Cpmsm 2023 - Study guides, Class notes & Summaries

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 five active medical staff How many medical staff members comprise a Credentials Committee? 5 At least five active medical staff How many medical staff members must serve on an ...

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 correctness and completeness of the application. If an application from an external entity is used it must include the questions and attestations as identified above. Signature stamps are not acceptable u...

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 correctness and completeness of the application. If an application from an external entity is used it must include the questions and attestations as identified above. Signature stamps are not acceptable u...

Why is it important to check that the practitioner is not currently exclude, suspended, debarred, or ineligible to participate in Federal health care programs? The facility will not get paid for treating patients unless the service is provided by an authorized provider. Which of the following credentials must be tracked on an ongoing basis? Licensure According to NCQA standards, an organization that discovers sanction information, complaints, or adverse events regarding a practit...

AAAHC Accreditation Association for Ambulatory Health Care 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 peer-based accreditation processes, education and research. Accreditation is ultimately awarded to organizations that are found to be in compliance with their standards. With a single focus on the ambulatory care comm...

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 ...

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 facilities. While previously primarily osteopathic focuses, HFAP is not authorized by the Centers for Medicare and Medicaid Services (CMS) to survey all hospitals for compliance with the Medicare Conditions ...

NAMSS CPCS-CPMSM 2023 Healthcare Facilities Accreditation Program (HFAP) - ANS-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 facilities. While previously primarily osteopathic focuses, HFAP is not authorized by the Centers for Medicare and Medicaid Services (CMS) to survey all hospitals for compliance with the...