Which statement about NPDB querying is true?

Which statement about NPDB querying is true?

• A. Hospitals are the only organization required to query the NPDB
• B. Medical schools are required to query the NPDB for admissions
• C. Insurance providers are required to query the NPDB for each claim
• D. Practitioners must query NPDB before licensure

Answer: (A)

NPDB querying is used in credentialing decisions. When a hospital (or another organization performing credentialing) evaluates a practitioner for initial appointment or for privileges, it is required to check the NPDB to uncover any past disciplinary actions, malpractice payments, or other information that could affect a practitioner’s ability to provide safe care. This requirement is what makes hospitals the primary organizations mandated to perform NPDB queries in the credentialing process. Medical schools do not query the NPDB for admissions, so that option isn’t accurate. Insurance providers aren’t required to query NPDB for every claim, and practitioners don’t perform NPDB queries as part of licensure—licensure reviews are conducted by the licensing bodies, which may incorporate NPDB information but do not require the practitioner to initiate a NPDB query themselves.

NPDB querying is used in credentialing decisions. When a hospital (or another organization performing credentialing) evaluates a practitioner for initial appointment or for privileges, it is required to check the NPDB to uncover any past disciplinary actions, malpractice payments, or other information that could affect a practitioner’s ability to provide safe care. This requirement is what makes hospitals the primary organizations mandated to perform NPDB queries in the credentialing process.

Medical schools do not query the NPDB for admissions, so that option isn’t accurate. Insurance providers aren’t required to query NPDB for every claim, and practitioners don’t perform NPDB queries as part of licensure—licensure reviews are conducted by the licensing bodies, which may incorporate NPDB information but do not require the practitioner to initiate a NPDB query themselves.