Questions and Correct Answers | New
Update
Why is it important to check that the practitioner is not currently exclude,
suspended, debarred, or ineligible to participate in Federal health care programs? -
🧠ANSWER ✔✔The facility will not get paid for treating patients unless the
service is provided by an authorized provider.
Which of the following credentials must be tracked on an ongoing basis? -
🧠ANSWER ✔✔Licensure
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.
What is the name of the entity that was established thru the Health Care Quality
Improvement Act of 1986 to restrict the ability of incompetent physicians, dentists,
and other health care practitioners to move from state to state without disclosure or
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,discovery of previous medical malpractice payment and adverse action history? -
🧠ANSWER ✔✔The Nation Practitioner Data Bank
When developing clinical privileging criteria, which of the following is important
to evaluate? - 🧠ANSWER ✔✔Established standards of practice such as specialty
board recommendations.
What is the main reason for periodically assessing appropriateness of clinical
privileges for each specialty? - 🧠ANSWER ✔✔To protect patient safety by
ensuring current competency, relevance to the facility, and accepted standards of
care.
Which of the following specialists is most likely to perform a PTCA? -
🧠ANSWER ✔✔Interventional Cardiologist
The Joint Commission hospital standards require that clinical privileges are
hospital specific and - 🧠ANSWER ✔✔Based on the individual's demonstrated
current competence and the procedures the hospital can support.
Which of the following would be routinely performed by a cardiologist? -
🧠ANSWER ✔✔Transesophageal Echocardiography
Which NCQA required committee makes recommendations regarding
credentialing decisions? - 🧠ANSWER ✔✔Credentialing Committee
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, HFAP standards require three medical staff committees to be delineated in the
medical staff structure; what are they? - 🧠ANSWER ✔✔Medical Executive
Committee, the Utilization Review Committee and the Utilization of Osteopathic
Methods and Concepts Committee
If you needed to find out about what the federal government requires in regards to
anti-trust issues, what law would you consult? - 🧠ANSWER ✔✔The Sherman
Anti-trust Act
Peer references should be obtained from: - 🧠ANSWER ✔✔Practitioners in the
same professional discipline as the applicant.
Patrick v. Burgett is an important case because it: - 🧠ANSWER ✔✔Illustrates the
potential for antitrust liability arising out of peer review activities.
If a medical staff member has privileges and / or medical staff appointment
revoked, he/she must be: - 🧠ANSWER ✔✔Provided due process
Access to credentials files should be: - 🧠ANSWER ✔✔Described fully in an
access policy
Which of the following bodies approves clinical privileges? - 🧠ANSWER ✔✔The
Governing body / Board
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STATEMENT. ALL RIGHTS RESERVED