NAMSS CPCS Participation Guide Exam Questions and Answers 100% Pass

NAMSS CPCS Participation Guide
Exam Questions and Answers 100%
Pass


Hospital Credentialing Driven by: - ✔✔- Federal/State Regulations


- CMS


- Hospital CoPs


- HCQIA


- Accreditation Standards


- TJC


- HFAP


- DNV


-Bylaws, Rules and Regs


-Standard of Care (legal aspect)


Managed Care Org Credentialing Driven by: - ✔✔-Federal/State Regulations


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, -Policies and Procedures


-Accreditation Standards (NCQA, URAC)


-Standard of Care (legal aspect)


-HEDIS/CAHPS


MCO Organization Chart - ✔✔Director of Managed Care


Contracts Management --> Client Services


Financial Management --->Network Administration


CVO Organizational Chart - ✔✔(depending on size)


Director ---> Contract sales/Credentialing Staff/Human Resources


CVO Credentialing Driven by: - ✔✔- Contract


- Accredidation Standards (NCQA, URAC,TJC,AAAHC, CMS, HFAP & DNV)


-Policies and Procedures


Ambulatory Care/Medical Office/Surgical Center Credentialing Driven by: - ✔✔-

Accreditation Standards (AAAHC, TJC, NCQA)


- CMS Regulations


- State law


- Policies and Procedures



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