Provider Directory weekly and have participating medical groups (PMGs) verify their information annually. **Section menu** - [Providers](https://www.sutterhealthplan.org/providers "Providers") - [Provider portal](https://www.sutterhealthplan.org/providers/portal "Provider portal") - [Non-participating provider claim information](https://www.sutterhealthplan.org/providers/non-participating-provider "Non-participating provider claim information") - [Provider verification process](https://www.sutterhealthplan.org/providers/provider-verification-process "Provider verification process") - [Providers](https://www.sutterhealthplan.org/providers "Providers") - [Provider portal](https://www.sutterhealthplan.org/providers/portal "Provider portal") - [Non-participating provider claim information](https://www.sutterhealthplan.org/providers/non-participating-provider "Non-participating provider claim information") - [Provider verification process](https://www.sutterhealthplan.org/providers/provider-verification-process "Provider verification process") ## Provider details at your fingertips Participating medical groups (PMGs) are responsible for providing accurate and updated information about their physicians and healthcare providers — including nurse practitioners, labs and skilled nursing facilities — through a provider verification process. The PMGs are responsible for verifying a physician's training, licensure and board certification(s) information. Credentialing happens when a doctor first joins a group and is updated every 36 months through recredentialing. We oversee this process to verify that PMGs uphold national standards. To learn about a doctor’s education or residency, visit the [California Department of Consumer Affairs](https://search.dca.ca.gov/ "California Department of Consumer Affairs") and search by doctor's name or license number. ## Provider verification process **Name, address, phone number and gender** When a provider joins or leaves a PMG, the PMG must notify us. They’re also responsible for providing accurate and up-to-date information about their providers, including name, address, phone number and gender. **Acceptance of new patients** This field shows whether a provider is currently accepting new patients. The PMG must notify SHP when a provider starts or stops accepting new patients. **Board certifications**  Physicians earn board certification in a medical specialty through the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA). PMGs verify these certifications during credentialing and re-credentialing and share the information with us.  To check a physician’s current board certification status, visit [ABMS Certification Matters](https://certificationmatters.org./). For a Doctor of Osteopathic Medicine, you can confirm their certification by calling the AOA Member Service Center at [800 621-1773]() and selecting option 1. **Hospital affiliations** This field shows the Sutter hospitals where doctors can treat or admit patients. PMGs verify hospital affiliation information during the credentialing and re-credentialing process and report it to us, including any updates or changes to a physician’s affiliations. **Medical group affiliations** This field identifies which PMG a provider is associated with. When a provider joins or leaves a Sutter Health Plan PMG, the PMG must notify us. **Spoken languages** This field shows the languages other than English that the physician speaks and understands. Physicians self-report this information to their affiliated PMG when they’re credentialed and re-credentialed. Then, the PMGs report this information to us. **Specialty** A specialty is a specific area of medicine that a provider focuses on. It could be related to a body system, an age group or a unique technique for diagnosing or treating certain conditions. A specialist may or may not be board certified. Our PMGs verify specialty information during the credentialing and re-credentialing process and report any changes to us. **Accreditation status and quality information** We verify information from PMGs to confirm that each hospital meets state and federal requirements and holds proper accreditation from the appropriate organization. We verify hospitals when they join Sutter Health (credentialing) and every 36 months afterward (re-credentialing). Accreditation means a hospital has been evaluated and met specific quality and safety standards set by an accrediting body, such as [The Joint Commission (TJC)](http://jointcommission.org/). We also annually review and verify the hospital’s name, location and accreditation status. Accrediting bodies We work with these authorities to ensure accreditation for our in-network providers and facilities. [California Department of Consumer Affairs](https://search.dca.ca.gov/) [Verify certification status](https://www.certificationmatters.org/) [The Joint Commission (TJC)](http://www.jointcommission.org/) [Verify a hospital’s accreditation](https://www.jointcommission.org/who-we-are/who-we-work-with/find-accredited-organizations) [Learn quality and performance ratings](http://calhospitalcompare.org/) Need help planning? Customer Service can answer your questions about how to access care while traveling, how to file claims and more. ### Message us Submit a secure message and we’ll contact you within five business days.  [Complete the form](https://feedback.sutterhealth.org/f/136895/8368 "Complete the Form") ### Call us Call 855-315-5800 or TTY 855-830-3500, weekdays: 8:00 am – 7:00 pm. Call [855-315-5800](tel:+18553155800) ### Email us Email shpserviceteam@sutterhealth.org with details about how we can help you. 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