CPMSM questions and answers 2023/2024 updated to pass

CPMSM Why it is important to check that the practitioner is not currently excluded suspended the board or in eligible to participate in federal healthcare programs - correct answer The facility won't get paid for treating patients unless service is provided by authorized provider Which of the following credentials must be tracked on an ongoing basis - correct answer Licensure According to NCQA standards and organization that discovers sanction information complaints or adverse events regarding a practitioner must take what action - correct 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 through the healthcare quality improvement act of 1986 to restrict the ability of incompetent physicians Dennis and other healthcare practitioners to move from state to state without disclosure or discovery a previous medical malpractice payment and adverse action history - correct answer The national practitioner data Bank When developing clinical privileging criteria which of the following is important to evaluate - correct answer Establish standards of practice such a specialty board recommendations What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty - correct answer To protect patient safety by ensuring current competency relevance to the facility and excepted standards of care Which of the following specialist is most likely to perform a PTCA - correct answer An interventional cardiologist The joint commission hospital standards require the clinical privileges or hospital specific and - correct answer Based on the individuals demonstrate occur in confidence and the procedures the hospital can support Which of the following would be routinely performed by a cardiologist - correct answer Transesophageal echocardiography Which NCQA required committee makes recommendations regarding credentialing decisions - correct answer Credentialing committee HFAP standards require three medical staff committees to be delineated in the medical staff structure two of them or the medical executive committee and the utilization of osteopathic methods and concepts committee required for hospitals with 10 or more DO's who admit patients and provide direct patient care what is the other required medical staff committee - correct answer Utilization review committee If you needed to find out about what the federal government requires in regards to antitrust issues what law would you consult - correct answer Sherman antitrust act Pier references should be obtained from - correct answer Practitioners who have referred patients to the provider Patrick versus Burgett is an important case because it - correct answer Illustrates the potential for anti-trust liability arising out of peer review activities If the medical staff member has privileges and or medical staff appointment revote here she must be - correct answer Reported immediately to the national practitioner data Bank Access to credentials file should be - correct answer Describe fully in an access policy Which of the following bodies approves clinical privileges - correct answer Governing body or Board What primary source verification is required by NCQA prior to provisional credentialing - correct answer Licensure and five-year malpractice history or NPDD According to joint commission standards initial appointments to the medical staff are made for a period of - correct answer Not to exceed two years