Hcqia - Study guides, Class notes & Summaries

CPCS - Certified Provider Credentialing Specialist Questions and Answers 100% Pass Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? Yes According to TJC, who may amend the medical staff bylaws? Governing body/board. Failure to meet the established qualifications and criteria for appointment should be reported to whom? The applicant NCQA requires the MCO to obtain a minimum of how may years of work history? Five years According to the...

CPMSM HFAP stands for? - correct answer Healthcare Facilities Accreditation Program (Accrediting organization for AOA. Provides accreditation programs for primarily osteopathic hospitals) The following bodies approves clinical privileges? - correct answer Governing Body or Board Which NCQA-required committee makes recommendations regarding credentialing decisions? - correct answer Credentialing Committee What primary source verification is required by NCQA prior to temporary privileges/...

Boyd vS Albert Einstein correct answer: Doctrine of Ostensible Agency - HMO found liable in patient's death. Chest perforation during breast biopsy, chest pain/MI six weeks later. Elam vS CollegePark correct answer: Doctrine of Corporate Negligence - Med Records had information on many lawsuits agains podiatrist Patrick vs Burget correct answer: Anticompetitive Peer Review - Led to development of HCQIA Gonzales vs Nork & Mercy Hospital correct answer: Hospitals owe patients a duty ...

CPMSM- HCQIA (Healthcare Quality Improvement Act) and NPDB (National Practitioner Databank)2024 M- HCQIA (Healthcare Quality Improvement Act) and NPDB (National Practitioner Databank) Study CPMSM- HCQIA (Healthcare Quality Improvement Act) and NPDB (National Practitioner Databank) In-class activity Classic Live Checkpoint Self-study activity Flashcards Learn Test Match What does HCQIA stand for? Health Care Quality Improvement Act 1 / 22 Profile Picture ...

CPCS CPMSM Sample Questions 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 for appointment should be reported to whom? - correct answer The applicant NCQA requires the MCO to obtain a minimum of ???? years of work history? - correct answer ...

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 medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported to whom? - The applicant NCQA requires the MCO to obtain a minimum of years of work history? - Five years According to NCQA what policy must an organization have in place to obtain approval to enter in...

WGU C426 Healthcare Values and Ethics Rated A+ Normative Ethics Attempt to determine what moral standards should be followed so that human behavior and conduct may be morally right. Consequential Ethics Theory of ethics emphasizes that the morally right action is whatever action leads to the maximum balance of good over evil. - What will be the effects of each course of action? - Will they be positive or negative? - Who will benefit? - What will do the least harm? Utilitarian Ethics The conce...

What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners must be notified of credentialing decision within how many days? - 60 Days The DHHS mails a copy of the NPDB report to the named provider. If the provider wishes to dispute the reports accuracy, the prov...

CPCS Credentialing Cases Latest Update Graded A+ Darling v. Charleston Fact: Negligent treatment resulting in amputation of teenagers leg Key: Charitable Immunity Doctrine Johnson v. Misericordia Fact: Patient injured by physician who failed to disclose malpractice cases Key: Negligent credentialing; failure of initial credentialing Elam v. College Park Fact: Podiatrist's negligence Key: Negligent Credentialing Patrick v. Burget Fact: Peer review for anti-competitive reasons Key: HCQIA, Viol...

HFAP stands for? Healthcare Facilities Accreditation Program (Accrediting organization for AOA. Provides accreditation programs for primarily osteopathic hospitals) The following bodies approves clinical privileges? Governing Body or Board Which NCQA-required committee makes recommendations regarding credentialing decisions? Credentialing Committee What primary source verification is required by NCQA prior to temporary privileges/provisional credentialing? Licensure and ...