The National Practitioner Data Bank (NPDB) reports and exposes high-risk providers, allowing organizations to perform due diligence by screening and monitoring a provider applicant. Verifiable is one of four organizations that have automated NPDB verifications allowing organizations to decrease the time it takes to run these verifications while also lowering credentialing costs by using these verifications as a phase-gate to full credentialing.
What To Know About The National Practitioner Data Bank (NPDB)
To ensure an organization’s credentialing processes align with specific accreditation standards, many organizations leverage the National Practitioner Data Bank or NPDB. Certifying bodies such as NCQA, URAC, HFAP and The Joint Commission each recognize NPDB querying and monitoring as meeting the requirements for: Licensure Sanction, Malpractice/Professional Liability History and Medicare/Medicaid Sanction screening. Some accreditations go so far as to require an NPDB query at point of hire, reappointment and/or the granting of temporary privileges.
What is NPDB?
The NPDB is a repository of reports containing information on healthcare providers, entities and suppliers. It is reported by Malpractice Payers, State Medical and Dental Boards, Hospitals, Professional Societies, DEA, Federal Government Agencies including the Department of Health and Human Services, State Agencies including Medicaid Fraud Control Units, Health Plans and private accredited organizations.
The NPDB Collects Information and Maintains Reports on the Following:
- Medical malpractice payments
- Federal and state licensure and certification actions
- Adverse clinical privileges actions
- Adverse professional society membership actions
- Negative actions or findings by private accreditation organizations and peer review organizations
- Health care-related criminal convictions and civil judgments
- Exclusions from participation in a Federal or state health care program (including Medicare and Medicaid exclusions)
- Other adjudicated actions or decisions
Many organizations screen providers through an NPDB lookup, referred to as a query, as part of NCQA-compliant credentialing or if mandated by federal law. However, the reports are confidential and not available to the public, therefore a query must be run by either the provider (self-query) or a registered organization (with permission from the provider).
How Do I Register With NPDB To Obtain Access and Run a Query?
How Verifiable Can Help
Verifiable is one of four organizations that have automated NPDB verifications for organizations looking to streamline and speed-up their credentialing, onboarding or pre-screening processes. Automated NPDB queries can be run via the Verifiable Salesforce App, the Verifiable Platform, or an integration with Verifiable’s API. This integration helps organizations ensure they are mitigating risk by screening and monitoring providers against the NPDB, while also staying compliant with accrediting bodies such as NCQA.
Contact us to learn more about how Verifiable can help your organization automate NPDB queries.