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NAMSS CPCS/CPMSM 2023 Study Set for Certification Courses

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Healthcare Facilities Accreditation Program (HFAP) correct answer: Provides Accreditation programs from allopathic and osteopathic actute care hospitals, critical access hospitals, ambulatory surgical centers, ambulatory care/office based surgery, clinical laboratories and behavioral health facilit...

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NAMSS Certification Questions With Complete Solutions

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AHRQ - Agency for Healthcare Research and Qualtiy correct answer: An agency within DHHS established in 1989 to improve quality, appropriateness and effectiveness of US Healthcare AHRQ correct answer: Agency for Healthcare Research and Qualtiy 1989 Medicare Program correct answer: Establishe...

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CPMSM Study Questions With Complete Solutions

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When developing clinical privileges the following are important to evaluate? correct answer: Established standards of practice such as, specialty board recommendations. What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty? correct answer: ...

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CPMSM Study 65 Questions With Complete Solutions

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Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? correct answer: The facility will not get paid for treating patients unless service is provided by an authorized provider Which of the ...

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CPMSM Practice Exam| 150 Questions| With Complete Solutions

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Why it is important to check that the practitioner is not currently excluded suspended the board or in eligible to participate in federal healthcare programs correct answer: The facility won't get paid for treating patients unless service is provided by authorized provider Which of the followin...

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CPMSM Practice Test| 105 Questions| With Complete Solutions

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Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? correct answer: The facility won't get paid for treating patients unless service is provided by authorized provider Which credentials ...

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CPMSM PRACTICE EXAM |210 QUESTIONS | WITH COMPLETE SOLUTIONS

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HFAP correct answer: Refers to a CVO as a Professional Credentialing Organization (PCO) HFAP Appointment time frame correct answer: 2 years TJC Appointment time frame correct answer: No longer than every 2 years NCQA Appointment time frame correct answer: 3 years (to the month) URAC ...

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CPMSM Study Guide - Credentialing and Privileging Questions With Complete Solutions

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Why get accredited? correct answer: 1. assists organizations in monitoring and improving quality of care 2. Deemed status 3. Marketing reasons - shows that expectations for providing safe, quality health care are met 4. may favorably influence liability insurance premiums 5. for a hospital, may...

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CPMSM - Study Guide Material Questions With Complete Solutions

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What are four models of HMOs? correct answer: Staff Model Group Model Network Model Independent Practice Association (IPA) What are the four types of committees? correct answer: Standing Ad hoc Task force Continuous quality improvement team How many medical staff members comprise a Byl...

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CPMSM Study Guide (TJC) - CMH77 Questions With Complete Solutions

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Where must accreditors submit their standards for approval? correct answer: CMS When is deemed status given? correct answer: After approval by CMS What are requirements set by forces outside the organization? correct answer: External criteria What factors are defined by the hospital's m...

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CPCS/CPMSM Sample Questions With Complete Solutions

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Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? correct answer: Yes According to the Joint Commission, who may amend the medical staff bylaws? correct answer: Governing Body Failure to meet the established qualifications and criteria...

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CPCS/CPMSM Exam| 490 Questions| With Complete Solutions

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Applicant completes an application that includes, reasons for inability to perform, las of present illegal drug use, loss of license or felony convictions. Loss or limitation of privileges or disciplinary actions. Current malpractice insurance coverage, current signed attestation confirming the corr...

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CPMSM Practice Test Questions With Complete Solutions

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According to URAC who should oversee the clinical aspects of the credentialing program within the organization? correct answer: Senior Clinical Staff Person Name 3 sources of verification of education of a dentist according to NCQA correct answer: Dental school, specialty board, state licensing...

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CPMSM Knowledge Check Questions With Complete Solutions

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Medicare requires providers to perform what process every 3-5 years? correct answer: Revalidation According to DNV standards, initial appointments to the medical staff are not to exceed what time period? correct answer: 36 months / 3 years T/F: The Joint Commission standards require that the...

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CPMSM Ultimate Study Set 03/2023 Questions With Complete Solutions

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NPDB correct answer: National Practitioner Databank NPDB Contains: (what type of info) correct answer: - adverse licensure - clinical privilege actions - membership actions (professional/society) - paid malpractice judgements - exclusions from Medicare/Medicaid - actions by US DEA What ...

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CPMSM Study Guide| 480 Questions| With Complete Solutions

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Non-profit under religious/community control. correct answer: Voluntary/Charitable Hospital Non-profit under city, state, county. correct answer: Govt (non-federal) hospital Owned/operated by fed gov't, supported by fed funds, e.g., VA. Under direct supervision of Surgeon General. correct a...

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CPMSM Practice Tests / Extras Questions With Complete Solutions

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What does HEDIS stand for? correct answer: Healthcare Effectiveness Data and Information Set What is HEDIS? correct answer: is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has be...

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CPMSM Acronyms Well Explained With Complete Solutions

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AAAHC Accreditation Association for Ambulatory Health Care correct answer: Formed in 1979. Ambulatory means the same as outpatient or overnight stay. It is the preeminent leader in developing standards to advance and promote patient safety, quality and value for ambulatory health care through pe...

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CPMSM Practice Test Questions With Complete Solutions

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Medical Staff correct answer: according to the Joint Commission who is responsible for developing criteria for FPPE when issues affecting the provision of safety patient care are identified. 5 years correct answer: NCQA requires an organization to obtain a claims history for a minimum of how ma...

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CPMSM Study Questions With Complete Solutions

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If a CVO that an AAAHC wants to use isn't accredited, you must do what first? correct answer: Perform an assessment of the capability & quality of the CVO's work When are changes in medical staff bylaws final? correct answer: After approval from the governing body What should be kept in th...

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CPMSM- HCQIA (Healthcare Quality Improvement Act) and NPDB (National Practitioner Databank)

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What does HCQIA stand for? correct answer: Health Care Quality Improvement Act When was HCQIA enacted by congress? correct answer: 1986 What is the purpose of HCQIA? correct answer: HCQIA was enacted to created a national tracking system of physicians with a history of medical malpractice p...

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CPMSM Preparation| 155 Questions| With Complete Solutions

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Why is it important to check that the practitioner is not currently exclude, suspended, debarred, or ineligible to participate in Federal health care programs? correct answer: The facility will not get paid for treating patients unless the service is provided by an authorized provider. Which of ...

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CPMSM accreditation questions with complete solutions

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What is the NCQA timeframe for appointment correct answer: every 36 months to the month What is the HFAP appointment timeframe correct answer: not to exceed 2 years What is the TJC appointment timeframe correct answer: not to exceed 2 years What is the URAC appointment timeframe correct ...

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CPMSM Study Group - 1st half Questions With Complete Solutions

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Does not specifically addressed in the standards health status and Nondiscrimation a.TJC b.HFAP c.DNV GL D.NCQA correct answer: DNV GLS How many peer references does HFAP require at initial appointment? correct answer: 1 According to NCQA what requires ongoing monitoring between recrede...

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