CPCS 2023/2024 Practice Exam Already Graded A

CPCS 2023/2024 Practice Exam Already Graded A Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? a. A facility could lose its accreditation if it does not do so b. It is required by Medicare Conditions or Participation c. The facility won't get paid for treating patients unless service is provided by an authorized provider. Which of the following credentials must be tracked on an ongoing basis? a. Post graduate education completed b. Closed medical malpractice claims c. Licensure. According to NCQA standards, an organization that discovers sanction information, complaints, or adverse events regarding a practitioner must take what action? a. Determine if there is evidence of poor quality that could affect the health and safety of its members. b. Immediately take action to remove the provider from its panel c. Notify the practitioner that he/she is under investigation and initiate the hearing process What is the name of the entity that was established through the Health Care Quality Improvement Act of 1986 to restrict the ability of incompetent practitioners to move from state to state without disclosure or discovery of previous medical malpractice payment and adverse action history? a. Emergency Medical Treatment and Active Labor Act b. The National Practitioner Data Bank. c. The Patient Safety and Quality Improvement Act When developing clinical privileging criteria, which of the following is important to evaluate? a. How many providers are in that specialty b. Established standards of practice, such as specialty board recommendations. c. Whether or not the quality department can support the FPPE process What is the main reason for periodically assessing appropriateness of clinical privileges of each specialty? a. It is required by accreditation standards b. It is required by the Medicare Conditions of Participation c. 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? a. OB/GYN b. Urologist c. Interventional Cardiologist. (PTCA = Percutaneous transluminal coronary angioplasty aka stent placement) The Joint Commission hospital standards require that clinical privileges are hospital specific and... a. Based on the individual's demonstrated current competence and the procedures the hospital can support. b. Based on board certification c. Based on the privileges the individual is currently approved to perform at other hospitals Which of the following would be routinely performed by a cardiologist? a. Hysterectomy b. Transesophageal Echocardiography. c. Urethral dilation Which NCQA-required committee makes recommendations regarding credentialing decisions? a. Medical Executive Committee b. Quality Care Committee c. Credentialing Committee. HFAP standards require which three medical staff committees to be delineated in the medical staff structure? a. Medical Executive Committee. b. Utilization of Osteopathic Methods & Concepts Committee. (required for hospitals with ten or more DOs who admit patients and provide direct patient care) c. Utilization Review Committee. d. Credentials Committee e. Investigational Review Board How often does NCQA require that delegation reports be evaluated by the health plan? a. Monthly b. Quarterly c. Semi-Annually. Peer