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What are four models of HMOs? - Staff Model Group Model Network Model Independent Practice Association (IPA) What are the four types of committees? - Standing Ad hoc Task force Continuous quality improvement team How many medical staff members comprise a Bylaws Committee? - 5 At least f...

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

According to URAC who should oversee the clinical aspects of the credentialing program within the organization? - Senior Clinical Staff Person Name 3 sources of verification of education of a dentist according to NCQA - Dental school, specialty board, state licensing board NCQA requires MCO's t...

What does HEDIS stand for? - Healthcare Effectiveness Data and Information Set What is HEDIS? - 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 been adopted by public purchaser...

hen a professional review action has been brought against a practitioner reasons for the action summary of the appeal rights and process ability to request a hearing and the specific time period for submitting the request allowing for at least 30 calendar days after the notification for practiti...