CPMSM Knowledge Check questions and answers rated A+ 2023/2024

CPMSM Knowledge Check Medicare requires providers to perform what process every 3-5 years? - correct answer Revalidation According to DNV standards, initial appointments to the medical staff are not to exceed what time period? - correct answer 36 months / 3 years T/F: The Joint Commission standards require that the applicant's participation in continuing education is evaluated and considered on initial appointment to the medical staff. - correct answer False. Participating in continuing education must be considered in decisions about reappointment to membership on the medical staff or renewal or revision of individual clinical privileges. The standards do not require this to be evaluated on initial appointment. According to NCQA standards, on initial application, review of information on sanctions, restrictions on licensure and limitations on scope of practice must cover what period of time? - correct answer The most recent five-year period What are the two elements of Due Process? - correct answer Substantive and Procedural According to the HCQIA, at what times must the hospital query the National Practitioner Data Bank for a physician, dentist or other health care practitioner? - correct answer - Initial appointment - Reappointment (renewal) - Request for new privileges and every 2 years thereafter What medical staff committee(s) is/are required by Joint Commission hospital standards for the medical staff? - correct answer Medical Executive Committee Under Robert's Rules of Order, when more than one motion is proposed, which motion takes precedence? - correct answer the most recent motion takes precedence over the ones T/F: Voluntary surrender or restriction of clinical privileges for 14 days is reportable to the NPDB - correct answer False Reportable on the 15th day Which specialty is most likely to be granted privileges for surgical management of congenital septal and valvular defects? - correct answer Cardiovascular or cardiothoracic surgeon URAC standards require the organization to provide a written notification to providers within how many days of the credentialing determination? - correct answer 10 business days (Note: NCQA requires within 60 calendar days) NCQA standards require the organization to have written policies and procedures that delineate certain practitioner rights and to communicate these rights to the practitioner. Name the 3 rights that must be provided to applicants. - correct answer • Right to correct erroneous information • Right to receive the status of their credentialing or recredentialing application upon request • Right to review information submitted to support their application What is the purpose of the MAC? - correct answer A MAC (or Medicare Administrative Contractor) provides regional services on behalf of Medicare, including processing claims, enrolling providers and other activities. T/F: HFAP standards allow a hospital to accept the credentialing and privileging decision of another organization (credentialing/privileging by proxy) for teleradiology services - correct answer True The case of Darling v. Charleston Memorial Community Hospital was significant in that it set aside a long standing doctrine that was applied to hospitals. What is that doctrine? - correct answer Charitable Immunity Doctrine CMS Conditions of Participation for Hospitals require that criteria for selection to the medical staff include evaluation of five areas. One of these is competence. Name the 4 remaining areas. - correct answer Character, judgment, experience and training