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CPMSM TEST QUESTIONS AND ANSWERS
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CPMSM TEST QUESTIONS AND ANSWERS2024-2025
According to URAC, who should be in charge of the clinical parts of the
credentialing program inside the organization? - ANSWER Senior Clinical Staff
Name three sources for verifying a dentist's education according to NCQA. Dental
schools, speciality boards, and state licensing boards
NCQA mandates MCOs to re-credential practitioners at least every three years.
HFAP is also known as ANSWER AOA, an osteopathic association.
T/F No accreditation body demands verification of malpractice insurance -
ANSWER: True
What six criteria are observed in an initial site visit by NCQA? ANSWER 1.
Physical accessibility. 2. Physical appearance. 3. Adequate waiting and exam
rooms. 4. Appointment availability 5. Adequacy of treatment 6. Record-keeping
procedures
According to TJC, which of the following should be utilized to determine present
competence? 1. Board Certification. 2. Malpractice Face Sheet. 3. Hospital
Verification. 4. Patient complaint record - hospital verification
According to NCQA, who has final control over credentialing decisions? -
ANSWER Credentials committee of the medical director, whether it is a clean file
EMTALA does not apply to the following two entities: the military and Shriners.
, Name the six general competencies according to ACGME and ABMS: ANSWER
1. Patient Care 2. Medical/clinical knowledge 3. Practice-based learning and
improvement. 4. Interpersonal and Communication Skills 5. Professionalism 6.
System-based practice.
What does the medical staff actively measure, assess, and improve? - ANSWER
Patient safety data.
If a hospital loses accreditation due to giving false information to the joint
commission, it may be barred from participating in the accreditation process for an
extended period. - ANSWER 1 year
What method does the NCQA employ to publicly report survey results? -
ANSWER Health Plan Report Card.
According to the Joint Commission, what areas of an organization's system,
structure, and process are most relevant to the organization's patient safety and
quality of care, as well as the most vulnerable to bad outcomes? - ANSWER
Critical priority areas:
According to NCQA, what must be contained in an organization's right to appeal
policy? - ANSWER Written notice of the action, stating the reasons for it
How many days does a CVO have to request a reconsideration of its certification
denial? - Answer 30 days.
An MCO may appeal the accreditation decision by NCQA within how many days?
ANSWER 30 days.
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