CPMSM Study Questions | 65 Questions with 100% Correct Answers | Updated & Verified | 2023

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 take what action? - 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 Improvement Act of 1986 to restrict the ability of incompetent physicians, dentists, and other health care practitioners to move from state to state without disclosure or discovery of previous medical malpractice payment an adverse action history? - National Practitioner Data Bank When developing clinical privileging criteria, which of the following is important to evaluate? - Established standards of practice such as, specialty board recommendations What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty? - To protect patient safety by ensuring current competency, relevance to the facility, and accepted standards of care