McLaren Health Plan Community Provider Directory

Welcome to McLaren Health Plan (MHP).  MHP has thousands of doctors and many leading hospitals ready to care for you. We combine the resources of independent physicians, multi-specialty groups, ambulatory care centers, ancillary providers, and hospitals to offer our members access to the high quality health care providers you expect.

Each family member must choose a Primary Care Provider (PCP).  Your PCP will coordinate your health care needs.  Please use this directory as a reference when you need to choose a provider for health care services.

If you have any questions regarding the participation status of any health care provider please check this site, or contact Customer Service toll free at (888) 327-0671.

DEFINITIONS

The Provider portion of the directory includes definitions, verification sources and timeliness as listed below:

Provider Name and Gender
– This information is self-reported by the provider and is not verified by McLaren Health Plan.

Office Location(s), Phone Number, Hours and Office Website (if applicable)
– This information is self-reported by the provider and is not verified by McLaren Health Plan.

Provider Specialty
– The clinical area that the physician has identified as his/her area of expertise and which, at initial credentialing, McLaren Health Plan verified that the physician completed a recognized residency or fellowship program.

Primary Care Provider (PCP)                                                                                                       
- Defined as Family or General Practitioners, Pediatricians, Internists, Nurse Practitioners and Physician Assistants

Specialty Care Provider (SPC)                                                                                      
– Defined as a provider with a focus on specific areas of care. They have extensive training and education in their specific area of care.

CLAS Trained                                                                                      

- Indicates the provider has completed the cultural and linguistic training

Medical Group Affiliation

- Indicates the group a provider participates with

Hospital Affiliation
– The primary network hospital(s) the physician uses, as reported by the physician at initial credentialing and as changes occur. MHP verifies the physician’s standing with the hospital initially and every 3 years thereafter. This information may change in between the 3-year re-verification period.

Board Certification
– Whether the physician has qualified for, taken, and passed a comprehensive test of knowledge in his/her clinical specialty. The physician reports this information to MHP initially and as changes occurs. MHP verifies the physician’s certification status and certification expiration date initially and when the certification expires. *To confirm board certification on your own, you can access the following website: www.abms.org

Accepts New Patients
– Applicable to primary care physicians only and indicates if physician is accepting new patients into the practice. The physician self-reports this information to MHP annually and as changes occur; the information is not verified by MHP.

Languages
– Languages other than English spoken by the physician. The physician self-reports this information to MHP at initial credentialing. The information is not verified by MHP.

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­The Hospital portion of the directory includes definitions, verification sources and timeliness as listed below:

Facility Name, Location and Phone Number
– This information is self-reported by the hospital and is not verified by McLaren Health Plan.

Accreditation
– Whether the hospital has sought and achieved compliance with the standards of a nationally recognized entity that assesses the quality and performance of hospitals. The hospital reports this information to MHP at initial credentialing and as changes occur. MHP verifies the accreditation status with the accrediting organization initially and at least every 3 years thereafter or when the accreditation expires, whichever comes first. This information may change in between the 3-year re-verification period.

Quality Data
- The hospital directory section contains quality data from recognized national or stat sources, or contains a link to recognized source for quality data specific to each hospital. If there are limitations to linking to the specific data, a link to the quality data landing page will be available.

If you would like a printed copy of the directory please contact Customer Service at (888)327-0671 (TTY: 711

For Marketplace Members

Practitioners: McLaren Health Plan Community does not use quality measures, member experience measures or cost-related measures to select practitioners.

Hospitals: McLaren Health Plan Community does not use quality measures, member experience measures, member experience measures, patient safety measure or cost-related measures to select hospitals.