Cpmsm study - Study guides, Class notes & Summaries

CPMSM Study Guide - Credentialing and Privileging Questions and Answers fully solved 1. assists organizations in monitoring and improving quality of care 2. Deemed status 3. Marketing reasons - shows that expectations for providing safe, quality health care are met 4. may favorably influence liability insurance premiums 5. for a hospital, may be required in order to obtain managed care contracts 6. employers and unions may require for providing healthcare coverage to employees Why get acc...

CPMSM NEWEST ACTUAL EXAM STUDY GUIDE AND PRACTICE QUESTIONS AND DETAILED CORRECT ANSWERS 2024 | A+GRADE VERFIED

Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? - The facility will not get paid for treating patients unless service is provided by an authorized provider Which of the following credentials must be tracked on an ongoing basis? - Licensure According to NCQA standards, an organization that discovers sanction information, complaints, or adverse events regarding a practitioner must ...

CPMSM STUDY GUIDE MATERIAL EXAM ...

CPMSM Study Questions Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? - The facility will not get paid for treating patients unless service is provided by an authorized provider Which of the following credentials must be tracked on an ongoing basis? - Licensure According to NCQA standards, an organization that discovers sanction information, complaints, or adverse events r...

CPMSM Cards, CPMSM Study (MCO), CPMSMBoyd vS Albert Einstein - correct answer Doctrine of Ostensible Agency - HMO found liable in patient's death. Chest perforation during breast biopsy, chest pain/MI six weeks later. Elam vS CollegePark - correct answer Doctrine of Corporate Negligence - Med Records had information on many lawsuits agains podiatrist Patrick vs Burget - correct answer Anticompetitive Peer Review - Led to development of HCQIA Gonzales vs Nork & Mercy Hospital - correct ...

CPMSM Study Guide Questions and Answers 2024.

NPDB - ACCURATE ANSWERS National Practitioner Databank NPDB Contains: (what type of info) - ACCURATE ANSWERS - adverse licensure - clinical privilege actions - membership actions (professional/society) - paid malpractice judgements - exclusions from Medicare/Medicaid - actions by US DEA What must Hospitals and Other Health Care Entities report on for Physicians & Dentists (3 things), and how quickly must it be reported? - ACCURATE ANSWERS - Professional review actions based on compete...

CPMSM Cards, CPMSM Study (MCO), CPMSM questions and answers verified 2024

What are four models of HMOs? - ACCURATE ANSWERS Staff Model Group Model Network Model Independent Practice Association (IPA) What are the four types of committees? - ACCURATE ANSWERS Standing Ad hoc Task force Continuous quality improvement team How many medical staff members comprise a Bylaws Committee? - ACCURATE ANSWERS 5 At least five active medical staff How many medical staff members comprise a Credentials Committee? - ACCURATE ANSWERS 5 At least five active medical s...