CPCS Exam 2023 A+

CPCS Exam 2023 A+ What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - ANS-HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - ANS-Medical School, AMA, ECFMG, AOA According to NCQA practitioners must be notified of credentialing decision within how many days? - ANS-60 Days The DHHS mails a copy of the NPDB report to the named provider. If the provider wishes to dispute the reports accuracy, the provider has how many days to do so? - ANS-60 Days According to URAQ, within how many days must the practitioner be notified of credentialing decisions? - ANS-10 Days How many days does a practitioner have to dispute an NPDB report accuracy - ANS-60 Days Which accrediting body requires five year verification of malpractice history - ANSNCQA What is commonly used source for verifying malpractice history - ANS-NPDB According to the JC a fair hearing and appeals process as described in the medical staff bylaws is available to whom? - ANS-Medical staff members and non-members holding clinical privileges T/F Only the highest of training must be verified according to NCQA - ANS-True According to the Joint Commission a peer recommendation should address what six competencies? - ANS-Medical knowledgenTechnical & clinical skillnclinical judgmentninterpersonal skillsncommunication skillsnprofessionalism Telemedicine - according to JC what two options are available for credentialing a the original site? - ANS-Full credentialing, use of the distant sites credentialing According to JC what is included in the process of planning and implementing privileges? - ANS-Develop & approve procedure listnProcess the applicationnEvaluate applicant specific informationnSubmit recommendations to governing body for applicant specific delineated privilegesnNotify the applicant, relevant personnelnMonitor the use of privileges Are payments made by a physician in a malpractice claim reportable to the NPDB? - ANS-No Who requires Peer References - ANS-JC, HFAP, AAAHC Who reappoints - ANS-JC, HFAP, NCQA, URAC Who requires an attestation? - ANS-NCQA, URAC, AAAHC Who requires education verification? - ANS-JC, HFAP, URAC, AAAHC Who requires statement regarding felony convictions? - ANS-HFAP, NCQA, AAAHC Attestation must state that the information submitted is complete & correct - ANSNCQA, AAAHC Attestation must state that the information submitted is complete & accurate - ANSURAC Attestation must include inquiry regarding illegal drug use? - ANS-NCAQ Attestation must include inquiry regarding inability to perform essential functions? - ANS-NCQA Attestation must include inquiry regarding history or loss or limitations of licensure or privileges or disciplinary actions? - ANS-NCQA Attestation must include inquiry regarding current malpractice coverage? - ANS-NCQA Attestation must include inquiry regarding felony convictions? - ANS-NCQA Applicant must attest to limitations on ability to perform functions of the position with or without accomodation, if any - ANS-NCQA Applicant must attest to lack of present illegal drug use - ANS-AAAHC Applicant must attest to history or loss of license and felony convictions, if any - ANSAAAHC Applicant must attest to history of loss or limitations of privileges or disciplinary actions, if any - ANS-AAAHC Applicant must attest to current malpractice insurance coverage? - ANS-AAAHC Who requires a malpractice history for applicants? - ANS-JC, HFAP, NCQA, URAC, AAAHC Who must have a process in place to address complaints? - ANS-JC, HFAP, NCQA, URAC Who requires Board Certification? - ANS-None Who requires criminal background checks? - ANS-HFAP Who requires applicant ID - ANS-JC Who requires an NPDB - ANS-JC, HFAP, NCQA, AAAHC Who requires current competence? - ANS-JC, HFAP, CMS How often does the OIG report to the NPDB? - ANS-Monthly Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - ANS-Yes According to the JC, who may amend the medical staff bylaws? - ANS-Governing Body Failure to meet the established qualifications and criteria for appointment should be reported to whom? - ANS-The applicant NCQA requires the MCO to obtain a minimum of ???? years of work history? - ANSFive Years According to NCQA what policy must an organization have in place to obtain approval to enter into a delegated agreement? - ANS-Credentialing policies Hospitals must query the NPDB when: - ANS-Initial appointmentngranting of privelegesnevery two years NCQA requires verifications must be less than how many days old? - ANS-180 What is the verification time limit on malpractice history according to the NCQA? - ANS180 days Time limited credential must be verified by the CVO within how many days prior to submission to the client? - ANS-120 days According to AAAHC, for initial appointments, in addition to licensure and education, what verification is required? - ANS- Continues...