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CPMSM- URAC Utilization Review Accreditation Commission Test questions and answers 2025 lates
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CPMSM- URAC Utilization Review Accreditation Commission Test questions and answers 2025 lates
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CPMSM- URAC Utilization ReviewAccreditation Commission Test
questions and answers 2025 latest
update.
What does URAC stand for? - answer Utilization Review
Accreditation Committee
What does URAC use as the list of providers (practitioners
and facilities) that fall within the scope of the
credentialing program? - answer The organization's
provider directory
If the organization chooses to list practitioners at a
contracted facility in its provider directory, do those
providers have o be credentialed? - answer Yes. If the
contracted provider is listed in the directory, they must be
credentialed regardless of whether or not the organization
contracts directly with the practitioner.
Credentials collected for health care facilities include (as
applicable) but are not limited to what? - answer State
License
OIG Status
Copy of liability insurance policy declaration sheet
Signed and dated attestation that application is complete
and accurate
Accreditation status (e.g.- TJC, CARF, AAAHC etc...)
, Any other information necessary to determine if the
facility meets the network-based health benefits plan
participation criteria
What must be completed prior to listing a provider on the
online or paper directory? - answer The credentialing
process
Name 3 ways to document formal approval of the
credentialing plan. - answer 1. Individually signed/dated
policies & procedures
2. A signed/dated master list of policies & procedures
3. Signed/dated meeting minutes documenting formal
approval
How often must the credentialing plan be
reviewed/approved? - answer Annually
Who is responsible for oversight of the clinical aspects of
the credentialing program? - answer The senior clinical
staff person of the organization
Who is responsible for the overall direction of the
credentialing program and approving/disapproving
applications for network participation? - answer The
Credentialing Committee
Does the Credentialing Committee have to review clean
applications? - answer No. If the application is clean,
then it does not need to go the Credentialing Committee
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