Self-Queriers Survey: Module 9
Number of questions: 7
Experience with the NPDB Dispute Process
Q 9.1. You have indicated that you had/have been involved in the NPDB’s Dispute Resolution Process (previously known as Secretarial Review). What type(s) of report(s) did you dispute? (Select all that apply.)
Medical Malpractice Payment
State Licensure Action
Clinical Privileges / Panel Membership Action
Health Plan Other Adjudicated Action (e.g., contract termination)
Professional Society Membership Action
Federal Licensure (including DEA)
Government Administrative Action
Federal or State Exclusion or Debarment
Private Accreditation / Peer Review Organization Action
Judgment or Conviction
Other (Please Explain) ____________
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Q 9.2. Why did you dispute the NPDB report(s)? (Select all that apply.)
Information in the report was incorrect
Report was submitted for reasons other than professional competence or professional conduct
You were treated unfairly by the reporting entity
The action was not reportable to the NPDB
Court advised to go through the NPDB administrative process
Legal counsel advised to dispute
Wrong practitioner reported
Wrong action included in the report (Please Explain) _______
Other (Please Explain) _______
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Q 9.3. Before you initiated your dispute process with the NPDB, what other actions were taken? (Select all that apply.)
Tried to resolve the issue directly with the entity that submitted the report to the NPDB
Tried to contact the entity but the entity did not respond or refused further communication
Could not engage with the entity that submitted the report because it no longer exists
Hired legal counsel to try to resolve the issue with the entity that submitted the report to the NPDB
Filed a legal case in the Federal court system
Other (Please Explain) _______
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Q 9.4. Please rate your level of satisfaction with the NPDB’s Disputes Resolution Process (as opposed to the decision that was rendered).
Rating Scale
Very Satisfied / Satisfied / Neither Satisfied Nor Dissatisfied / Dissatisfied / Very Dissatisfied
Survey Page Break
Q 9.5. Based on your dispute, what happened to your report?
No change was made to the report.
Some of the details in the report regarding the action were changed.
The report was voided. Skip the next question.
Other (please explain) _________
Q 9.6. Did you file for re-consideration with the NPDB?
Yes
No
Q 9.7. Why did you file for re-consideration with the NPDB? (Select all that apply.)
Had new evidence not submitted previously
Did not agree with the NPDB’s decision
Believed escalating my case would result in a different outcome
Lawyer recommended filing for re-consideration
Court advised to first exhaust all of the NPDB’s administrative processes
Other (Please Explain) ______
Piping logic:
Survey will be directed to Module 10.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-04-12 |