CPCS Exam Study Guide with Complete Solutions Graded A 2024

NCQA - National Committee for Quality Assurance Which of the 7 accreditation bodies require appointment time frames no greater than 3 years AND base their cycle to the MONTH and NOT the day. - NCQA & URAC (National Committee of Quality Assurance AND Utilization Review Accreditation Commission ) Which of the 7 accreditation bodies makes the RECOMMENDATION appointment timeframe be at LEAST 24 months, in the absence of a State law. - CMS, HFAP, DNV, and AAAHC TJC - The Joint Commission Which of the 7 accreditation bodies only allow a 2 year appointment - The Joint Commission Which of the 7 accreditation bodies uses the terminology LIP - The Joint Commission By what standard do the TJC consider you a LIP (Licensed Independent Practitioner) - Be permitted by State law and the organization: 1) Provide Care 2) Treatment 3) Services Without direction OR supervision The Joint Commission allows for the credentialing equivalent process for Non LIP ONLY If they are not providing what type of care to patient. - Medical Level of Care- 1) Making medical diagnosis 2)Treatment Decision ABMS - American Board of Medical Specialties URAC - Utilization Review Accreditation Commission NPDB - National Practitioner Data Bank DNV - Det Norske Veritas AAAHC - Accreditation Association for Ambulatory Health Care LIP - Licensed Independent Practitioner HFAP - Healthcare Facilities Accreditation Program AMA - American Medical Association What 2 types of practitioner must be on the medical staff for DNV - MD and DO What primary sources allowed to be used to verify Board Certification. - AMA, AOA, ABMS, State License Agency, Confirmation from Specialty Board Does the FSMB (Federation State Medical Board) verify a practitioner board certification? - No, the FSMB does not verify board certification. FSMB verifies the following: 1)Education and Training 2)Ongoing Monitoring of Sanctions 3)Medicare/Medicaid Sanctions 4)Medical Board Sanctions According to HFAP who decides the qualifications for NON- Physicians First Assistant - Medical Staff Rules and Regulations According to AAAHC how often does board certification need to be monitored. - Verified at initial, reappointment and ongoing basis. Does TJC require you to verify Board Certification at the time of reappointment? - TJC does not require board certification be verified at reappointment. Individually each hospital decides if verification is needed at reappointment depending on Rules and Regulations and Bylaws. What is the time limit for board certification for NCQA and URAC? - 180 days. CVO (120) How often does Board Certification be required verified for the accrediting body of URAC - Only at the time of initial appointment, if the board certification expires, or if there is no record of verification in the practitioner file. According to Robert's Rules of Order what must you have first to prompt a discussion before the committee body? - 1)A motion 2)Motion seconded 3)Motion stated by the chair. Privilege motion - Deal with things relating to the comfort of the assembly or other situations so important they may interrupt pending business and must be decided IMMEDIATELY by the chair or by the members without debate.