Rated A+
** How many days are allowed for notification of credentialing decision per URAC
standards? - ANSWER-10
** How many forms of ID are required for disaster privileging? - ANSWER-2
Access to credentials files should be: - ANSWER-Described fully in an access policy
According to AAAHC, which must be monitored on an on-going basis? - ANSWER-
Current licensure
According to AAAHC, which of the following establishes and is responsible for the
credentialing and reappointment process for physicians and dentists? - ANSWER-
Governing body
According to HFAP standards, when confirming malpractice coverage, the organization
must: - ANSWER-Have evidence of professional liability insurance, which includes
certificate amounts of coverage
According to NCQA standards, a copy of which is an acceptable verification of the
document? - ANSWER-DEA certificate
According to NCQA standards, an organization that discovers sanction information,
complaints, or adverse events regarding a practitioner must take what action? -
ANSWER-Determine if there is evidence of poor quality that could affect the health and
safety of its members.
According to NCQA standards, the application attestation statement must affirm that the
application - ANSWER-Is correct and complete
According to NCQA standards, which is an acceptable source for primary source
verification of Medicare and Medicaid sanction activity against physicians? - ANSWER-
Federation State Medical Boards
According to NCQA standards, which of the following is an approved source for
verification of board certification? - ANSWER-State licensing agency if the state
licensing agency conducts primary source verification of board status
According to NCQA, a practitioner must provide documentation of work history for a
minimum of how many years? - ANSWER-5
, According to NCQA, an initial application must include which of the following
verifications? - ANSWER-5 years of pending malpractice claims history
According to NCQA, at recredentialing, which of the following must be verified within
180 days prior to the credentialing decision? - ANSWER-Lifetime board certification
According to NCQA, how frequently must a delegate submit reports to the organization?
- ANSWER-Semi-annually
According to NCQA, how frequently must an organization show evidence of an
evaluation of the history of complaints for all practitioners? - ANSWER-Every 6 months
According to NCQA, how frequently must ongoing monitoring of Medicare / Medicaid
sanctions to be conducted? - ANSWER-Monthly
According to NCQA, what is the verification time limit for the attestation? - ANSWER-
365 days
According to NCQA, when must specific practitioner site visits be conducted? -
ANSWER-When a complaint is filed
According to NCQA, which of the following documents must be verified thru the direct
source? - ANSWER-Licensure
According to The Joint Commission, the process to disseminate all privilege granting,
modifying, or restricting decisions is approved by which of the following? - ANSWER-
Governing Board
According to TJC standards, a nurse practitioner functioning independently and
providing a medical level of care must: - ANSWER-be granted delineated clinical
privileges
According to TJC standards, initial appointments to the medical staff are made for a
period of: - ANSWER-Not to exceed two years
According to TJC standards, medical staff bylaws are required to include - ANSWER-a
mechanism for selection and removal of officers
According to TJC standards, medical staff bylaws should define - ANSWER-The
structure of the medical staff
According to TJC standards, professional criteria for the granting of clinical privileges
must include at least - ANSWER-Relevant training or experience, ability to perform
privileges requested, current licensure and competence.