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National Credentialing Forum February 5, 2015 Ivy Vedamuthu U.S. Department of Health and Human Services Health Resources and Services Administration National.

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Presentation on theme: "National Credentialing Forum February 5, 2015 Ivy Vedamuthu U.S. Department of Health and Human Services Health Resources and Services Administration National."— Presentation transcript:

1 National Credentialing Forum February 5, 2015 Ivy Vedamuthu U.S. Department of Health and Human Services Health Resources and Services Administration National Practitioner Data Bank

2 Presentation Overview Purpose Fee Changes System Enhancements Research Survey Compliance 2015 Educational Forum Resources Contact Information 2

3 Purpose Created under three statutes to meet several needs Flagging system for effective credential reviews Protection against unfit practitioners Deter fraud and abuse in the health care system

4 Fee Changes Fee Structure Changes One Time $4.75 $3.00 Continuous $3.25 $3.00 Self Query $8.00$5.00 In October 2014, users of the NPDB saved $784,000.00

5 System Enhancements

6 Benefits of Moving to the Cloud Cost Savings: Implementing the first HRSA system to move to a cloud data center will save a significant amount of money in maintenance costs each year Scalability: Faster and easier adjustment to ebb and flows of use Faster on-screen response time: The screens load faster and the system is more responsive

7 System Enhancements Field of Licensure Updates and Report Input Changes Some occupation titles were retired or merged, and replaced with more accurate titles Users may now specify an "Other Name for Occupation” in more cases

8 System Enhancements QRXS Submission Duplication Checking Many large entities use the Querying and Reporting XML Software (QRXS) to submit high-volume batch queries and reports. Occasionally, users will inadvertently submit duplicate transactions, resulting in errors or duplicate charges. New automated checks have been added to help detect and limit accidental duplicate transactions.

9 System Enhancements Upcoming Changes Re-designing the user screens for self-query, one-time query and continuous query to make them more intuitive and require fewer steps/clicks. Enhancements to come in April and May of 2015

10 Research Survey

11 Comprehensive Survey of NPDB Eligible Users 13 years since last survey Survey response rate of 68% for organizations Findings reveal: user satisfaction with NPDB technology user perceptions of information impact of information on hiring, credentialing, licensing, or granting clinical privileges to health care practitioners. Findings will be used to improve user experience

12 Compliance

13 Data Bank compliance efforts over past 2 years: Reviewed 2,154 health professions in 50 states, DC, and 5 territories (96% compliant) 6,505 previously missing reports submitted by entities 868 of those reports disclosed a total of 2,682 times State Board Adverse Action Comparison Impact (As of Oct. 2014)

14 Compliance Total: ~403,000 Practitioner Reports Approximate Number of New Data Bank Reports Submitted (Practitioners Only) From 2010 – 2013 by Profession

15 2015 Educational Forum

16 When: April 7, 2015 Where: DC Area How: In-person only 2015 Educational Forum 16

17 2015 Educational Forum There are five areas of focus for attendees Reporting to the National Practitioner Data Bank (NPDB) Interpreting a Query Response Leveraging the NPDB’s Online Research Applications System Updates The New NPDB Guidebook

18 2015 Educational Forum The NPDB has created a series of four instructional videos Data Bank Customer Support Resource Series: Research Applications Data Bank Customer Support Resource Series: Reporting Adverse Licensure Actions Data Bank Customer Support Resource Series: Reporting Clinical Privileges Actions Data Bank Customer Support Resource Series: Reporting Medical Malpractice Payments

19 NPDB Compliance Tip Line Resources 19 Web Site – – NPDB Guidebook – Interactive Training – FAQs, Brochures, and Fact Sheets – Statistics – Instructions for Reporting and Querying Customer Service Center or 800-SOS-NPDB

20 The next open enrollment period is November 15, February 15, 2015 The next open enrollment period is November 15, February 15, 2015 The Health Insurance Marketplace

21 Ivy Vedamuthu Disputes Team Lead Policy and Disputes Branch Division of Practitioner Data Bank Bureau of Health Workforce Health Resources and Services Administration U.S. Department of Health and Human Services Telephone: Contact Information 21


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