OMB Number: 0915-0366; Expiration date: XX/XX/202X
Entities Survey: Module 14
Number of questions: 2
This module is relevant for only those participants who query the NPDB, either directly or through an authorized agent.
Matches in Query Response
Q 14.1. Has your organization ever received a query response containing an adverse action report, a judgment or conviction report, or a medical malpractice payment report from the NPDB?
Yes Go to Q 14.2
No Go to Module 16
Other (Please explain) ________ Go to Module 16
Q 14.2. When was the last time your organization received such a response to your query?
In the last month
1 month to 3 months
3 months to 6 months
6 months to 1 year
1 year to 2 years
2 to 3 years
More than 3 years
Survey Page Break
Piping Logic:
If participants select “yes” to Q 14.1, they will be directed Q 14.2, and then to Module 15 to provide additional details of matched responses. Otherwise, they will be directed to Module 16 about reports.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-02-15 |