Cpmsm practice tes Study guides, Class notes & Summaries
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CPMSM Practice Tests / Extras
- Exam (elaborations) • 8 pages • 2024
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CPMSM Practice Tests / Extras 
 
What does HEDIS stand for? - Healthcare Effectiveness Data and Information Set 
 
What is HEDIS? - is a widely used set of performance measures in the managed care 
industry. HEDIS is a multipurpose tool originally designed to address private employers' needs 
and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of 
NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is 
collected through a c...
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CPMSM Practice Test| 105 Questions| With Complete Solutions
- Exam (elaborations) • 14 pages • 2023
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Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? correct answer: The facility won't get paid for treating patients unless service is provided by authorized provider 
 
Which credentials must be tracked on an ongoing basis? correct answer: Licensure 
 
According to NCQA standards, an organization that discovers sanction info, complaints, or adverse events regarding a practitioner mus...
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CPMSM Practice Test (Latest) Updated Qs & As Graded A+
- Exam (elaborations) • 4 pages • 2024
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CPMSM Practice Test (Latest) Updated Qs & As Graded A+
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CPMSM Practice Test Questions With Complete Solutions
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Medical Staff correct answer: according to the Joint Commission who is responsible for developing criteria for FPPE when issues affecting the provision of safety patient care are identified. 
 
5 years correct answer: NCQA requires an organization to obtain a claims history for a minimum of how many years 
 
every 6 Months correct answer: According to NCQA how frequently must a delegate submit a report to the organization 
 
For health plans 180 days, for CVO 120 days correct answer: verific...
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CPMSM Practice Tests / Extras Questions With Complete Solutions
- Exam (elaborations) • 8 pages • 2023
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What does HEDIS stand for? correct answer: Healthcare Effectiveness Data and Information Set 
 
What is HEDIS? correct answer: is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is collected through a combinat...
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CPMSM PRACTICE TEST QUESTIONS WITH CORRECT SOLUTIONS RATED A+
- Exam (elaborations) • 101 pages • 2024
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CPMSM PRACTICE TEST QUESTIONS WITH CORRECT SOLUTIONS RATED A+ 
Your insurance agent is John, and who is the principal in this agency relationship? 
A. None. B. Your insurance company. C. Your insurance agent. D. You. - CORRECT ANSWER-Your insurance company Your insurance company authorizes your agent to do business with you. 
Statutory Law Defenses are determined by which of the following? 
A. Judicial decisions. B. Executive decisions. C. Enactment of Legislatures. D. Administrative decisions. ...
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CPMSM Practice Test Questions With Complete Solutions
- Exam (elaborations) • 6 pages • 2023
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According to URAC who should oversee the clinical aspects of the credentialing program within the organization? correct answer: Senior Clinical Staff Person 
 
Name 3 sources of verification of education of a dentist according to NCQA correct answer: Dental school, specialty board, state licensing board 
 
NCQA requires MCO's to recredential practitioners at least every correct answer: 3 years 
 
HFAP is commonly known as correct answer: AOA, an osteopathic organization 
 
T/F No accreditat...
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CPMSM Practice Tests Extras questions well answered
- Exam (elaborations) • 5 pages • 2023
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CPMSM Practice Tests Extras 
What does HEDIS stand for? - correct answer Healthcare Effectiveness Data and Information Set 
 
What is HEDIS? - correct answer is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is...
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CPMSM Practice Tests / Extras| Questions with 100% Correct Answers | Latest Update 2024 | Verified
- Exam (elaborations) • 8 pages • 2024
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CPMSM Practice Tests / Extras| Questions with 100% Correct Answers | Latest Update 2024 | Verified
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CPMSM Practice Tests QUESTIONS AND ANSWERS RATED A+ 2023|2024 UPDATE
- Exam (elaborations) • 9 pages • 2023
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CPMSM Practice Tests QUESTIONS AND 
ANSWERS RATED A+ 2023|2024 
UPDATE 
What does HEDIS stand for? - Correct Answer-Healthcare Effectiveness Data and 
Information Set 
What is HEDIS? - Correct Answer-is a widely used set of performance measures in the 
managed care industry. HEDIS is a multipurpose tool originally designed to address 
private employers' needs and has been adopted by public purchasers, regulators and 
consumers. HEDIS is an element of NCQA accreditation and the basis of consumer...
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