CPCS 2018 Practice Exam 2 Questions & Answers

CPCS 2018 Practice Exam 2 Questions & Answers URAC standards require primary source verification of which two elements when initially credentialing a provider? - ANSWERSa. State licensure & Board certification or highest level of education. b. Medical malpractice claims & Professional liability coverage c. Health status & Ability to perform privileges requested True/False: AOA-HFAP standards allow a hospital to accept the credentialing and privileging decision of another organization (credentialing/privileging by proxy for teleradiology services)? - ANSWERSTrue. In credentialing/privileges for telemedicine, The Joint Commission allows the originating site to use credentialing and privileges information from the distant site if these three requirements are met: - ANSWERS1. The distant site is TJC accredited. 2. The originating site has evidence of an internal review of the practitioner's performance of these privileges and sends to the distant site information that is useful to assess the practitioner's quality of care, treatment, and services for use in privileging and performance improvement. 3. The practitioner is privileged at the distant site for those services to be provided at the originating site. CMS Conditions of Participation for Hospitals require that criteria for selection of medical staff include evaluation of what five things? - ANSWERS1. Character. 2. Competence. 3. Training. 4. Experience. 5. Judgment. NCQA requires verification of which three factors prior to provisionally credentialing a provider? - ANSWERS1. Current signed application with attestation. 2. PSV of a current, valid license to practice. 3. PSV of past 5 years of malpractice claims or settlements from the malpractice carrier or NPDB.