Exam (elaborations)
CPMSM- URAC Utilization Review Accreditation Commission Test questions and answers 2025 lates
- Course
- Institution
CPMSM- URAC Utilization Review Accreditation Commission Test questions and answers 2025 lates
[Show more]
Content preview
CPMSM- URAC Utilization ReviewAccreditation Commission Test
questions and answers 2025 latest
update.
What does URAC stand for? - answer Utilization Review
Accreditation Committee
What does URAC use as the list of providers (practitioners
and facilities) that fall within the scope of the
credentialing program? - answer The organization's
provider directory
If the organization chooses to list practitioners at a
contracted facility in its provider directory, do those
providers have o be credentialed? - answer Yes. If the
contracted provider is listed in the directory, they must be
credentialed regardless of whether or not the organization
contracts directly with the practitioner.
Credentials collected for health care facilities include (as
applicable) but are not limited to what? - answer State
License
OIG Status
Copy of liability insurance policy declaration sheet
Signed and dated attestation that application is complete
and accurate
Accreditation status (e.g.- TJC, CARF, AAAHC etc...)
, Any other information necessary to determine if the
facility meets the network-based health benefits plan
participation criteria
What must be completed prior to listing a provider on the
online or paper directory? - answer The credentialing
process
Name 3 ways to document formal approval of the
credentialing plan. - answer 1. Individually signed/dated
policies & procedures
2. A signed/dated master list of policies & procedures
3. Signed/dated meeting minutes documenting formal
approval
How often must the credentialing plan be
reviewed/approved? - answer Annually
Who is responsible for oversight of the clinical aspects of
the credentialing program? - answer The senior clinical
staff person of the organization
Who is responsible for the overall direction of the
credentialing program and approving/disapproving
applications for network participation? - answer The
Credentialing Committee
Does the Credentialing Committee have to review clean
applications? - answer No. If the application is clean,
then it does not need to go the Credentialing Committee
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller GUARANTEEDSUCCESS. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
77254 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now