16 Organizations - Report experiences

16 Organizations - Report experiences.docx

Survey of Eligible Users of the National Practitioner Databank

16 Organizations - Report experiences

OMB: 0915-0366

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OMB Number: 0915-0366; Expiration date: XX/XX/202X


Self-Queriers Survey: Module 16

Number of questions: 5



Report in the NPDB


Q 16.1. What type of report does the NPDB contain regarding your organization? (Please select all that apply.)


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) ____________


Q 16.2. What is the impact of having a report in the NPDB on your business?


Neutral

Slightly Negative

Somewhat Negative

Moderately Negative

Extremely Negative


Survey Page Break


Q 16.3. Has your organization ever added its own statement (also called a subject statement) to the NPDB report?


Yes

No Skip the next question


Q 16.4. What impact has adding your organization’s own statement made?

Text box


Survey Page Break


Q 16.5. Please explain how having a report in the NPDB impacts your business.

Text box



Piping Logic:


Survey will be directed to Module 17.



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