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CPCS EXAM STUDY GUIDE LATEST VERSION
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CPCS EXAM STUDY GUIDE LATEST VERSION...
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CPCS EXAM STUDY GUIDE LATEST VERSIONIt is defined by the joint commission as - ANSWER The process of obtaining,
verifying, and assessing the qualifications of a health care practitioner who
seeks to provide patient care in or for a hospital
NCQA defines credentialing as ANSWER A process by which an organization
reviews and evaluates the qualifications of licensed independent practitioners to
provide services to its members.
The number one reason for credentialing is to answer patient safety
The three major reasons for credentialing are - ANSWER 1. Patient Safety
2. Risk Management concerns
3. Required by accrediting and regulatory agencies
What does CoPs stand for ANSWER Medicare Conditions of Participation The
CoPs which are contained in the code of federal regulations are intended to
protect patient health and safety and to ensure quality of care for hospitalized
patients
Why get Accredited - ANSWER Accreditation helps an organization to
monitor and improve quality of care. It can be used in place of some medicare
certification requirements, this means they have "deemed status." This means an
accredited organization meets the medicare and medicaid requirements for
participation.
Other reasons to become accredited - ANSWER 1. may positively impact
liability insurance premiums
, 2. may be required in order to obtain managed care contracts
3. Employers and unions may require accreditation for providing health care
coverage to employees
After CMS approves an Accreditor they are given deemed status, name the
accreditors that have deemed status - ANSWER 1. The joint commission TJC
2. American Osteopathic Association Health Facilities Accreditation program
(AOA-HFAP)
3.Det Norske Veritas Healthcare Inc. (DNV)
4. National Integrated accreditation for healthcare organizations (NIAHO)
5. National committee for quality assurance (NCQA)
6. URAC
7. Accreditation association for ambulatory health care (AAAHC)
What is Compliance - ANSWER Participate in the development,
implementation, an ongoing assessment of bylaws, rules and regulations,
policies & procedures to ensure continuous compliance with accreditation
regulatory standards.
What is the MSO - ANSWER Medical Staff Organization - while many
regulatory agencies & Accreditation bodies require that certain organizational
components be in place, the exact formal structure and specific mechanisms of
operation are left to the discretion of the MSO and governing body of the
healthcare organization
What are the functions of the MSO - ANSWER The provision of patient care,
evaluation of the quality of patient care, maintenance of the MSO.
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