Special Qualifiers and Limitations on Data Provided
Information in the Find a Doctor/Hospital Tool and related data are offered because we believe they can be helpful to you in your selection of health-care providers. However, we want you to clearly understand that there are important qualifiers and limitations to the information provided.
The most important things to keep in mind in using the tool and related data are:
- While we try to provide an opinion or estimate the cost of care for specific physicians, we know that our limited claims data does not present the entire picture or background on any physician or other provider, and we want you to clearly understand that as well. The information we provide to you is based on claims that have been submitted by participating providers to us or one of our affiliates; that's all. We have not reviewed every patient or claim of the provider rated, nor have we necessarily conducted any other individualized survey or investigation of any provider's practice. The cost of care ratings reflected for a physician are based on limited claims data available to us, but they are not intended as statements of fact about a physician; instead, the cost of care ratings are merely ourstatement of opinion, based on the limited areas that we review and rate.
- The information concerning the cost of care and quality measures is not an endorsement of a particular provider specialty or treatment. It is simply information we have developed based on the limited claims data available to us and that we are sharing with our members. Circumstances of physicians or other providers may vary from case to case or from one time period to another. Therefore, this information should be used as a general reference only, keeping in mind all the limitations described here.
- The information reported in Find a Doctor/Hospital Tool and related data will generally be at least nine months old, and often older, because there is always a necessary lag time between when we can review the claims filed and analyze and report those results.
- Although the tool and related data can be helpful to you, because of the limitations outlined here, you should not rely on the Find a Doctor/Hospital Tool for any decision about selection of a health-care provider; instead, you should consult other sources of information, including discussing cost and quality issues with your own physician(s).
- Nothing you read in Find a Doctor/Hospital Tool should be interpreted or used as advice or recommendation on medical treatment or services that you may receive. We do not offer medical advice or recommendations of any kind. You should always consult your own physician(s) and make your own investigation and decision regarding whether to undergo any particular treatment or whether to utilize the services of a particular provider.
- The quality measures reflected in Find a Doctor/Hospital Tool are NOT our recommendations. Instead, they generally reflect a consensus among medical experts as collected and reported by various national sources, such as the National Committee for Quality Assurance, or the U.S. Department of Health and Human Services' Center for Medicare and Medicaid Services, among others. These nationally-recognized guidelines represent standards that most informed practitioners believe physicians should follow in many - but not all - situations, based on currently-available medical knowledge and technology. The quality measures show how often all participating Arkansas physicians in a particular specialty, as a group, provided these expert-recommended treatments to their patients. Note that Find a Doctor/Hospital Tool does not specifically rate any individual physician on how often he or she uses the selected quality measures; instead, you are provided a statistical illustration of how often ALL participating Arkansas physicians used the particular quality measure, information you can then compare to your actual experience with your physician. Regardless of the information reflected in any given quality measure reported in Find a Doctor/Hospital Tool, you should consult with your physician about whether any given treatment, test or procedure is right for you. Because individual circumstances may vary, it is always possible that a particular quality measure, while recommended by experts in most cases, may not be the most appropriate measure in your particular case.
- Although we try to check the accuracy of our data before publication, we cannot guarantee the accuracy of the claims data on which the Find a Doctor/Hospital Tool and related materials are based because there is always the possibility of computer or human error, which could affect the information.
- Because of the limitations on our data sources, as explained above, we do not assume any responsibility or liability to you or others who may use the Find a Doctor/Hospital Tool or related materials. We cannot be responsible for the accuracy or timeliness of the information we furnish, for the reasons noted above. If you elect to use the Find a Doctor/Hospital Tool or related materials on this Web site, you agree to release Health Advantage and its affiliates, directors, officers and employees from any claim for damages or injury to you alleged to arise from reliance on or use of any Find a Doctor/Hospital Tool opinions or related information or materials.
- Please review the "Special Qualifiers and Limitations On Data Provided" before utilizing any opinions or related materials that we make available to you.