OMB Number: 0915-0366; Expiration date: XX/XX/202X
Entities Survey: Module 18
Number of questions: 21
Experiences and Satisfaction with Reporting Adverse Actions to the NPDB
(Excluding Medical Malpractice Payment Reports)
Q 18.1. How long have your work responsibilities included reporting adverse actions to the NPDB?
Less than 1 year
1 to 3 years
3 to 5 years
More than 5 years
Survey Page Break
Q 18.2. Please select one of the following options that applies to you:
My work responsibilities used to include reporting adverse actions to the NPDB but no longer do.
My current work responsibilities include reporting adverse actions to the NPDB.
Survey Page Break
Q 18.3. Below we describe the two methods used for reporting to the NPDB. Which of these two methods best describes how you most frequently report to the NPDB on behalf of your organization? Select one option.
Web-based reporting: NPDB’s Integrated Querying and Reporting Service (IQRS) is a web-based service for querying and reporting by registered entities and authorized agents designated on behalf of registered entities.
QRXS: As an alternative to the IQRS, the NPDB offers an XML-based machine-to-machine interface called the Querying and Reporting XML Service (QRXS), which can be used by users who store and manage practitioner data within their own information or credentialing systems or submit a large number of queries or reports to the NPDB.
Q 18.4. Overall, how satisfied are you with your experience of reporting to the NPDB?
Rating Scale
Very Satisfied / Satisfied / Neither Satisfied Nor Dissatisfied / Dissatisfied / Very Dissatisfied
If the response to Q 18.3 is “Web-based reporting”, go to 18.5.
If the response to Q 18.3 is “QRXS”, skip to 18.6.
Q 18.5. Using the scale provided, please rate your satisfaction with the following aspects of reporting to the NPDB.
Rating Scale
Very Satisfied / Satisfied / Neither Satisfied Nor Dissatisfied / Dissatisfied / Very Dissatisfied
NPDB’s online instructions for reporting
NPDB’s online help for reporting
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Q 18.6. Please rate your level of agreement with the following statements concerning reporting adverse actions to the NPDB. (Only one answer per row.)
Rating Scale
Completely Agree / Agree / Neither Agree or Disagree / Disagree / Completely Disagree
The first time that I reported to the NPDB, I found it easy to do.
I feel confident that I can teach a fellow coworker how to report to the NPDB.
I have difficulties in completing all of the tasks of reporting to the NPDB.
I usually have to ask for help when I report to the NPDB.
I needed to learn a lot of things before I could get going with reporting to the NPDB.
Survey Page Break
Q 18.7. Using the scale provided, please rate your experience regarding each of the following aspects of reporting adverse actions to the NPDB.
Rating Scale
Extremely Easy / Easy / Neutral / Difficult / Extremely Difficult / Not Applicable
Finding the Website
Logging in (DBID, user ID, and password)
Navigating the Website
Collecting All of the Required Input
Selecting the Right Options from the Dropdown Menus
Knowing What to Report
Creating a Factually Sufficient Narrative
Other (Please Explain) __________
Survey Page Break
Q 18.8. From the date an adverse action occurred to the date an Adverse Action Report is filed, how much time usually elapses before you file a report to the NPDB?
Fewer than 30 days
30 to 60 days
61 to 120 days
More than 120 days
If the response is “less than 30 days,” skip to 18.9.
Q 18.9. Explain the reason for your choice about the time elapsed from when an adverse action occurs to the date you file a report to the NPDB.
Textbox
Survey Page Break
Q 18.10. We are interested in learning about the time it takes your organization to complete a typical adverse action report. Please provide estimated time (in minutes) for the following aspects of the reporting process:
Minutes spent collecting information about the report ________
Minutes spent filing the report to the NPDB __________
Not applicable (please explain) ______________
Q 18.11. In an Adverse Action Report, the NPDB requires that you select at least one, and up to five, Adverse Action Classification responses (e.g., “Revocation of License” or “Reduction of Clinical Privileges”). How difficult is it for you to assign the correct code from this list?
Rating Scale
Very easy / easy / neutral / difficult / very difficult
Q 18.12. Should any changes be made to the list of Adverse Action Classification responses?
Yes, additional responses should be added (please specify) ___________
Yes, existing responses should be changed (please specify) __________
No changes are needed (please elaborate) ___________
Survey Page Break
Q 18.13. In an Adverse Action Report, the NPDB requires that you select at least one, and up to five, Basis for Action (e.g., “Practicing without a License” or “Failure to Obtain Informed Consent”). How difficult is it for you to assign the correct code from this list?
Rating Scale
Very easy / easy / neutral / difficult / very difficult
Q 18.14. While filing your adverse action report, if you selected the “Other” category in your response for Basis for Action, what were your reasons for doing so? (Select all that apply.)
None of the categories captured the Basis for Action for that report
Entity officials or management advised to select the “Other” option
Entity’s legal counsel advised to select the “Other” option
Practitioner’s legal counsel advised to select the “Other” option
It was too hard to find the right code
NPDB system prompted to pick “Other”
Not applicable (I have never selected the “Other” category for Basis of Action)
Survey Page Break
Q 18.15. Should any changes be made to the list of Basis for Action responses?
Yes, additional responses should be added (please specify) ___________
Yes, existing responses should be changed (please specify) __________
Yes, responses should be tailored according to the reported profession (please specify) _____
No changes are needed (please elaborate) ___________
Q 18.16. If you have any other comments about the information reported to the NPDB for adverse actions, please provide them here:
Text box
Survey Page Break
Q 18.17. NPDB reports contain one or more text fields for reporters to further describe the action. How often do each of the following occur with respect to the information you provide in these text fields for Adverse Action Reports?
Rating
scale for each item below:
Never
/ Rarely / Sometimes / Often / Always
Content is drafted by legal counsel
Content is drafted or reviewed by entity officials or management
Content is reviewed by legal counsel
Content is reviewed by the subject of the report prior to filing
Content is negotiated with respect to the report
Survey Page Break
Q 18.18. About how many times in the last 3 years was your report submission to the NPDB rejected due to missing information? Select a number below. If you have never experienced this, select zero.
Select a number: ___ [drop down menu of 0 to 10]
If the response is 0 (zero), skip the next question.
Q 18.19. The last time this happened, what action did you take? (Select all that apply.)
None (did not finish the report)
Informed the NPDB
Obtained the missing information and re-submitted the report
Completed the missing information with the “dummy” data option provided by the NPDB
Other (please explain) ____________
Survey Page Break
Q 18.20. When submitting a clinical privileges action report or a professional society action report to the NPDB, does your organization use the NPDB’s report forwarding service in order to send an electronic report to the appropriate state authority?
Yes
No
Not Applicable
Other (Please Explain) ________
If “yes,” show the next question. Otherwise, end this module and go to Module 19.
Q 18.21. How would you rate your level of satisfaction with the NPDB’s report forwarding service for clinical privileges or professional society actions?
Very Satisfied
Satisfied
Neither Satisfied Nor Dissatisfied
Dissatisfied
Very Dissatisfied
Piping logic:
Survey will be directed to Module 19 (Report Information) next.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-02-15 |