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Querying Webcast

The webcast occurred on February 20, 2020. Watch a recording of the webcast by selecting the link below.

Q&As

  1. Credentialing standards require us to query the NPDB any time a provider requests a new privilege. If a provider is on Continuous Query, what is the best way to demonstrate during a survey or compliance review that the NPDB was queried when the privilege was requested?
    Enrollment in Continuous Query meets the mandatory hospital querying requirements of the Health Care Quality Improvement Act of 1986 and routine survey standards. If the health care entity being reviewed is using Continuous Query, a private accreditation organization may be provided with a printed or electronic copy of the Manage Continuous Query Subjects list, which lists all enrolled health care practitioners and the latest disclosure date for all reports disclosed after initial enrollment. This list may be compared with the Continuous Query Report Disclosures list, which provides the names of the enrolled health care practitioners, the types of reports, the report disclosure date, whether the report was reviewed, and the date and name of the person who reviewed the report. In these instances, the private accreditation organization personnel who review the information are subject to the confidentiality provisions of the NPDB.

  2. If we enroll a registered nurse, certified registered nurse anesthetist, or physician in Continuous Query, would there be any benefit to running an annual query knowing I would receive any new reports with Continuous Query? My company has me query annually, but then sometimes I am querying the practitioner twice in one year if a re-appointment is due.
    As long as you have the practitioner enrolled in Continuous Query, there is no need for other queries. Any reports will be disclosed to you through Continuous Query, and it meets re-appointment requirements. There is no benefit to querying twice in one year if you enroll your practitioners in Continuous Query. A one-time query would reveal no more information than you are already receiving from the Continuous Query.

  3. If a practitioner is enrolled in Continuous Query and requests an additional privilege, do I need to submit a One-Time Query?
    Continuous Query enrollments provide one full year of constant information monitoring, so there is no need for an additional query. If your organization is performing a review of a practitioner's credentials, conducting an investigation, or needs an updated query response for any reason, Continuous Query gives you updated information at any time for the practitioner. Continuous Query keeps you informed about your enrolled practitioners, notifying you within 24 hours of any new report that has one of them as a subject. A One-Time Query gives you only a single point-in-time response about a practitioner.

  4. Can health care entities query the NPDB when credentialing registered nurses, medical assistants, dental assistants, and behavioral health counselors?
    Yes. Eligible health care organizations can query on health care practitioners such as registered nurses, medical assistants, dental assistants, and behavioral health counselors. The organizations must be registered with the NPDB and authorized to query for NPDB information. It is usually appropriate to query on these practitioners when health care organizations are entering into an employment or affiliation relationship with them.

  5. If issuing temporary privileges, do we need to run a query at the time temporary privileges are granted and again when full membership and privileges are granted? For example, full privileges may be granted within 30 days after the temporary privileges are granted.
    If the temporary privileges were granted on a Continuous Query, then the Continuous Query is all that's needed, as it will provide proof of querying each time it's necessary, such as for granting temporary privileges and full privileges. However, if One-Time Queries are used, whenever a practitioner applies for temporary clinical privileges or full privileges, you must query the NPDB on each of those occasions.

  6. Do we need to query registered nurses, licensed practical nurses, and dental assistants? Do we need to query allied health professionals?
    Hospitals must query on practitioners when they are putting them on their medical staff or granting them privileges. Hospitals and other health care entities may query on practitioners when making determinations regarding employment or affiliation. For example, the human resources departments of hospitals and health care entities may query the NPDB on nurses, nurse aides, radiologic technicians, physical therapists, and other health care practitioners when making hiring decisions.

  7. Are multiple departments involved in the hiring and credentialing of a practitioner, such as the human resources and medical staff offices, allowed to share queries?
    Yes, as long as they are involved in one business decision, for one facility, for one process. For example, a hospital may have only one facility and only one process (hiring and credentialing), but multiple offices. In this instance, it is fine to share the queries because there is only one business decision.

  8. What if you have a contract with another entity to do its credentialing, but your own facility also credentials. Do you have to run separate queries for both the contracted facility and your own? There are two separate decision-making bodies, my entity has a committee, and so does the other hospital. My entity gathers documents and sends them to the other hospital's committee for approval. Are two separate queries required in this example?
    Yes. If there are two separate decision-making bodies, then the querying is decentralized and a separate query is required for each entity. If one entity makes decisions for both entities, then the querying would be centralized, and that entity could submit one query per practitioner for the entities.

  9. Can you explain the difference between centralized vs decentralized?
    Query responses may be shared between hospitals sites within a health care system, if the health care system:
    • provides for centralized credentialing;
    • has a centralized peer review process;
    • has one decision-making body; and
    • has one unified medical staff.
    If the hospitals maintain separate medical staff credentialing processes with separate decision-making bodies, the hospitals must query separately. According to NPDB regulations at 45 CFR § 60.20(a), "Persons and entities receiving information from the NPDB, either directly or from another party, must use it solely with respect to the purpose for which it was provided." If, by applying to one hospital, a health care practitioner is granted privileges to practice at both institutions and the institutions have a single decision-making body, the peer review process is centralized and one hospital may query on behalf of both hospitals. For more information, see the Chapter D of the NPDB Guidebook.

  10. What if I have submitted a query and then realized I made a mistake, for example, on the SSN. Is there any way I can edit this without running a new query?
    A One-Time query cannot be edited if a mistake is made. You must submit a new One-Time query. To edit a Continuous Query enrollment, see How to Update a Practitioner Profile in Continuous Query.

  11. When using Continuous Query, if no reports exist, is there a document available to demonstrate that we used the NPDB to monitor our practitioners?
    You can click View Confirmation from the subject detail screen. This gives you a PDF, which serves as proof you are monitoring the subjects, even if there are no reports.

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