CPCS exam 2023 Complete Questions & Solutions

What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - ANSWER HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - ANSWER Medical School, AMA, ECFMG, AOA According to NCQA practitioners must be notified of credentialing decision within how many days? - ANSWER 60 Days The DHHS mails a copy of the NPDB report to the named provider. If the provider wishes to dispute the reports accuracy, the provider has how many days to do so? - ANSWER 60 Days According to URAQ, within how many days must the practitioner be notified of credentialing decisions? - ANSWER 10 Days How many days does a practitioner have to dispute an NPDB report accuracy - ANSWER 60 Days Which accrediting body requires five year verification of malpractice history - ANSWER NCQA What is commonly used source for verifying malpractice history - ANSWER NPDB According to the JC a fair hearing and appeals process as described in the medical staff bylaws is available to whom? - ANSWER Medical staff members and non-members holding clinical privileges T/F Only the highest of training must be verified according to NCQA - ANSWER True According to the Joint Commission a peer recommendation should address what six competencies? - ANSWER Medical knowledgenTechnical & clinical skillnclinical judgmentninterpersonal skillsncommunication skillsnprofessionalism Telemedicine - according to JC what two options are available for credentialing a the original site? - ANSWER Full credentialing, use of the distant sites credentialing According to JC what is included in the process of planning and implementing privileges? - ANSWER Develop & approve procedure listnProcess the applicationnEvaluate applicant specific informationnSubmit recommendations to governing body for applicant specific delineated privilegesnNotify the applicant, relevant personnelnMonitor the use of privileges Are payments made by a physician in a malpractice claim reportable to the NPDB? - ANSWER No Who requires Peer References - ANSWER JC, HFAP, AAAHC Who reappoints - ANSWER JC, HFAP, NCQA, URAC Who requires an attestation? - ANSWER NCQA, URAC, AAAHC Who requires education verification? - ANSWER JC, HFAP, URAC, AAAHC Who requires statement regarding felony convictions? - ANSWER HFAP, NCQA, AAAHC Attestation must state that the information submitted is complete & correct - ANSWER NCQA, AAAHC Attestation must state that the information submitted is complete & accurate - ANSWER URAC Attestation must include inquiry regarding illegal drug use? - ANSWER NCAQ Attestation must include inquiry regarding inability to perform essential functions? - ANSWER NCQA Attestation must include inquiry regarding history or loss or limitations of licensure or privileges or disciplinary actions? - ANSWER NCQA Attestation must include inquiry regarding current malpractice coverage? - ANSWER NCQA Attestation must include inquiry regarding felony convictions? - ANSWER NCQA Applicant must attest to limitations on ability to perform functions of the position with or without accomodation, if any - ANSWER NCQA Applicant must attest to lack of present illegal drug use - ANSWER AAAHC Applicant must attest to history or loss of license and felony convictions, if any - ANSWER AAAHC Applicant must attest to history of loss or limitations of privileges or disciplinary actions, if any - ANSWER AAAHC Applicant must attest to current malpractice insurance coverage? - ANSWER AAAHC Who requires a malpractice history for applicants? - ANSWER JC, HFAP, NCQA, URAC, AAAHC Who must have a process in place to address complaints? - ANSWER JC, HFAP, NCQA, URAC Who requires Board Certification? - ANSWER None Who requires criminal background checks? - ANSWER HFAP Who requires applicant ID - ANSWER JC Who requires an NPDB - ANSWER JC, HFAP, NCQA, AAAHC Who requires current competence? - ANSWER JC, HFAP, CMS How often does the OIG report to the NPDB? - ANSWER Monthly Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - ANSWER Yes According to the JC, who may amend the medical staff bylaws? - ANSWER Governing Body Failure to meet the established qualifications and criteria for appointment should be reported to whom? - ANSWER The applicant NCQA requires the MCO to obtain a minimum of ???? years of work history? -