CPMSM CORRECT FINAL EXAMS QUESTIONS AND
ANSWERS SURE A+
✔✔According to NCQA standards an appropriate verification source for verification of
board certification - ✔✔state licensing agency, if state agency conducts primary
verification of board status.
✔✔TJC requires for Re-Appointment to the medical staff - ✔✔Primary source
verification of malpractice suits
✔✔URAC's health network standards state - ✔✔each applicant within the scope of the
credentialing program submits an application that includes at least
-State licensure information, including current license(s) and history of licensure in all
jurisdictions.
✔✔According to AAAHC current Licensure - ✔✔must be monitored on an ongoing basis
✔✔According to TJC a Nurse Practitioner - ✔✔functioning independently and providing
a medical level of care must be granted delineated clinical privileges
✔✔Education Commission of Foreign Medical Graduates - ✔✔Acceptable source for
verification for medical education of an international graduate.
, ✔✔NCQA requires board cert verification - ✔✔In all cases (appointment and
reappointment)
✔✔AAAHC gives responsibility to: - ✔✔the governing body for approving and ensuring
compliance with policies and procedures related to credentialing, quality improvement,
and risk management.
✔✔Medicare Conditions of participation (MCoP) - ✔✔In order for a healthcare facility to
participate in the Medicare and Medicaid programs it must comply with:
✔✔According to TJC's self governing medical staff standard - ✔✔the medical staff
determines the mechanism for establishing and enforcing criteria for assigning oversight
responsibilities to practitioners with independent privileges.
✔✔A good rule of thumb for a Medical Staff application - ✔✔is for the application to
provide a chronological history of the applicant's education, training, and work history.
✔✔Provider Panel - ✔✔In order to participate in a managed care plan, a provider must
be accepted to the plan's _________________.
✔✔Current State Licensure - ✔✔In order for any provider to practice medicine in any
state he/she must first possess a
✔✔Residency Training - ✔✔Is considered post-graduate education.
✔✔Discrimination of any type - ✔✔Can not be used to evaluate credentials
✔✔Release of Liability Statement - ✔✔Release statement signed by the applicant for
medical staff appointment should include a statement providing immunity to those who
respond in good faith to request for information.
✔✔PSV by Telephone conversation - ✔✔When documenting a telephone conversation
regarding primary source verification the name of the person and organization
contacted, date of call, what was discussed and who conducted the interview should be
included.
✔✔Red Flags - ✔✔Unexplained delays between graduation and medical school,
incomplete training, and unexplained lapses in professional practice are examples of
✔✔According to HFAP standards on Malpractice Coverage - ✔✔When confirming
malpractice coverage the organization must have evidence of professional liability
coverage, which includes a certificate showing amounts of coverage.
ANSWERS SURE A+
✔✔According to NCQA standards an appropriate verification source for verification of
board certification - ✔✔state licensing agency, if state agency conducts primary
verification of board status.
✔✔TJC requires for Re-Appointment to the medical staff - ✔✔Primary source
verification of malpractice suits
✔✔URAC's health network standards state - ✔✔each applicant within the scope of the
credentialing program submits an application that includes at least
-State licensure information, including current license(s) and history of licensure in all
jurisdictions.
✔✔According to AAAHC current Licensure - ✔✔must be monitored on an ongoing basis
✔✔According to TJC a Nurse Practitioner - ✔✔functioning independently and providing
a medical level of care must be granted delineated clinical privileges
✔✔Education Commission of Foreign Medical Graduates - ✔✔Acceptable source for
verification for medical education of an international graduate.
, ✔✔NCQA requires board cert verification - ✔✔In all cases (appointment and
reappointment)
✔✔AAAHC gives responsibility to: - ✔✔the governing body for approving and ensuring
compliance with policies and procedures related to credentialing, quality improvement,
and risk management.
✔✔Medicare Conditions of participation (MCoP) - ✔✔In order for a healthcare facility to
participate in the Medicare and Medicaid programs it must comply with:
✔✔According to TJC's self governing medical staff standard - ✔✔the medical staff
determines the mechanism for establishing and enforcing criteria for assigning oversight
responsibilities to practitioners with independent privileges.
✔✔A good rule of thumb for a Medical Staff application - ✔✔is for the application to
provide a chronological history of the applicant's education, training, and work history.
✔✔Provider Panel - ✔✔In order to participate in a managed care plan, a provider must
be accepted to the plan's _________________.
✔✔Current State Licensure - ✔✔In order for any provider to practice medicine in any
state he/she must first possess a
✔✔Residency Training - ✔✔Is considered post-graduate education.
✔✔Discrimination of any type - ✔✔Can not be used to evaluate credentials
✔✔Release of Liability Statement - ✔✔Release statement signed by the applicant for
medical staff appointment should include a statement providing immunity to those who
respond in good faith to request for information.
✔✔PSV by Telephone conversation - ✔✔When documenting a telephone conversation
regarding primary source verification the name of the person and organization
contacted, date of call, what was discussed and who conducted the interview should be
included.
✔✔Red Flags - ✔✔Unexplained delays between graduation and medical school,
incomplete training, and unexplained lapses in professional practice are examples of
✔✔According to HFAP standards on Malpractice Coverage - ✔✔When confirming
malpractice coverage the organization must have evidence of professional liability
coverage, which includes a certificate showing amounts of coverage.
