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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 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...

Where must accreditors submit their standards for approval? - CMS When is deemed status given? - After approval by CMS What are requirements set by forces outside the organization? - External criteria What factors are defined by the hospital's medical staff and governing body or the MCO's board...

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 repor...

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...