Why is it important to check that the practitioner is not currently excluded, suspended, de-
barred, or ineligeble to participate in Federal health care programs?
ANSWER
The Faciltiy won't get paid for treating patients unlsee service is provided by authorized pro-
vider.
Which of the following credentials must be tracked on an ongoing basis
ANSWER
Licensure
Accoding to NCQA standards, an organization that discovers sanction information, com-
plaints, or adverse events regarding a practitioner must take what action?
ANSWER
Determine if there is evidence of poor quality that could affect the health and safety of its
members.
What is the name of the entity that was established through the Health Care Quality Im-
provement Act of 1986 to restrict the abiltiy of incompetent physicians, dentists and other
health care practtitioners to move from state to state without disclosure or discovery of pre-
vious medical malpractice payment and adverse action history?
ANSWER
The National Practitioner Data Bank
When developing clinical privileging criteria, which of the following is important to evaluate?
ANSWER
1
, Established standards of practice such as, specialty board recommendations.
What is the main reason for periodically assessing appropriateness of clinical privileges for
each specialty?
ANSWER
To proctect patient safety by ensuring current competency, revelance to the facility, and ac-
cepted standards of care.
Which of the following specialists is most likely to perform a PTCA?
ANSWER
Interventional Cardiologist
What is the correct order the JC uses to process applications?
ANSWER
1. Receive application
2. Verify completeness and that all requested materials are included
3. Process Application: Conduct Primary Source Verification and verify current competency
for privileges requested
4. Chief of Service/Department Chair review and recommendation (if departmentalized)
5. Executive Committee reviews and makes recommendations to the Board of Trustees
6. Board approves
7. Notify applicant of final decision
What is the correct order NCQA uses to process applications?
ANSWER
1. Receive application
2. Verifly completeness and that all requested materials are included
3. Process application: Conduct Primary Source Verification
2
barred, or ineligeble to participate in Federal health care programs?
ANSWER
The Faciltiy won't get paid for treating patients unlsee service is provided by authorized pro-
vider.
Which of the following credentials must be tracked on an ongoing basis
ANSWER
Licensure
Accoding to NCQA standards, an organization that discovers sanction information, com-
plaints, or adverse events regarding a practitioner must take what action?
ANSWER
Determine if there is evidence of poor quality that could affect the health and safety of its
members.
What is the name of the entity that was established through the Health Care Quality Im-
provement Act of 1986 to restrict the abiltiy of incompetent physicians, dentists and other
health care practtitioners to move from state to state without disclosure or discovery of pre-
vious medical malpractice payment and adverse action history?
ANSWER
The National Practitioner Data Bank
When developing clinical privileging criteria, which of the following is important to evaluate?
ANSWER
1
, Established standards of practice such as, specialty board recommendations.
What is the main reason for periodically assessing appropriateness of clinical privileges for
each specialty?
ANSWER
To proctect patient safety by ensuring current competency, revelance to the facility, and ac-
cepted standards of care.
Which of the following specialists is most likely to perform a PTCA?
ANSWER
Interventional Cardiologist
What is the correct order the JC uses to process applications?
ANSWER
1. Receive application
2. Verify completeness and that all requested materials are included
3. Process Application: Conduct Primary Source Verification and verify current competency
for privileges requested
4. Chief of Service/Department Chair review and recommendation (if departmentalized)
5. Executive Committee reviews and makes recommendations to the Board of Trustees
6. Board approves
7. Notify applicant of final decision
What is the correct order NCQA uses to process applications?
ANSWER
1. Receive application
2. Verifly completeness and that all requested materials are included
3. Process application: Conduct Primary Source Verification
2
