CPMSM Practice Test UPDATED ACTUAL
Exam Questions and CORRECT Answers
Medical Staff - CORRECT ANSWER - according to the Joint Commission who is
responsible for developing criteria for FPPE when issues affecting the provision of safety patient
care are identified.
5 years - CORRECT ANSWER - NCQA requires an organization to obtain a claims
history for a minimum of how many years
every 6 Months - CORRECT ANSWER - According to NCQA how frequently must a
delegate submit a report to the organization
For health plans 180 days, for CVO 120 days - CORRECT ANSWER - verification time
limit for malpractice claims history
Nurse Practitioners, Nurse Midwife, Optometrist, Physical or Occupational Therapist, in Speech
and Language Therapist - CORRECT ANSWER - During an NCQA accreditation audit
which practitioner type would be included in an audit file
every 6 months - CORRECT ANSWER - According to NCQA how frequently must an
organization show evidence of an evaluation of the history of complaints for all practitioners
Medical Staff Structure, Qualifications for medical staff appointment, Duties and Privileges for
each medical staff category, Requirements for completing and documenting histories and
physicals, Description of medical staff member eligibility to vote, Medical Staff officers
position, function, size, and composition of MEC. - CORRECT ANSWER - According to
the Joint Commission medical staff bylaws must delineate which of the following
120 day - CORRECT ANSWER - In order to remain compliant with NCQA standards a
CVO must ensure that time-sensitive information is not older than how many days when it is
released to the client
, active state license - CORRECT ANSWER - According to NCQA and initial application
must include which of the following verifications.
for health plans 180 days, for CVO 120 days. - CORRECT ANSWER - what is the
verification time limit for a state license
When a complaint is filed - CORRECT ANSWER - according to NCQA when must
specific practitioner site visit be conducted
Tracer mythology - CORRECT ANSWER - In educating medical staff leadership to the
Joint Commission survey process which of the following should be used
every three years - CORRECT ANSWER - according to URAC how often must a periodic
review of delegated functions occur
HCQIA - CORRECT ANSWER - which of the following specifically delineates the
required components of a fair hearing process
Medical School Graduation - CORRECT ANSWER - According to the Joint Commission
the AMA is considered an equivalent primary source for which of the following
monthly unless the agency is not on a consistent schedule then it must be requested every 6
months - CORRECT ANSWER - according to NCQA how frequently must ongoing
monitoring of Medicare Medicaid sanctions be conducted
licensure - CORRECT ANSWER - According to NCQAwhich of the following documents
must be verified through the direct source
Annually - CORRECT ANSWER - according to URAC how frequently must the
credentialing program Plan be reviewed.
Exam Questions and CORRECT Answers
Medical Staff - CORRECT ANSWER - according to the Joint Commission who is
responsible for developing criteria for FPPE when issues affecting the provision of safety patient
care are identified.
5 years - CORRECT ANSWER - NCQA requires an organization to obtain a claims
history for a minimum of how many years
every 6 Months - CORRECT ANSWER - According to NCQA how frequently must a
delegate submit a report to the organization
For health plans 180 days, for CVO 120 days - CORRECT ANSWER - verification time
limit for malpractice claims history
Nurse Practitioners, Nurse Midwife, Optometrist, Physical or Occupational Therapist, in Speech
and Language Therapist - CORRECT ANSWER - During an NCQA accreditation audit
which practitioner type would be included in an audit file
every 6 months - CORRECT ANSWER - According to NCQA how frequently must an
organization show evidence of an evaluation of the history of complaints for all practitioners
Medical Staff Structure, Qualifications for medical staff appointment, Duties and Privileges for
each medical staff category, Requirements for completing and documenting histories and
physicals, Description of medical staff member eligibility to vote, Medical Staff officers
position, function, size, and composition of MEC. - CORRECT ANSWER - According to
the Joint Commission medical staff bylaws must delineate which of the following
120 day - CORRECT ANSWER - In order to remain compliant with NCQA standards a
CVO must ensure that time-sensitive information is not older than how many days when it is
released to the client
, active state license - CORRECT ANSWER - According to NCQA and initial application
must include which of the following verifications.
for health plans 180 days, for CVO 120 days. - CORRECT ANSWER - what is the
verification time limit for a state license
When a complaint is filed - CORRECT ANSWER - according to NCQA when must
specific practitioner site visit be conducted
Tracer mythology - CORRECT ANSWER - In educating medical staff leadership to the
Joint Commission survey process which of the following should be used
every three years - CORRECT ANSWER - according to URAC how often must a periodic
review of delegated functions occur
HCQIA - CORRECT ANSWER - which of the following specifically delineates the
required components of a fair hearing process
Medical School Graduation - CORRECT ANSWER - According to the Joint Commission
the AMA is considered an equivalent primary source for which of the following
monthly unless the agency is not on a consistent schedule then it must be requested every 6
months - CORRECT ANSWER - according to NCQA how frequently must ongoing
monitoring of Medicare Medicaid sanctions be conducted
licensure - CORRECT ANSWER - According to NCQAwhich of the following documents
must be verified through the direct source
Annually - CORRECT ANSWER - according to URAC how frequently must the
credentialing program Plan be reviewed.
