CPMSM QUESTIONS AND ANSWERS LATEST UPDATED 2024

CPMSM QUESTIONS AND ANSWERS LATEST UPDATED 2024 According to URAC who should oversee the clinical aspects of the credentialing program within the organization? Senior Clinical Staff Person Name 3 sources of verification of education of a dentist according to NCQA Dental school, specialty board, state licensing board Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:06 / 0:15 Full screen NCQA requires MCO's to recredential practitioners at least every 3 years HFAP is commonly known as AOA, an osteopathic organization T/F No accreditation body requires verification of malpractice insurance True What six criteria are observed in an initial site visit by NCQA 1. Physical accessibility 2. Physical appearance 3. Adequacy of waiting and exam rooms 4. Appointment availability 5. Adequacy of treatment 6. Record keeping processes According to TJC which of the following should be used to verify current competence? 1. Board Certification 2. Malpractice Face Sheet 3. Hospital Verification 4. Patient complaint record Hospital verification According to NCQA, who has ultimate authority in credentialing decision? Credentials committee of medical director if it is a clean file What two entities does EMTALA not apply Military and Shriners Name the six general competencies according to ACGME and ABMS 1. Patient Care 2. Medical/clinical knowledge 3. Practice based learning and improvement 4. Interpersonal and communication skills 5.Professionalism 6. System based practice The medical staff is actively involved in measuring, assessing and improving what? Patient safety data If a hospital loses accreditation for providing falsified information to the joint commission, it may not participate in the accreditation process again for a period of how long? 1 year What does the NCQA use for public reporting of survey results? Health Plan Report Card Areas of an organization's system, structure and process that are most relevant to the organization's patient safety & quality of care, AND most at rick for negative outcomes are referred to as what according to the Joint Commission? Critical focus areas According to NCQA what must be included in the organizations rights to appeal policies? Written notification of the action including the reasons for the action If a CVO wishes to request reconsideration of denial of its certification it must do so within how many days? 30 days An MCO may appeal the accreditation decision by NCQA within how many days 30 days T/F Negligence is considered a standard of care violation True If a hospital changes ownership/control/change in capacity, it must notify TJC in writing not less than how many days after he change? 30 days Cancer Registry programs may be accredited for up to 3 years In order for an organization to apply for NCQA survey, they must have been in operation for how long? 18 months In order to apply for NCQA certification the CVO must have been under contract to provide verification services at least Six months According to URAC's health network standards, each applicant within the scope of the credentialing program submits an application that includes at least.... State licensure information, including current license(s) and history of licensure in all jurisdiction According to The Joint Commission hospital standards, _________________________________ is an element of a self-governing medical staff The medical staff determines the mechanism for establishing and enforcing criteria for assigning oversight responsibilities to practitioners with independent privileges.