CPCS/CPMSM Sample Questions

CPCS/CPMSM Sample Questions Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to the Joint Commission, who may amend the medical staff bylaws? - Governing Body Failure to meet the established qualifications and criteria for appointment should be reported to whom? - The applicant NCQA requires the MCO to obtain a minimum of ???? years of work history? - 5 years According to NCQA what policy must an organization have in place to obtain approval to enter into a delegated agreement? - Credentialing policies How often does the OIG report to the NPDB? - Monthly Hospitals must query the NPDB when: - Initial appt, granting of privileges, every two years NCQA requires verifications must be less than how many days old? - 180 days What is the verification time limit on malpractice history according to the NCQA? - 180 days Time limited credential must be verified by the CVO within how many days prior to submission to the client? - 120 days According to AAAHC, for initial appointments, in addition to licensure and education, what verification is required? - Experience and hospital affiliation What accreditation body states "the NPDB is an acceptable source for sanctions or limitations on licensure, Medicaid/Medicare sanctions and malpractice history? - NCQA Who is required to query the NPDB? - Hospitals Is disciplinary action taken against the license of a dentist reportable to the NPDB? - Yes Under HCQIA, a hospital failure to report an adverse privilege action lasting longer than 30 days may cause the organization to lose HCQIA immunity for how many years? - 3 years According to NCQA, verification of Medicare/Medicaid sanctions can be queried by any of what sources? - AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, Sate Agency According to NCQA, how often must an organization conduct an audit of the credentialing process delegated to another organization? - Annually How far back does the Joint Commission require evaluation of malpractice history? What source may be used? - Back to medical school. NPDB. Is an internet verification from a website not contracted by the primary source that attests to the accuracy and timeliness of the information considered a complete verification by NCQA? - No What accreditation bodies require privileges to be distributed to essential department personnel? - Joint Commission/CMS