CPMSM - Study Guide Material UPDATED
ACTUAL Exam Questions and CORRECT
Answers
What are four models of HMOs? - CORRECT ANSWER - Staff Model
Group Model
Network Model
Independent Practice Association (IPA)
What are the four types of committees? - CORRECT ANSWER - Standing
Ad hoc
Task force
Continuous quality improvement team
How many medical staff members comprise a Bylaws Committee? - CORRECT
ANSWER -5
At least five active medical staff
How many medical staff members comprise a Credentials Committee? - CORRECT
ANSWER -5
At least five active medical staff
How many medical staff members must serve on an Infection Control Committee? - CORRECT
ANSWER -3
At least three active medical staff
,How many medical staff members must serve on a Medical Records Committee? - CORRECT
ANSWER -1
At least one active medical staff
How often should the Medical Records committee meet? - CORRECT ANSWER - At least
quarterly
How many medical staff members must serve on a Pharmacy & Therapeutics Committee? -
CORRECT ANSWER -5
At least five active medical staff
How often should the Pharmacy & Therapeutics committee meet? - CORRECT
ANSWER - At least quarterly
How many medical staff members must serve on a Utilization Review Committee? - CORRECT
ANSWER -1
At least one active medical staff
How often should the Utilization Review Committee meet? - CORRECT ANSWER -
Every other month
What is the process of obtaining, verifying, and assessing the qualifications of a health care
practitioner who seeks to provide patient care services in or for a hospital? - CORRECT
ANSWER - Credentialing
What are the three reasons for credentialing? - CORRECT ANSWER - Patient Safety
, Risk Management
Required by agencies
Which three accreditors have been granted "deemed status"? - CORRECT ANSWER -
TJC, HFAP, DNV
Which two organizations offer accreditation for managed care organizations? - CORRECT
ANSWER - NCQA, URAC
Who is the main accreditor for ambulatory care facilities? - CORRECT ANSWER -
AAAHC
Physicians who are employees of a facility as hospitalists and who are not listed in the provider
directory are not included in the scope of the credentialing standards with this accreditation? -
CORRECT ANSWER - URAC
For which accreditation, do the following practitioners need *not* to be credentialed including:
-exclusively in the inpatient setting caring for organization members only in the hospital setting
-practice exclusively in free-standing setting for members directed to facility
-pharmacists working for a PBM (pharmacy benefits management) organization for UM
functions
-locum tenens working less than 90 days
-rental network practitioners providing out of area care - CORRECT ANSWER - NCQA
What are Medicare CoP's minimum criteria for appointment to the medical staff/granting of
medical staff privileges? - CORRECT ANSWER - CCJET
character
competence
judgement
experience
ACTUAL Exam Questions and CORRECT
Answers
What are four models of HMOs? - CORRECT ANSWER - Staff Model
Group Model
Network Model
Independent Practice Association (IPA)
What are the four types of committees? - CORRECT ANSWER - Standing
Ad hoc
Task force
Continuous quality improvement team
How many medical staff members comprise a Bylaws Committee? - CORRECT
ANSWER -5
At least five active medical staff
How many medical staff members comprise a Credentials Committee? - CORRECT
ANSWER -5
At least five active medical staff
How many medical staff members must serve on an Infection Control Committee? - CORRECT
ANSWER -3
At least three active medical staff
,How many medical staff members must serve on a Medical Records Committee? - CORRECT
ANSWER -1
At least one active medical staff
How often should the Medical Records committee meet? - CORRECT ANSWER - At least
quarterly
How many medical staff members must serve on a Pharmacy & Therapeutics Committee? -
CORRECT ANSWER -5
At least five active medical staff
How often should the Pharmacy & Therapeutics committee meet? - CORRECT
ANSWER - At least quarterly
How many medical staff members must serve on a Utilization Review Committee? - CORRECT
ANSWER -1
At least one active medical staff
How often should the Utilization Review Committee meet? - CORRECT ANSWER -
Every other month
What is the process of obtaining, verifying, and assessing the qualifications of a health care
practitioner who seeks to provide patient care services in or for a hospital? - CORRECT
ANSWER - Credentialing
What are the three reasons for credentialing? - CORRECT ANSWER - Patient Safety
, Risk Management
Required by agencies
Which three accreditors have been granted "deemed status"? - CORRECT ANSWER -
TJC, HFAP, DNV
Which two organizations offer accreditation for managed care organizations? - CORRECT
ANSWER - NCQA, URAC
Who is the main accreditor for ambulatory care facilities? - CORRECT ANSWER -
AAAHC
Physicians who are employees of a facility as hospitalists and who are not listed in the provider
directory are not included in the scope of the credentialing standards with this accreditation? -
CORRECT ANSWER - URAC
For which accreditation, do the following practitioners need *not* to be credentialed including:
-exclusively in the inpatient setting caring for organization members only in the hospital setting
-practice exclusively in free-standing setting for members directed to facility
-pharmacists working for a PBM (pharmacy benefits management) organization for UM
functions
-locum tenens working less than 90 days
-rental network practitioners providing out of area care - CORRECT ANSWER - NCQA
What are Medicare CoP's minimum criteria for appointment to the medical staff/granting of
medical staff privileges? - CORRECT ANSWER - CCJET
character
competence
judgement
experience
