NAMSS STUDY COMBINED SETS; CPCS PRACTICE
QUESTIONS AND VERIFIED ANSWERS
Why it is necessary to check whether the practitioner is currently excluded,
suspended, debarred or otherwise ineligible to participate in Federal health care
programs? - ANSWER The Facility won't get paid for the patients being
treated unless service is provided by an authorized provider.
Which of the following credentials needs to be monitored on an ongoing basis -
ANSWER Licensure
When an organization identifies sanction information, complaints, or adverse
events related to a practitioner, for example, under the NCQA standards, it must
take the following action: - ANSWER Identify whether there is poor quality
evidence that may jeopardize the health and safety of its members.
What does the Health Care Quality Improvement Act of 1986 call the entity it
established 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
In the development of clinical privileging criteria, which of the following will
you want to evaluate? - ANWER Established norms of practice such as,
specialty board recommendations.
For each of the specialties periodically evaluating appropriateness of clinical
privileges is done for what purpose? - ANSWER To proctect patient safety by
ensuring current competency, revelence to the facility, and accepted standards
of care.
, Which of the following specialists is most likely to perform a PTCA? -
ANSWER Interventional Cardiologist
What is the correct order the JC uses to process applications? - ANSWER 1.
Receive application
2. Verify completeness and that all requested materials are included
3. Process Application: Conduct Primary Source Verification and verify current
competency for privileges requested
4. Chief of Service/Department Chair review and recommendation (if
departmentalized)
5. Executive Committee reviews and makes recommendations to the Board of
Trustees
6. Board approves
7. Notify applicant of final decision
What is the order NCQA uses in its Process? - ANSWER 1. Receive
application
2. Verifly completeness and that all requested materials are included
3. Process application: Conduct Primary Source Verification
4. Medical Director reviews and approves or makes recommendation to
Credentials Committee, if required by procedure
5. Credentials Committee reviews for information only or to approve
6. Notify applicant of final decision
What is the sequence in which HFAP processes applications? - ANSWER 1.
Receipt of application and verification for completeness and inclusion of all
requested materials.
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