Ncqa - Study guides, Class notes & Summaries

CPCS Exam 2016 Questions & Answers MCO acronym for - ANSWERSManaged Care Organization - main accreditors: NCQA, URAC NAMSS acronym for - ANSWERSNational Association of Medical Staff Services CPCS acronym for - ANSWERSCertified Provider Credentialing Specialist CVO acronym for - ANSWERSCredential Verifications Organization HEDIS acronym for - ANSWERSHealthcare Effectiveness Data Information Set CAHPS acronym for - ANSWERSConsumer Assessment of Healthcare Providers & Systems ...

CPCS - Credentialing and Privileging Questions and Answers Rated A+ TJC Phone PSV What accreditation can use phone for PSV for all information including: licensure, education, training, experience, competence, and peer references LIP any individual permitted by law and by the hospital to provide patient care services w/o direction or supervision, LIP any individual permitted by law and by the hospital to provide patient care services w/o direction or supervision, TJC - DNV - HFAP Accreditatio...

What is the benefit of a medical home? - Better quality, patient experience, reduced costs, reduced disparities in care and lower rates of provider burnout What is the new format of the standards? - Concept, Competency and Criteria How do you achieve recognition? - Complete 40 core and 25 elective credits across 5 of the 6 concepts How do you demonstrate continued recognition? - A series of virtual reviews and annual reporting How many and what are the PCMH standards? - 6, TC, KM, AC, CM, ...

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, ...

CPCS Exam Questions & Answers 2024/2025 Q - The _____ defines credentialing as "the process of obtaining, verifying, and assessing the qualifications of a health care practitioner who seeks to provide patient care services in or for a hospital. - ANSWERSA - The Joint Commission Q- The _____ defines credentialing as a process by which an organization reviews and evaluates qualifications of licensed independent practitioners to provide services to its members. - ANSWERSA - NCQA Q - Wha...

CPCS 2022 Fall Study (Accred Grid+Roberts Rules+Practice Exams) Already Passed True or False: According to The Joint Commission, the applicant's ability to perform privileges requested must be evaluated and this evaluation must be documented in the credentials file. True 2 MULTIPLE CHOICE OPTIONS According to HFAP – information regarding ability to perform is requested for each a. Applicant b. Applicant & Re-applicant c. Re-applicant Applicant & Reapplicant True or False: According to ...

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

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: 5 years According to NCQA wh...

CPMSM 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 Appointment time frame - correct answer 3 years AAAHC Appointment time frame - correct answer 3 years Attestation Statement - correct answer TJC and Medicare do not specifically address, URAC allows electronic signature, all others require. Board Certification Verification - ...

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