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URAC BUNDLED EXAMS 2023 WITH 100% COMPLETE SOLUTIONS
URAC EXAM 2023 WITH 100% COMPLETE SOLUTIONS WORK - URAC Audit Questions & Answers 2023 (100% correct)
[Show more]URAC EXAM 2023 WITH 100% COMPLETE SOLUTIONS WORK - URAC Audit Questions & Answers 2023 (100% correct)
[Show more]How do you (or the organization) provide oversight to ensure the company is compliant with applicable laws and regulations? correct answers1) Review the policies and procedures to confirm that we are accurately following the standard regulations. 
2)The Compliance team conducts internal audits and r...
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Add to cartHow do you (or the organization) provide oversight to ensure the company is compliant with applicable laws and regulations? correct answers1) Review the policies and procedures to confirm that we are accurately following the standard regulations. 
2)The Compliance team conducts internal audits and r...
Credentialing Program correct answerscovers all practitioners who are participating providers and are providing health care services 
 
Credentialing may be delegated to correct answers1. a contracted network 
2. a group 
3. a clinic 
Delegation oversight is required and delegated entity must be per...
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Add to cartCredentialing Program correct answerscovers all practitioners who are participating providers and are providing health care services 
 
Credentialing may be delegated to correct answers1. a contracted network 
2. a group 
3. a clinic 
Delegation oversight is required and delegated entity must be per...
What is your involvement in patient management? correct answersInvolves prescription dispensing, reimbursement, counseling, and patient clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
How do we promote drug adherence? correct answersInitial counseling...
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Add to cartWhat is your involvement in patient management? correct answersInvolves prescription dispensing, reimbursement, counseling, and patient clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
How do we promote drug adherence? correct answersInitial counseling...
Patient Care: What is your involvement in Patient Management? correct answersPatient Management involves prescription dispensing, reimbursement, counseling and patient clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
Patient Care: How do we promote dru...
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Add to cartPatient Care: What is your involvement in Patient Management? correct answersPatient Management involves prescription dispensing, reimbursement, counseling and patient clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
Patient Care: How do we promote dru...
Patient Care: What is your involvement in Patient Management? correct answersPatient management involves prescription dispensing, reimbursement, counseling, and patient clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
Patient Care: How do we promote dr...
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Add to cartPatient Care: What is your involvement in Patient Management? correct answersPatient management involves prescription dispensing, reimbursement, counseling, and patient clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
Patient Care: How do we promote dr...
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Add to cartWho has access to the controlled substances? Only pharmacists 
 
Who has access to the pharmacy? Access is limited to pharmacists and technicians. 
 
How do you know if a recalled drug is currently being processed for an order and is still in the pharmacy in a tote or packed? The recall information ...
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Add to cartWho has access to the controlled substances? Only pharmacists 
 
Who has access to the pharmacy? Access is limited to pharmacists and technicians. 
 
How do you know if a recalled drug is currently being processed for an order and is still in the pharmacy in a tote or packed? The recall information ...
What is your involvement in patient management? correct answersPatient management involves prescription dispensing, reimbursement, counseling, and pt clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
How do we promote drug adherence? correct answersDuri...
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Add to cartWhat is your involvement in patient management? correct answersPatient management involves prescription dispensing, reimbursement, counseling, and pt clinical care activities we do. My involvement depends on the role I am assigned for the day. 
 
How do we promote drug adherence? correct answersDuri...
PATIENT CARE 
Have the intake technician explain the electronic prescribing prescription intake process. correct answersPractice touring the pharmacy, explain each work station, introduce team members and what their primary responsibility is during prescription intake. 
 
PATIENT CARE 
Have a Phar...
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Add to cartPATIENT CARE 
Have the intake technician explain the electronic prescribing prescription intake process. correct answersPractice touring the pharmacy, explain each work station, introduce team members and what their primary responsibility is during prescription intake. 
 
PATIENT CARE 
Have a Phar...
Technique is used by many pharmaceutical companies with health plans and PBMs to increase formulas correct answersRebates for preferred formulary position, health economic data, including a growing number of head-to-head clinical trials, member copayment coupons to offset copayment. 
 
Recent legisl...
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Add to cartTechnique is used by many pharmaceutical companies with health plans and PBMs to increase formulas correct answersRebates for preferred formulary position, health economic data, including a growing number of head-to-head clinical trials, member copayment coupons to offset copayment. 
 
