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How to Submit a Report

To submit a report, complete the report form based on the type of action your organization took against the subject. In the narrative description, provide background information and explain the circumstances of the action that led to the report. Organizations who query will use the information you provide, in conjunction with other relevant information, to make decisions about hiring, licensing, and credentialing practitioners. The description provides future queriers a clear understanding of what the subject of the report did, or is alleged to have done, that led to you filing the report.

Submitting a Report

  1. Sign in and select Report on the Select an Option page.
  2. On the Report Type page, choose what you would like to do:
    • Report a new action that is not related to previously reported action select Start a new report.
    • Complete a draft report, select Continue a draft report.
    • Void, correct, record a notice of appeal, or report a subsequent action related to a previously reported action (i.e., reinstatement of privileges), select Modify an existing report.
  3. On the Identify the Subject page, select whether the subject is a practitioner or an organization, then enter the subject's name.
  4. Select the type of action on the following page. Use the Adverse Action Report selection for clinical privileges, professional society and licensure actions, and Medicare or Medicaid exclusions.
  5. Complete all four sections of the report form . Enter as much information as possible in the Subject Information section. You can use the search tool to find the subject's profession or license type or choose from the frequently used professions.
  6. Complete the Action Information section and include a detailed narrative.
    Note: You can select "Save and finish later" to save the report as a draft for 30 days.
  7. Review the information you provided to ensure it is correct, then complete the Certification section.
    Note: You must send a copy of certain reports to the appropriate state board. Reporters may mail a copy of the report to the appropriate state licensing board or send an electronic version of the report through the NPDB system, provided the appropriate state board accepts electronic notices.
  8. Save or print a copy of the report on the Report Submission Complete page.

How to Retrieve a Report

After submitting your report, it will appear instantly on the Report Submission Complete page and can be saved to your computer as a PDF by selecting Save Report to Your Computer. You may view, save, or print the report again at another time by completing the following steps:

  1. Sign in and select Reporting Activity under the Report Options section on the Select an Option page. The following Reporting Activity page will list all practitioners who your organization has reported in the last 30 days, with the most recently reported practitioners first.
  2. Select the subject's name to show all reports on the practitioner, with additional data on each report, such as report type, report DCN, and submitter. Select the PDF link to view the report.