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When Should Your Organization Query the NPDB? – ANA Continues to Speak Out Against Harmful Cuts to Health Care – (866) 348-2889

The NPDB is a health care workforce tool designed to provide important information to organizations, and to facilitate dialogue between the organization and the practitioner. Entities authorized to query the NPDB are permitted to do so for the following reasons:

Compliance Review Infographic
Professional review activities
Mandatory two-year review of clinical privileges or medical staff membership (hospitals)
Licensing or certification
Fraud and abuse investigation
Certification to participate in a government program
Claims processing
Hospitals are required to query the NPDB for every member of their privileged staff at initial appointment, and every two years thereafter. Health care organizations such as federally-qualified health centers, long-term care facilities, HMOs, and others use the NPDB query response as part of their review and credentialing process. Many accreditation organizations such as the Joint Commission, DNV, and AAAHC require organizations to query the NPDB.