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CPCS Study Guide Practice Test(CPCS Study Guide Practice Test)2023 With Complete Solutions.
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CPCS Study Guide Practice Test(CPCS Study Guide Practice Test)2023 With Complete Solutions.
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CPCS Study Guide Practice Test (CPCS Study Guide Practice Test )2023 With Complete Solutions.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 It is required by the Medicare Conditions of Participation.
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 three medical staff committees to be delineated in the medical staff structure. Two of them are the Medical Executive Committee and the Utilization of Osteopathic Methods & Concepts Committee (required for hospitals with ten or more DOs who admit patients and provide direct patient care). What is the other required medical staff committee? - Answer Utilization Review Committee CPCS Study Guide Practice Test (CPCS Study Guide Practice Test )2023 With Complete Solutions.
How often does NCQA require that delegation reports be evaluated by the health plan? - Answer Semi-Annually
Peer references should be obtained from: - Answer Practitioners in the same professional discipline as the applicant
NCQA recognizes which of the following as the final approval of an applicant who does not meet criteria for a clean file? - Answer Credentialing Committee
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 two 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
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