NAMSS STUDY COMBINED SETS: CPCS
PRACTICE Q&A QUESTIONS WITH
CORRECT ANSWERS
i Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or
ineligeble to participate in Federal health care programs? - The Faciltiy won't get paid for treating
patients unlsee service is provided by authorized provider.
Which of the following credentials must be tracked on an ongoing basis - Licensure
Accoding to NCQA standards, an organization that discovers sanction information, complaints, or adverse
events regarding a practitioner must take what action? - Determine if there is evidence of poor quality
that could affect the health and safety of its members.
What is the name of the entity that was established through the Health Care Quality Improvement Act of
1986 to restrict the abiltiy of incompetent physicians, dentists and other health care practtitioners to
move from state to state without disclosure or discovery of previous medical malpractice payment and
adverse action history? - The National Practitioner Data Bank
When developing clinical privileging criteria, which of the following is important to evaluate? -
Established standards of practice such as, specialty board recommendations.
What is the main reason for periodically assessing appropriateness of clinical privileges for each
specialty? - To proctect patient safety by ensuring current competency, revelance to the facility, and
accepted standards of care.
Which of the following specialists is most likely to perform a PTCA? - Interventional Cardiologist
What is the correct order the JC uses to process applications? - 1. Receive application
2. Verify completeness and that all requested materials are included
3. Process Application: Conduct Primary Source Verification and verify current competency for privileges
requested
4. Chief of Service/Department Chair review and recommendation (if departmentalized)
5. Executive Committee reviews and makes recommendations to the Board of Trustees
6. Board approves
7. Notify applicant of final decision
What is the correct order NCQA uses to process applications? - 1. Receive application
2. Verifly completeness and that all requested materials are included
3. Process application: Conduct Primary Source Verification
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