Previous to the Healthcare Quality Improvement Act (HCQIA) of 1986, there was no single, national source available to organizations required to perform credentialing to assess whether or not their practitioners had previous actions taken against them related to medical malpractice settlements, adverse privileging actions, state and federal licensure actions, Medicare exclusions or debarment, among other items.
As a result of the HCQIA, the National Practitioner Data Bank (NPDB) was established as a secure, confidential, national, web-based repository, with federal requirements for reporting for insurance carriers, state and federal licensing boards, hospitals, and other entities across the nation. Federal law also required specific entities to query the NPDB as an informational mechanism to assess the history and quality of their practitioners.
Today, query of the NPDB is one of many primary source verifications performed as part of an organization’s credentialing program. The NPDB offers One-Time Queries that can be performed at specific credentialing or privileging instances or intervals, or Continuous Queries, a powerful ongoing monitoring tool which continuously tracks all potential Data Bank actions and report those actions back to the subscribing organization in real time.
While medical staffs and organizations are ultimately responsible for reviewing the NPDB and entire scope of the credentialing investigation before approving an applicant, the NPDB does allow organizations responsible for querying to delegate the function through an Authorized Agent agreement.
If your organization has considered delegated credentialing activities to a Credentials Verification Organization (CVO), like PCVS, PCVS can serve as your Authorized Agent for NPDB querying, whether it be One-Time Queries or Continuous Queries. PCVS offers a customizable array of credentialing services to meet your organization’s needs – individual primary source verifications, like the NPDB, the entire scope of credentialing activities, sanction monitoring, or somewhere in between.
PCVS holds the prestigious quality distinction of being a dually-assessed CVO by the National Committee of Quality Assurance (NCQA) and the Utilization Review Accreditation Commission (URAC). We provide credentialing services to clients across the nation, with the unique ability to customize services to individual client’s needs. Contact us today to learn more about how PCVS can work for you.