Recent legisl...
What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? correct answersHFAP, CMS 
 
According to JC & HFAP name four approved sources PSV for Medical Education correct answersMedical School, AMA, ECFMG, AOA 
 
Acco...
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Add to cartWhat two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? correct answersHFAP, CMS 
 
According to JC & HFAP name four approved sources PSV for Medical Education correct answersMedical School, AMA, ECFMG, AOA 
 
Acco...
According to NCQA, in which situation should a practitioner be notified about a discrepancy and be required to submit additional information? correct answersWhen actions are listed on a license 
 
The Joint Commision defines credentialing as? correct answersThe Process of obtaining, verifying, and a...
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Add to cartAccording to NCQA, in which situation should a practitioner be notified about a discrepancy and be required to submit additional information? correct answersWhen actions are listed on a license 
 
The Joint Commision defines credentialing as? correct answersThe Process of obtaining, verifying, and a...
quality measures associated to healthcare in the US correct answersFour categories of healthcare delivery activities that can be measures include structure, process, outcome, and patient experience 
 
Differentiate types of quality measure and example applications correct answers- Structure: charact...
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Add to cartquality measures associated to healthcare in the US correct answersFour categories of healthcare delivery activities that can be measures include structure, process, outcome, and patient experience 
 
Differentiate types of quality measure and example applications correct answers- Structure: charact...
what is the primary objective of quality improvement? correct answersIMPROVEMENT IN PATIENT OUTCOMES 
 
DEVELOPED A SET OF MANAGEMENT PRINCIPLES IN 1950S? correct answersDeming 
 
four principles of Total Quality Management correct answers1. CQI: PHILOSOPHY TO CONTINUOUSLY SEEK IMPROVEMENT. 
2. INN...
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Add to cartwhat is the primary objective of quality improvement? correct answersIMPROVEMENT IN PATIENT OUTCOMES 
 
DEVELOPED A SET OF MANAGEMENT PRINCIPLES IN 1950S? correct answersDeming 
 
four principles of Total Quality Management correct answers1. CQI: PHILOSOPHY TO CONTINUOUSLY SEEK IMPROVEMENT. 
2. INN...
What elements should a peer recommendation include according to TJC? correct answersPatient Care, medical clinical knowledge, practice based learning, interpersonal and communication skills, system-based practice 
 
Peer recommendations according to NCQA correct answersThere is no specific requireme...
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Add to cartWhat elements should a peer recommendation include according to TJC? correct answersPatient Care, medical clinical knowledge, practice based learning, interpersonal and communication skills, system-based practice 
 
Peer recommendations according to NCQA correct answersThere is no specific requireme...
1. The BoP is under the Dept of ___ 
2. The Agency for Health Care Admin Division of Quality Assurance deals with ___ and ___ 
3. The State Ins Commissioner ensures ___ with state laws 
4. Most pharmacy laws regulated at ___ level correct answers1. Health 
2. Medicare/caid 
3. compliance 
4. state 
...
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Add to cart1. The BoP is under the Dept of ___ 
2. The Agency for Health Care Admin Division of Quality Assurance deals with ___ and ___ 
3. The State Ins Commissioner ensures ___ with state laws 
4. Most pharmacy laws regulated at ___ level correct answers1. Health 
2. Medicare/caid 
3. compliance 
4. state 
...
TJC (The Joint Commission) Definition of Credentialing correct answersThe process of obtaining, verifying, and assessing the qualifications of a health care practitioner who seeks to provide patient care services in or for a hospital. 
 
NCQA (National Committee for Quality Assurance) definition of ...
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Add to cartTJC (The Joint Commission) Definition of Credentialing correct answersThe process of obtaining, verifying, and assessing the qualifications of a health care practitioner who seeks to provide patient care services in or for a hospital. 
 
NCQA (National Committee for Quality Assurance) definition of ...
the right of payer to recover any legal settlement or award dollars associated with healthcare costs if a member was harmed by a third party. correct answersSubrogation 
 
Under _________, people who lose their employer-based group coverage due to a life event are usually able to extend that coverag...
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Add to cartthe right of payer to recover any legal settlement or award dollars associated with healthcare costs if a member was harmed by a third party. correct answersSubrogation 
 
Under _________, people who lose their employer-based group coverage due to a life event are usually able to extend that coverag...
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 corr...
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Add to cartApplicant 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 corr...
UM focuses on telling doctors and hospitals what to do. correct answersFALSE 
 
The use of utilization guidelines targets only managed care patients and does not have an impact on the care of non-managed care patients. correct answersFALSE 
 
Nurse-on-call or medical advice programs are considered d...
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Add to cartUM focuses on telling doctors and hospitals what to do. correct answersFALSE 
 
The use of utilization guidelines targets only managed care patients and does not have an impact on the care of non-managed care patients. correct answersFALSE 
 
Nurse-on-call or medical advice programs are considered d...
False correct answersPatient experience is the same thing as patient satisfaction T or F 
 
False correct answersAll surveys officially designated as CAHPS surveys have been approved by the HEDIS Consortium, which is overseen by the Agency for Healthcare Research and Quality (AHRQ) T or F 
 
False c...
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Add to cartFalse correct answersPatient experience is the same thing as patient satisfaction T or F 
 
False correct answersAll surveys officially designated as CAHPS surveys have been approved by the HEDIS Consortium, which is overseen by the Agency for Healthcare Research and Quality (AHRQ) T or F 
 
False c...
HIM [health information management] professional correct answersthe responsibility of every healthcare professional is to be informed about healthcare documentation standards and to work with other HIM professionals to ensure accurate, timely documentation so that patients receive quality care. 
 
P...
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Add to cartHIM [health information management] professional correct answersthe responsibility of every healthcare professional is to be informed about healthcare documentation standards and to work with other HIM professionals to ensure accurate, timely documentation so that patients receive quality care. 
 
P...
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