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CPCS CPMSM - Participant Guide Sample Test questions and answers
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CPCS CPMSM - Participant Guide Sample Test questions and answers
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CPCS/CPMSM - ParticipantGuide Sample Test questions
and answers
Why it is important to check that the practitioner is not currently
excluded, suspended, debarred, or ineligible to participate in Federal
health care programs? - answer The facility won't get paid for treating
patients unless service is provided by authorized provider.
Which of the following credentials must be tracked on an ongoing basis? -
answer Licensure
According to NCQA standards, an organization that discovers sanction
information, complaints, or adverse events regarding a practitioner must
take what action? - answer 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 ability of
incompetent physicians, dentists, and other health care practitioners to
move from state to state without disclosure or discovery of previous
medical malpractice payment and adverse action history? - answer The
National Practitioner Data Bank
When developing clinical privileging criteria, which of the following is
important to evaluate? - 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? - answer To protect patient safety
by ensuring current competency, relevance to the facility, and accepted
standards of care.
,Which of the following specialists is most likely to perform a PTCA? -
answer Interventional Cardiologist
The Joint Commission hospital standards require that clinical privileges
are hospital specific and - answer Based on the individual's demonstrated
current competence and the procedures the hospital can support.
Which of the following would be routinely performed by a cardiologist? -
answer Transesophageal Echocardiography
Which NCQA-required committee makes recommendations regarding
credentialing decisions? - answer Credentialing Committee
HFAP standards require two medical staff committees to be delineated in
the medical staff structure. One of them is the Medical Executive
Committee. What is the other required medical staff committee? - answer
Utilization Review Committee
If you needed to find out about what the Federal Government requires in
regards to anti-trust issues, what law would you consult? - answer
Sherman Anti-trust Act
Peer references should be obtained from: - answer Practitioners in the
same professional discipline as the applicant
Patrick v. Burgett is an important case because it: - answer Illustrates
the potential for antitrust liability arising out of peer review activities.
If a medical staff member has privileges and/or medical staff appointment
revoked, he/she must be: - answer Provided due process.
Access to credentials files should be: - answer Described fully in an
access policy.
, Which of the following bodies approves clinical privileges? - answer
Governing Body or Board
What primary source verification is required by NCQA prior to provisional
credentialing? - answer Licensure and 5-year malpractice history or NPDB
According to The Joint Commission standards, initial appointments to the
medical staff are made for a period of: - answer not to exceed 2 years
According to The Joint Commission standards, temporary privileges may
be granted by: - answer The CEO on the recommendation of the medical
staff president or authorized designee
According to The Joint Commission Standards, which of the following items
must be verified with a primary source? - answer Licensure, training,
experience, and competence
According to NCQA standards, a copy of which of the following is
acceptable verification of the document? - answer DEA certificate
According to NCQA standards, which is an acceptable source for primary
source verification of Medicare and Medicaid sanction activity against
physicians? - answer Federation of State Medical Boards
According to The Joint Commission standards, which of following is
considered a designated equivalent source for verification of board
certification? - answer The American Board of Medical Specialties
Which of the following organizations have been recognized by The Joint
Commission and NCQA to provide primary source verification of medical
school graduation and residency training for U.S. graduates? - answer
American Medical Association Masterfile
According to NCQA standards, the application attestation statement must
affirm that the application - answer Is correct and complete.
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