The National Practitioner Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB) have merged! What does this mean for you and your physicians? Continuous queries, one time queries and self-queries are now less painful and more economical.
Since the NPDB and the HIPDB are now combined, the fee for a self-query is reduced to $5.00 and the fee for continuous and one time queries is reduced to $3.00. Once the results are processed, the NPDB sends an electronic copy of the results to the individual/organization querying the NPDB via email in addition to mailing the paper results.
The National Practitioner Data Bank changed the online self-query process so that it is more user friendly. Upon querying the data bank, the requestor has the option to verify personal information of the practitioner in lieu of submitting a notarized copy of the request. Previously, the process could take 4-6 weeks to process a paper request. With the new process, an individual can perform a self-query, pay the fees and verify their identity all online so that the report could be processed and generated quicker. Verifying a person's identity includes answering random questions about current and previous auto loans, mortgages, credit cards and addresses. For those who do not wish to complete the online identity verification process, you can continue to notarize and mail paper requests.
For AddVal clients needing an NPDB self-query, we will contact you about the option you prefer – answer the security questions or notarize request. Please be sure to update your links and favorites with the new website for The National Practitioner Data Bank - http://www.npdb.hrsa.gov/.
Are you looking to maximize your medical staff office personnel for privileging/ appointment/ reappointment? Hiring a new physician & want to check their background? Primary Verification by AddVal is the answer. Consider hiring AddVal to help lessen you and your staff's burden. We will work with you to tailor a package specific to your needs.
Revalidations are still problematic….
We continue to receive 1 or 2 panic calls each week where a physician’s Medicare claims are on hold because the revalidation was not completed. Medicare sends revalidation request letters & follows up with phone calls if the revalidation is not returned. Please do NOT ignore these requests….
As many of you know by now, the State Medical Assistance programs are moving forward with mandatory revalidation in the coming years. Each State is defining their revalidation process with some States requiring yearly revalidation (Delaware), some requiring revalidation every two years (NV), etc. If you and your practice participate with Medical Assistance, it is VERY important to respond to any & ALL revalidation requests from your State’s Medical Assistance program.
The reimbursement rates vary for Medical Assistance but you certainly want to avoid denial of claim payment, no matter how small, due to a missed revalidation. As with Medicare, the revalidation cannot be done until it is requested of the physician or practice. It is crucial to recognize the importance of responding to all mailed requests from Medicare & Medical Assistance within the time frames listed.
"Expecting the world to treat you fairly because you are a good person is like expecting the bull not charge you because you are vegetarian." --Rabbi Harold Kushner
If you need any help with Medicare credentialing or credentialing with any commercial insurers, or you are concerned about Medicare Revalidation please contact AddVal for assistance at 215-396-8972, firstname.lastname@example.org.